Hepatobiliary Cancer
It is a group of cancers that occur in the liver, gallbladder, and bile ducts.
Types of Hepatobiliary Cancer
1Liver Cancer (Hepatocellular Carcinoma – HCC):
- Hepatocellular Carcinoma (HCC): The most common type of primary liver cancer, originating in the hepatocytes (the main liver cells).
- Cholangiocarcinoma (Bile Duct Cancer): Cancer that occurs in the bile ducts, either inside (intrahepatic) or outside (extrahepatic) the liver.
- Angiosarcoma: A rare cancer that starts in the blood vessels of the liver.
- Hepatoblastoma: A rare type of liver cancer that typically affects children.
2.Gallbladder Cancer:
- A rare cancer that forms in the gallbladder, a small organ that stores bile produced by the liver.
3.Bile Duct Cancer (Cholangiocarcinoma):
- This cancer can be classified into intrahepatic (inside the liver) and extrahepatic (outside the liver) forms, affecting the bile ducts that carry bile from the liver to the small intestine.
Risk Factors
- Chronic Liver Disease: Conditions like cirrhosis (often due to chronic hepatitis B or C infections, or alcohol abuse) significantly increase the risk of liver cancer.
- Non-Alcoholic Fatty Liver Disease (NAFLD): Associated with obesity and diabetes, NAFLD can lead to liver cancer.
- Primary Sclerosing Cholangitis (PSC): A condition that causes scarring of the bile ducts and increases the risk of bile duct cancer.
- Gallstones: Chronic inflammation caused by gallstones can raise the risk of gallbladder cancer.
- Genetic Factors: Some genetic disorders like hemochromatosis (iron overload) are linked to a higher risk of liver cancer.
- Exposure to Toxins: Aflatoxins (produced by mold on grains and nuts), vinyl chloride, and other environmental toxins have been linked to liver cancer.
- Obesity and Diabetes: Both are linked to an increased risk of hepatocellular carcinoma.
Symptoms
Symptoms of hepatobiliary cancers often do not appear until the disease is advanced. When they do occur, they may include:
- Jaundice: Yellowing of the skin and eyes due to bile duct blockage.
- Abdominal Pain: Often in the upper right side, near the liver or gallbladder.
- Unexplained Weight Loss: Significant weight loss without trying.
- Loss of Appetite: A feeling of fullness after eating small amounts.
- Nausea and Vomiting
- Fatigue: Persistent tiredness.
- Dark Urine and Pale Stools: Due to bile flow obstruction.
Diagnosis
- Imaging Tests: Ultrasound, CT scans, MRIs, and sometimes PET scans to detect tumors and assess the spread.
- Biopsy : A sample of tissue taken from the liver, bile ducts, or gallbladder for microscopic examination.
- Blood Tests: Including liver function tests and tests for tumor markers such as alpha-fetoprotein (AFP), which is often elevated in hepatocellular carcinoma.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): A procedure to visualize the bile ducts and take tissue samples.
Treatment
It depend on the type and stage of the cancer and may include:
Surgery
- Laparoscopic/Open Liver Resection: Removing part of the liver containing the tumor.
- Laparoscopic/ Open Radical Cholecystectomy: Removal of the gallbladder in cases of gallbladder cancer.
- Embolization: Injecting substances to block the blood supply to the tumor (transarterial chemoembolization or radioembolization).
- Radiation Therapy: Targeted radiation to kill cancer cells or shrink tumors.
- Chemotherapy: Systemic or localized drugs to kill or slow the growth of cancer cells.
- Targeted Therapy: Drugs that specifically target cancer cell pathways, such as sorafenib for liver cancer.
- Immunotherapy: Boosts the immune system’s ability to fight cancer.
Hepatobiliary cancers are challenging to treat, especially if diagnosed late, making early detection and preventive care crucial for improving outcomes.