Liver cancer is a medical condition where cancerous cells form in the liver’s tissues. Should the cancer originate in the liver, it is known as primary liver cancer. Cancer that originates in other parts of the body and then spreads to the liver is referred to as secondary cancer.
The liver is among the largest organs present in the human body and comprises two lobes or sections. It is physically present towards the upper right side of the abdomen within the rib cage. The liver’s primary functions are the following:
- Helps break down and store the many nutrients absorbed from the intestine that are vital to maintaining the body’s ability to function. The liver converts these nutrients into energy and is used to build or repair the body’s tissues.
- It aids in clotting the blood after superficial cuts or injuries and prevents blood loss.
- Makes and delivers bile to the intestines to help digest and absorb any fats found in food.
- Breaks down and filters toxic waste in the blood, which then is ejected from the body as urine or stool.
The most common form of liver cancer is primary and originates in the liver itself. Approximately 80 percent of primary liver cancer cases globally are due to infections caused either by the hepatitis B or hepatitis C virus. These viruses can cause cirrhosis or scarring of the liver.
People contract hepatitis usually through:
- Unsafe or unprotected sex.
- By sharing unsterilized needles.
- Through blood transfusions, though, the likelihood of contracting hepatitis this way has fallen as all donated blood is now screened.
The main categories of liver cancer are:
Hepatocellular Carcinoma (HCC): Hepatocellular carcinoma is the most commonly occurring variety of primary liver cancer in adults. This form of cancer tends to affect people predominantly dealing with chronic liver conditions such as cirrhosis.
Fibrolamellar hepatocellular carcinoma, or FHCC, is a rare cancer of the liver that usually grows in teens and adults under 40 years old. This type of cancer differs from other types of liver cancer because it can even occur in people with healthy livers.
Cholangiocarcinoma (Bile Duct Cancer): Cholangiocarcinoma is a type of cancer that begins in the bile ducts, which are slender tubes that carry the digestive fluid bile. Bile makes its way from the liver to the gallbladder, where it is stored and then released into the small intestine for digesting any food consumed.
Angiosarcoma: Angiosarcoma of the liver is a rare form of cancer and can be fairly aggressive. It develops in the cells that are a part of the body’s immune system. Generally, it is complicated to pinpoint the cause of angiosarcoma of the liver, but it is a known fact that long-term exposure to industrial chemicals can increase the risk of angiosarcoma. Most angiosarcoma cases are common among older males in their 60s and 70s. Less than 2% of liver cancers are classified as angiosarcomas.
Metastatic Liver Cancer: Liver metastases are cancerous tumours that are secondary cancers that have spread or metastasised to the liver from elsewhere in the body. These tumours may appear shortly or even months after the initial growth develops.
The most common types of secondary cancers of the liver are:
- Colorectal cancers: When malignant cells form in the tissues of the colon and rectum, the condition is known as colorectal cancer. The colon, also known as the large intestine, comprises four parts and handles the final stages of the digestion process. Colorectal cancer occurs in either the large intestine or the rectum.
The colon, which is also known as the large intestine, is made up of four parts:
○ Ascending colon
○ Descending colon
○ Sigmoid colon
○ Transverse colon
- Gastrointestinal cancers: Cancer of the stomach or gastric cancer is the fourth most commonly occurring cancer worldwide—this type of cancer forms in the tissues lining the stomach. The stomach forms a part of the gastrointestinal system and is responsible for breaking down and digesting food.
When the cells lining the stomach grow rapidly, they form a tumour and, like other cancers, can spread to other organs via the lymph nodes.
Other forms of stomach cancer can occur, but they are relatively rare, and these include:
○ Gastrointestinal stromal tumour — soft-tissue cancer or sarcoma.
○ Gastrointestinal carcinoid tumours.
○ Lymphomas.
- Skin Cancers: Skin cancer manifests itself with the growth of abnormal cells in the skin’s tissues. As skin cells age and die, new cells grow in their place. At times there may appear a flaw in the process due to various reasons, and the cells may grow rapidly, ending up as either benign or malignant. If they are benign, they can be treated easily. However, if they are cancerous, the treatment procedure may not be as straightforward.
There are two kinds of skin cancer:
Melanoma: Melanoma is the more severe type of skin cancer and develops in the cells called melanocytes. These are the cells that produce melanin, the pigment that gives your skin its colour. Exposure to an abundance of sunlight or excess usage of tanning lamps and beds may escalate the risk of developing melanoma.
Melanomas usually form in areas exposed to the sun, such as:
○ Back
○ Legs
○ Face
○ Arms
Hidden melanomas usually develop in places not exposed to the sun and are less common.
Non-melanoma: Non-melanoma skin cancer refers to a cluster of cancers that grow slowly in the skin’s upper layers. The term non-melanoma helps differentiate these more common types of skin cancer from the more uncommon skin cancer known as melanoma.
A biopsy is an ideal option to test for the presence of any non-melanoma skin as this form of skin cancer is usually benign and hence is mainly localised.
The frequently encountered types of non-melanoma skin cancers are:
○ Basal cell carcinomas
○ Squamous cell carcinomas
○ Merkel cell carcinoma
Stages of liver cancer
As with most cancers, early diagnosis and prompt medical intervention will result in a better prognosis.
To help understand which stage the cancer is at, the oncologist will evaluate the following:
- Liver function
- Overall health
- The intensity of the symptoms
- The extent of the cancer spread.
The oncologist will also scrutinise the results of imaging tests to ascertain the progress of cancer and what steps can be taken to combat the condition.
Typical symptoms of liver cancer:
These are some of the more typical symptoms caused by the onset of primary liver cancer in adults. If you notice any of these, check in with your doctor as early as possible.
- A hard lump towards the right, below the rib cage.
- Any soreness in the upper abdominal region, particularly towards the right.
- Unexplained swelling in the abdomen.
- Pain close the right shoulder blade or the back.
- Jaundice – a condition where the skin and the whites of the eyes take on a yellowish shade.
- Bruising or bleeding occurs easily.
- Any tiredness or weakness that is out of the ordinary.
- Nausea often accompanies vomiting.
- Loss of or any reduction in appetite.
- Unexplained weight loss.
- Pale, chalky stools and dark urine
- Fever
Common factors and conditions increasing the risk of liver cancer:
- If the individual falls prey to either hepatitis B or hepatitis C.
- Excessive cigarette smoking and alcohol consumption.
- Cirrhosis or scarring of the liver is often worsened by untreated hepatitis and alcohol consumption.
- If the individual has diabetes.
- If the individual has hemochromatosis, a condition where the body absorbs and stores more iron than required.
- The presence of nonalcoholic fatty liver disease (NAFLD) causes a type of fat called triglycerides to accumulate in the liver. NAFLD can potentially cause cirrhosis or scarring of the liver and, in some cases, liver failure. NAFLD is usually noticed in obese individuals or those with Type 2 diabetes, excess body fat around the waist, or abnormal cholesterol levels.
- Excess intake of male hormones or steroids used for fostering muscle growth is also considered as risk factor.
Liver Cancer Treatment in India
Once the liver cancer has been diagnosed, the oncologist moves to determine the stage of the tumour. Various tests will have to be carried out that determine the size, location, and the cancer’s reach. Imaging tests such as CT, MRI, and bone scans help to grade the tumour.
The next step is the treatment phase. There are quite a few options for liver cancer treatment in India, depending on the cancer’s state and progression.
Surgery
The preferred treatment options for liver cancers are surgical resection (removal of the tumour via surgery) or a liver transplant. You will have the best prognosis if all of the cancerous growth in the liver is entirely removed. Tumours of small size can be treated with options such as radiation therapy.
Partial hepatectomy: Partial hepatectomy is a surgical procedure that takes out only part of the liver. Individuals with good liver function and a single tumour that has not spread into the blood vessels can undergo this form of surgery.
Before conducting the operation, imaging tests such as CT or MRI scans along with angiography are done to understand if the cancer can be removed altogether. If, during surgery, it is noticed that the tumour has grown too large or spread too far, then the patient is no longer an ideal candidate for the operative procedure.
Individuals with cirrhosis are eligible for surgery only if the liver can continue functioning to a reasonable extent once the tumour is removed. Doctors assess the liver’s functionality by assigning a Child-Pugh score which measures the level of cirrhosis based on specific lab tests and symptoms.
Possible side effects of partial hepatectomy:
- Bleeding after the surgery.
- Infections.
- Complications that arise from the anaesthetic.
- Blood clots.
- Pneumonia.
- Chances of the cancer recurring.
Liver transplant: When feasible, liver transplants offer the best chance of recovery from liver cancer and are the best option where tumours cannot be operated on. This may be because of the tumour’s location or because it has affected a significant part of the liver.
Transplants are ideal for treating patients if they have small tumours – either a single tumour less than 5 cm across or 2 to 3 tumours no larger than 3 cm across. The tumours should also not have reached nearby blood vessels. With a successful transplant, the risk of recurring cancer is vastly reduced, and the liver is likely to function normally.
While the patient awaits a liver transplant, the doctors would go ahead with conventional treatments such as chemotherapy or radiation to keep the cancer at bay or under control.
Possible side effects of liver transplants:
- Your body may reject the new liver.
- Internal bleeding or haemorrhage.
- The new liver may cease working within the first few hours, requiring another liver transplant procedure.
- Likelihood of picking up infections.
Ablation:
Ablation is a treatment best suited for patients with only a few small tumours and in cases when surgery is not recommended, such as due to ill health or reduced liver function. Ablation works best if the tumour size is within 3 cm across. If the tumour’s dimensions are a little larger, between 3-5 cm across, ablation may be used in combination with embolisation.
As ablation also targets the healthy tissue around the tumour, it is best avoided if the growth is present near major blood vessels, the diaphragm, or major bile ducts. Ablation therapy involves the transmission of heat via a needle-shaped probe placed into a liver tumour. The doctor takes the help of an ultrasound or a CT scan to guide the probe into the tumour.
Possible side effects of ablation therapy:
- Abdominal pain.
- Possible infection of the liver.
- Possible onset of fever.
- Abnormal results of liver tests.
Radiation Therapy:
Radiation therapy makes use of high-energy rays to eradicate cancer cells. This treatment option may not work for individuals whose liver is in an advanced state of cirrhosis or hepatitis.
Undergoing radiation therapy is much like having an X-ray taken, only much more potent. The procedure is painless, and the treatment session itself lasts for a short duration. Radiation therapy is often carried out every day of the week and lasts for several weeks.
Updated forms of radiation therapy, such as stereotactic body radiation therapy (SBRT), target only the tumour in the liver while sparing the healthy tissues nearby the effect of the radiation. Not only is this a more effective form of liver cancer treatment, but it also reduces potential side effects.
Possible side effects of radiation therapy:
- Blistering and peeling of the skin.
- Nausea and vomiting
- Fatigue
- Diarrhoea
- Appetite loss.
Chemotherapy:
Taking steps to eliminate cancer cells with the aid of specialised drugs is known as chemotherapy. Chemotherapy works best when a combination of drugs is administered to the individual rather than relying on a single drug. The medication can be administered intravenously or orally. Drugs used in chemotherapy reach most parts of the body, making it useful to target cancers that are no longer localised.
Chemotherapy treatment is usually done in cycles, allowing the body to recover from the effects of the drugs. The cycle can be as long as 2 to 3 weeks long, and the schedule depends on the medications used.
Possible side effects of chemotherapy:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Diarrhoea
- Increased infections as a result of low white blood cell count.
- Bruising or bleeding as a result of low blood platelet count.
- Fatigue as a result of low red blood cell count.
Liver Cancer Treatment Cost in India
The cost of medical treatment for all specialities, including liver cancer, is an affordable proposition compared to other countries. Along with cost-effective treatment, medical facilities in India are home to world-class amenities and infrastructure. Medical tourists will be spoilt for choice with the many available top liver cancer treatment hospitals in India.
Additionally, even the oncologists have the backing of years of experience and education from the best educational institutions within the country and overseas.
The cost of liver cancer treatment depends on the cancer stage and the treatment method the oncologist chooses. The patient’s overall health also plays a significant role in the cost incurred. Liver cancer treatment cost in India ranges from INR 1,50,000 (USD 1800) to INR 4,00,000 (USD 5000).
Top 10 best Liver Cancer Treatment Hospitals in India
India is home to several prestigious and some of the best hospitals for liver cancer treatment in India, specialising in diagnosing and treating liver cancer. These hospitals offer comprehensive care to patients with liver cancer by providing state-of-the-art facilities, cutting-edge technologies, and a multidisciplinary approach.
The patients also benefit from the medical teams of well-qualified oncologists, surgeons, radiologists, and other healthcare professionals committed to providing personalised and the most effective treatment possible. These hospitals also strive to deliver the best possible outcomes for patients with liver cancer by focusing on advanced medical research and innovation.
Here is a list and overview of some of the top hospitals for liver cancer treatment in India that stand out for their dedication and expertise towards the patient’s welfare:
Fortis Hospital, Mulund West, Mumbai:
Fortis Hospitals in Mumbai provides comprehensive care for patients across all stages of liver cancer. Fortis is the best liver cancer hospitalin India. The hospital being a premier medical centre, houses some of the most qualified doctors with profound knowledge in the detection and treatment of liver cancer. Fortis Hospitals offers world-class facilities paired with cutting-edge technology, including high-end diagnostic and therapeutic endoscopic procedures, interventional radiological procedures, and surgical interventions such as laparoscopic and robot-assisted liver surgeries and liver transplantation.
Kokilaben Dhirubhai Ambani Hospital, Andheri West, Mumbai:
The Department of Oncology is integral to Kokilaben Dhirubhai Ambani Hospital’s comprehensive cancer care and research, providing a collaborative, multi-disciplinary approach to cancer care.
The surgeons at this medical facility are adept at utilising some of the most advanced technology available for treating cancers. Many of the surgical procedures on offer are minimally invasive. These include robotic-assisted surgery, laparoscopic surgery, and video-assisted thoracic surgery (VATS). Using minimally invasive techniques means less pain, fewer complications, rapid healing, and quicker discharge from the hospital.
Medanta Hospital, Sector-38, Gurugram:
The Medanta Institute of Liver Transplantation and Regenerative Medicine is a specialised facility providing liver transplantation along with treatment for various liver illnesses, including cancer, for both adults and children. Their Living Donor Liver Transplant program has at its helm a group of highly trained and experienced physicians who have been involved with the operation since its inception. Medanta is also the best live cancer hospital in India.
The program has to its credit a high success rate with minimal post-surgery complications.
BLK Super Speciality Hospital, Radha Soami Satsang, New Delhi:
The BLK-Max Institute for Digestive and Liver ailments provides patient-centric and comprehensive care to individuals suffering from gastrointestinal, liver, and biliary disorders, all under one roof. It has many highly qualified and experienced personnel in the field of oncology over many decades.
Indraprastha Apollo Hospitals, Delhi-Mathura Road, New Delhi:
The Apollo Cancer Centre at Indraprastha Apollo Hospitals is a multidisciplinary facility combining cutting-edge technology with the medical fraternity’s most advanced and highly qualified healthcare professionals. Along with the benefit of being a stand-alone cancer unit, the Apollo Cancer Centre also has the added support of various other super specialities.
Gleneagles Global Health City, Perumbakkam, Chennai:
Gleneagles Global Health City’s multi-disciplinary clinical team views liver care holistically. As the liver is an intricate organ, its treatment requires the collaboration of various professionals to give the most suitable outcome for the patient.
Gleneagles Global Health City is one of Asia’s premier hospitals for treating liver illnesses. It is internationally recognised as one of the world’s most comprehensive multi-disciplinary disease-management centers.
Apollo Cancer Centre, Teynampet, Chennai:
Apollo Cancer Centre, India’s first ISO-certified healthcare provider, is among the best super speciality hospitals in the country, providing advanced care in Oncology, Orthopaedics, Neurology & Neurosurgery, Head and Neck surgery, and Reconstructive and Plastic surgery.
With a large pool of world-renowned specialists and a dedicated team of medical and paramedical professionals, Apollo Cancer Centre provides excellent healthcare of international standards, with outcomes comparable to those of the world’s best hospitals.
Fortis Hospital, Cunningham Road, Bengaluru:
Liver transplants at Fortis Hospital are carried out by the capable hands of the country’s most experienced and highly qualified team of experts who can claim extensive experience in patient care. The multi-disciplinary team comprises well-trained technical and nursing staff.
The surgeons have access to innovative and advanced technologies to treat patients successfully with disorders such as liver failure or other complex issues associated with the liver that require a transplant. The team is committed to providing a holistic approach to patient care while achieving excellent results and maintaining patient comfort.
Manipal Hospital, Whitefield, Bengaluru:
The liver transplant program at Manipal Hospitals is the most comprehensive of its kind in the country. Manipal is a leading and best liver cancer hospital in India. The transplant program is staffed by a team of well-qualified medical professionals who are fully capable of caring for the patient’s needs during the transplant process. Manipal Hospitals strives to provide tailor-made care that caters to each patient’s individual needs.
Gleneagles Global Hospitals, Richmond Road, Bengaluru:
When undergoing cancer treatment at Gleneagles Global Hospitals, the patient can avail of either surgery, radiation therapy, and chemotherapy depending upon the doctor’s advice. Having multiple options enhances the chances of a full recovery and lowers the risk of recurrence of the cancer. It is one of the best liver cancer hospitals in India.
The surgeons at Gleneagles have a program in place specifically to aid you in the journey right from undergoing the relevant procedure to recovery after the life-saving surgery. All the while, the professionals maintain the highest treatment standards required when people’s lives depend on it.
