Can Liver Cancer be Cured in India? - Most Valuable Details

The liver is a vital organ responsible for carrying out several body functions that keep a person alive. Liver cancer occurs due to the multiplication of cells present in the liver. Liver cancer can either be primary cancer or secondary cancer. 

Primary cancer begins in the cells of the liver and includes Hepatocellular carcinoma (61.8%), Cholangiocarcinoma or bile duct cancer, Liver angiosarcoma, and Hepatoblastoma. Some patients can even have combined Hepatocellular carcinoma and Cholangiocarcinoma (0.6 %).

On the other hand, cancer that starts in some other part of the body and eventually spreads into the liver is called secondary cancer. Among all the different types of cancers found in India, Hepatocellular carcinoma (HCC) is most commonly seen in the Indian population.

The exact causes of liver cancer are not known yet. However, a few factors can increase a person's risk of developing liver cancer. 

These factors can be modifiable or non-modifiable. 

Modifiable risk factors are those which can be controlled by following simple preventive measures. One can work on these factors and prevent their risk of developing liver cancer. 

Modifiable risk factors of liver cancer include:

1. Obesity: With a healthy lifestyle which includes eating healthily, exercising regularly, getting proper rest and managing stress, obesity can be taken care of and managed effectively. 
2. Diabetes Mellitus: Although there is no cure for type 2 diabetes, it can be put into remission with healthy lifestyle modifications.
3. Excessive consumption of alcohol: By controlling the urge to drink or getting professional treatment at a rehabilitation centre, the habit of excessive consumption of alcohol can be quit. Limiting alcohol consumption may also help decrease the risk of liver cirrhosis, another potential risk factor for liver cancer. 
4. Smoking: Quitting smoking can help in reducing the risk of not only liver cancer but also various other cancers like the cancers of the lungs, stomach, pancreas, colon and rectum. 
5. Hepatitis B virus (HBV) infection: Getting vaccinated against the Hepatitis B virus can help in preventing its contraction. 

Non-modifiable risk factors are those which cannot be changed or prevented. These include:

1. Having a family history of liver cancer: People having a family member with liver cancer are at risk of developing it too. 
2. Hepatitis C virus (HCV) infection: Since no vaccine is available for treating Hepatitis C, it can become a problem in some patients. Avoiding its contraction by following preventive measures can help.  
3. Liver cirrhosis: In liver cirrhosis, the liver becomes scarred. It cannot be reversed since the damage is caused over a long period. 
4. Non-alcoholic fatty liver disease (NAFLD): Proper medicines for treating non-alcoholic fatty liver disease (NAFLD) are unavailable. Hence, it cannot be reversed if it has progressed to liver cirrhosis. If caught in its early stages, it may be reversed with lifestyle changes in some patients.  

Note: People with non-modifiable risk factors are predisposed to developing liver cancer. In such cases, regular screening is crucial. It plays a vital role in the early detection of liver cancer. Hence, patients under this category are advised to undergo routine screening to prevent developing advanced stages of liver cancer.

Whether or not liver cancer is curable largely depends on the time of diagnosis. If diagnosed well before the cancer has not reached an advanced stage, liver cancer can be curable. 

The stages and time of diagnosis are of utmost importance before predicting the prognosis of liver cancer. The stages of liver cancer are an indication of its spread and based on the diagnostic test results, cancer in the liver is staged. 

There are four stages of liver cancer which include:

1. Stage 1 or very early stage
2. Stage 2 or early stage
3. Stage 3 or intermediate stage
4. Stage 4 or advanced stage

In India, most patients with liver cancer are diagnosed when their cancer is already in its advanced stage, i.e., it has spread to other body parts. Hence, it is not easily cured.

1. Liver cancer is curable in India when diagnosed in its early stages. 
2. Once diagnosed with liver cancer, the patient's healthcare provider will formulate a treatment plan. This treatment plan will depend upon the cancer stage, symptoms, age, and overall health of the patient. 
3. A liver transplant is an ideal treatment for patients with liver cancer. However, getting a liver transplant donor is very difficult. At times, most patients with liver cancer are not deemed fit for such a complex procedure as a liver transplant. 
4. But if all conditions are favourable, patients with liver cancer can be cured unless the patient has reached an advanced stage, i.e., the 4th stage. 4th stage liver cancer is not curable since cancer has already spread to the other body parts.

Treatment for Stage 1 or Very Early Stage Liver Cancer  

1. In stage 1 of liver cancer, the tumour is small and can be easily removed without significant risks and complications. Hence, surgery is the primary treatment for stage 1 cancer when the tumour is easily resectable (removable).
2. Early-stage liver cancer can be cured by surgically removing the tumour through a partial hepatectomy (removal of the liver) or by performing a liver transplant. In India, a liver transplant provides a good prognosis if a patient is diagnosed with liver cancer in its early stages.
3. Other treatment approaches can also be used to cure liver cancer, such as ablation therapy, which removes tumours of size 3 cm or less, and chemoembolisation.
4. In chemoembolisation, the blood supply to the tumour in the liver is cut off, causing it to die and shrink gradually. It is a good treatment option for liver cancer patients who cannot undergo surgery. 

Treatment for Stage 2 or Early-Stage Liver Cancer

1. Here, the tumour is more significant than 2 cm but not more than five cm and has spread into surrounding liver tissue. However, it has not spread to the lymph nodes or other body parts.
2. Liver cancer is curable in stage 2 as the tumour has not spread to other body parts. It can be cured entirely if liver transplantation is done. If the surgical removal of the tumour is possible, liver cancer is also curable.

If surgery and ever transplantation is not possible other treatment options that can help treat early-stage liver cancer include:

1. Radiation Therapy: Radiations are used to destroy the rapidly dividing tumour cells
2. Chemotherapy: Drugs are given that target and kill the tumour cells
3. Immunotherapy: Drugs target immune cells and make them attack the growing tumour cells

The treatments mentioned above are given to the patients:

1. If the tumour is huge and cannot be removed surgically, 
2. If cancer has spread entirely in the liver
3. If the liver cannot be treated through a surgery 
4. To shrink large tumours before surgery 

However, using these treatment options, it is hard to comment on if liver cancer can be cured as the results of these treatments are not that fruitful. It is best to consult a doctor regarding the prognosis of liver cancer at this stage.

Stage 3 or Intermediate Stage Liver Cancer Treatment 

1. As the stage advances, the prognosis becomes poorer. In stage 3 of liver cancer, at least one of the tumours is 5 cm in size or more but has not spread to the lymph nodes are other areas of the body. 
2. Stage 3 liver cancer can be cured in some cases, but remission is quite common. 
3. In these patients, along with ablation, chemoembolisation may be used for treating liver cancer. Surgery can also be tried for the operable tumour. 
4. In addition to the above treatment options, anti-cancer immunotherapy medications are usually prescribed to treat stage 3 liver cancer. They work by making the immune cells target the cancer cells.
5. Additionally, ablation therapy options like Radiofrequency ablation (RFA) and Microwave ablation (MWA) can also treat liver cancer if the tumour is more significant than 5 cm. 

Stage 4 or Advanced Stage

1. Stage 4 of liver cancer is when the cancer is in its most advanced form. This is the stage when cancer has spread to the lymph nodes and other vital organs. 
2. Unfortunately, the 4th stage of liver cancer is not curable. The treatment aims at providing symptomatic relief and improving the patient’s quality of life
3. Immunotherapy can be tried to prevent the progression of the tumour, but it cannot cure 4th-stage liver cancer.
4. Liver cancer can be cured when diagnosed in its early stages (stage 1 and stage 2), where the tumour size is less than 5cms. However, as cancer reaches its advanced stages, the cure for liver cancer may not be possible. In advanced stages of liver cancer, the treatment is focused more on providing symptomatic relief and improved quality of life to the patient. 

Most people in India are at risk of developing liver cancer. This is because of a sedentary lifestyle, smoking, exposure to secondhand smoke, etc. Measures for the prevention of liver cancer include the following, 

1. Getting vaccinated for Hepatitis B and avoiding the contraction of the Hepatitis C virus, as infections by HBV and HCV are among the most common risk factors responsible for increasing the risk of liver cancer in India. 
2. Avoiding excessive consumption of alcohol.
3. Avoid contracting hepatitis C by following safe sexual practices and ensuring that the needles used for making tattoos or piercings are well sterilised.
4. Avoid exposure to harmful cancer-causing chemicals.
5. Quitting the habit of smoking.
6. Adopting a healthy lifestyle, like eating healthily and exercising regularly.
7. To encourage people to maintain utmost cleanliness by educating people about the importance of waste management and appropriate sanitation to avoid contracting Hepatitis B infection due to faeces orally. 
8. Raising awareness and educating the public about the various risk factors of liver cancer and the critical signs and symptoms to watch out for.
9. Encouraging the public to undergo regular screening and diagnosis of liver cancer to ensure its early detection and treatment.

Curing liver cancer in its advanced stage is challenging, and the prognosis is poor. Timely diagnosis of liver cancer helps determine the stage of cancer, the extent of its spread, and if the diagnosed liver cancer is curable. 

Most liver cancer patients in India are diagnosed when their liver cancer has reached its advanced stage. Hence, treating them becomes very challenging. Liver cancer can be cured when diagnosed in its early stages. Hence, it is essential to acknowledge the symptoms of liver cancer at its early stages and get its treatment accordingly.

We at HexaHealth aim to provide the best to all our patients. Our qualified team of doctors guides our patients at every step, from diagnosis to treatment. At HexaHealth, we ensure to offer the best facilities to every patient who trusts us, as catering to our patient's needs is our top priority.