Know about medicine with Pharmacy Chulalongkorn University : Liver cancer is the number one cause of death in Thailand.

    Liver cancer, the leading cause of death in Thailand, requires prompt treatment for better chances of survival. While cancer can be detected and treated, early detection is crucial. Therefore, it is advisable to undergo regular physical examinations and monitor the body for any symptoms, ensuring a proactive approach to cancer prevention.

    According to 2021 statistics, liver cancer claims the lives of over 26,000 Thai individuals annually, accounting for 96.3% of cancer-related deaths. This high mortality rate emphasizes the severity of the issue.

    The primary risk factors for liver cancer are a history of hepatitis B or C infection and cirrhosis, which can be caused by alcohol consumption or other non-alcoholic factors such as fatty liver. Aflatoxin, a toxin produced by fungi commonly found in contaminated dry foods like cereals and nuts, is also strongly linked to liver cancer.

    The similarity between morbidity and mortality rates for liver cancer suggests that treatment outcomes are not as favorable as for other cancers. Late diagnosis is a contributing factor, often resulting in the cancer spreading beyond the liver and becoming inoperable. Additionally, the available medications for liver cancer are limited and not highly effective. The lack of specific symptoms for liver cancer further delays seeking medical help.

    Early-stage liver cancer typically presents no symptoms, making it difficult to detect until it reaches an advanced stage. Symptoms may include gastric-like discomfort, stomach burning, indigestion, distension, rib cage pain on the right side, anorexia, fatigue, weight loss, yellowing of the skin and eyes (jaundice), and ascites. By the time liver cancer is diagnosed, it becomes challenging to cure.

    As with other cancers, early detection significantly improves treatment efficacy. However, screening recommendations for liver cancer may differ from those for other types. For instance, while colon cancer screening usually begins at age 50, liver cancer screening is generally reserved for high-risk individuals due to economic considerations.

    High-risk individuals who should undergo liver cancer screening include those with any cause of cirrhosis, those diagnosed with hepatitis C and significant liver fibrosis, and individuals with a history of hepatitis B infection, particularly if they have a first-degree relative with liver cancer. Screening involves ultrasound examination of the upper abdomen and blood tests to measure Alpha Fetoprotein (AFP) levels. The frequency of screening varies based on individual risk factors, ranging from every year to every six months.

    The positive news is that localized liver cancer can be treated effectively if detected early. Treatment methods include needle procedures and direct delivery of chemotherapy drugs to the tumor through an artery catheter. Furthermore, for metastatic liver cancer, various new treatments like targeted drugs and immunotherapy are available, offering improved outcomes and prolonged survival with a better quality of life.

    Regardless of the stage of the disease, timely detection plays a crucial role in treatment outcomes. Therefore, immediate action should be taken upon diagnosis, especially while the liver is still functioning well.

    To reduce the risk of liver cancer, it is essential to limit alcohol consumption to avoid overworking the liver and potentially developing cirrhosis. Additionally, one should avoid consuming old food grains, nuts, and chili powder that may be contaminated with aflatoxin—a known carcinogen. Regular health check-ups are also advisable, allowing for timely identification of liver abnormalities and further diagnostic tests if needed.

Assoc. Prof. Dr. Nattada Areepiam and Asst. Prof. Dr. Bodin Tiwasuwan

Faculty of Pharmacy Chulalongkorn University