October 2019 is Liver Cancer Awareness Month. The American Liver Foundation wants to “encourage people who are at risk of liver cancer to follow up with their doctors and get proper ongoing screening for this, one of the deadliest forms of cancer.” Primary liver cancer, which originates in the liver, has tripled in frequency since 1980, and the awareness campaign is focusing on early detection. Seniors and caregivers in San Diego may not realize that the early stages of liver cancer are subtle and easy to miss. Older patients and home care companions for seniors, especially those exposed to hepatitis in their youth, need to know the risk factors, signs and symptoms of liver cancer.
Your liver is the football-sized organ on the upper right side of your abdomen, above the stomach and below the diaphragm. All your blood passes through the liver on its way around the body, where the liver continuously filters it for waste, toxins, drugs and anything else excretable. Unfortunately, this means that any cancer cells in the bloodstream pass through the liver too. Most liver cancer is actually secondary or metastatic, meaning it started elsewhere in the body and traveled to the liver.
Primary liver cancer, most commonly hepatocellular carcinoma, accounts for about two percent of all cancer in the U.S., but is the fifth and seventh leading cause of death for men and women, respectively. Liver cancer will strike about 42,000 people this year alone, men at twice the rate of women, Asian Americans and Pacific Islanders most commonly, and people over 60 most often. The other forms of primary liver cancer – intrahepatic cholangiocarcinoma and hepatoblastoma – are much less common. The elderly in home care who are unaware of these risk factors can miss the warning signs of liver cancer.
Livers damaged by chronic infection, cirrhosis, and other stresses are more likely to develop hepatocellular carcinoma. Currently, “Hepatitis B and C are the most common causes of hepatocellular carcinoma.” According to the CDC, “people born from 1945–1965, sometimes referred to as baby boomers, are 5 times more likely to have hepatitis C than other adults.” And both hepatitis and liver cancer are difficult to detect in the early stages. [We discussed the types of hepatitis on the Casa Companion Homecare Solutions blog in July 2017, World Hepatitis Day.] While Hep C is one of the risk factors for primary liver cancer, it’s not the only one. Per the Mayo Clinic, other risk factors include: cirrhosis, inherited liver diseases like hemochromatosis and Wilson’s disease, diabetes, nonalcoholic fatty liver disease, excessive alcohol consumption, and exposure to aflatoxins (produced by moldy crops.) Other research suggests that certain chemicals and herbicides, the hormones androgen and estrogen, and smoking all put the liver at risk of cancer.
Though liver cancer affects men and women over 60 more often than any other age group, primary liver cancer is difficult to detect in its early stages. The main reason is that the symptoms are similar to those of other conditions, or simply getting older. Risk factors like diabetes, excessive alcohol consumption and even smoking complicate diagnosis for seniors. Cancer.org says symptoms of liver cancer include:
- “Weight loss (without trying)
- Loss of appetite
- Feeling very full after a small meal
- Nausea or vomiting
- An enlarged liver, felt as fullness under the ribs on the right side
- An enlarged spleen, felt as fullness under the ribs on the left side
- Pain in the abdomen (belly) or near the right shoulder blade
- Swelling or fluid build-up in the abdomen (belly)
- Yellowing of the skin and eyes (jaundice)”
- And enlarged veins on the belly that can be seen through the skin
Further complicating things, experiencing one or more of these symptoms doesn’t necessarily indicate liver cancer. Small liver tumors don’t usually reveal themselves during a physical exam, and there are no generally used screening tests for people with no obvious risk factors in their history. Blood tests and ultrasounds every six months are recommended for patients who are at risk, though.
Currently, treatment for liver cancer targets the tumors with Radiofrequency ablation (RFA) and microwave therapy, Percutaneous ethanol injection, Radiation therapy, chemotherapy, targeted drug therapy, surgery, and even liver transplant. All these treatments can affect the senior body more strongly, and patients might need in home care in San Diego to manage the medications, implications of surgery and physical repercussions of an impaired liver. Cancer.net suggests any or all of the following home care solutions: a home health aide, a visiting nurse, physical therapy, a social worker and even support groups.
The liver is the body’s largest gland and the largest internal organ, performing functions we can’t live without. Companion caregivers and seniors need to know the warning signs of liver cancer, for as with every kind of cancer, the earlier it is detected, the better.