What Is Liver Cancer?
Cancer is an uncontrolled and abnormal growth of cells in the body. When the liver cells start growing aggressively, they result in liver cancer. Approximately twenty-five thousand men and eleven thousand women are diagnosed with liver cancer each year in the United States. The disease claims the lives of 19,000 men and 9,000 women annually. In the early stages, liver cancer is often asymptomatic. However, as cancer grows, individuals with cancer can present with the following symptoms:
-
Pain and discomfort in the upper right side of the abdomen.
-
Swelling in the abdomen.
-
A palpable hard lump in the abdomen (upper right side).
-
Back pain.
-
Jaundice (increased levels of bilirubin that causes yellowish discoloration of the skin).
-
Easy bruising and bleeding.
-
Tiredness and fatigue.
-
Loss of appetite.
-
Weight loss.
-
Nausea and vomiting.
When liver cells undergo DNA (deoxyribonucleic acid) changes (mutations), they result in liver cancer. Moreover, several risk factors make a person more susceptible to liver cancer; these include chronic hepatitis B and C infection, being obese, liver cirrhosis (scarring of liver cells), diabetes (a metabolic condition that causes elevated blood sugar levels), fatty liver, excessive alcohol consumption, exposure to aflatoxins (hazardous carcinogens created by a few molds), etc.
What Is a FibroScan?
FibroScan is an ultrasound-based noninvasive diagnostic tool used to gauge the degree of fibrosis, liver damage, and liver scarring caused by various liver diseases. FibroScan scanning, which is rapid, painless, and simple like a standard ultrasound examination, offers a non-surgical substitute for the standard liver biopsy to evaluate liver damage. Similar to ultrasounds, FibroScan also uses sound waves to visualize the liver. A FibroScan is technically known as transient elastography.
What Are the Stages of Fibrosis?
The development of an excessive amount of scar tissue, or fibrosis, in the liver is known as liver fibrosis. It typically occurs when the liver repeatedly tries to replace and repair damaged cells. As a result, the liver cells are replaced with scar tissue, which has no function whatsoever. Scar tissue has the potential to alter the internal anatomy of the liver and impair blood flow to and within the organ, hence reducing the blood supply to the liver cells. These cells die when there is not enough blood, which leads to the formation of more scar tissue. Additionally, the blood pressure in the portal vein, which delivers to the liver, rises. Following are the various stages of fibrosis:
-
F0: No fibrosis.
-
F1: Mild fibrosis that involves portal fibrosis without septa.
-
F2: Moderate fibrosis that involves portal fibrosis with few septa.
-
F3: Several septa, but there is no liver cirrhosis.
-
F4: Severe fibrosis or cirrhosis.
What Are the Uses of a FibroScan?
A FibroScan is used to diagnose several liver diseases. If the patient has one of the following chronic liver disorders, the doctor may advise a FibroScan test:
-
Hepatitis C infection.
-
Hepatitis B infection.
-
Alcoholic liver diseases.
-
Non-alcoholic steatohepatitis (a condition where there is a fat buildup in the liver).
-
Autoimmune hepatitis.
-
Liver cirrhosis.
-
Genetic disorders like hemochromatosis (a condition with excess iron in the blood) and Wilson’s disease (an inherited disease that leads to excess copper accumulation in the body).
-
Post-transplant liver health examination.
-
Liver cancer.
In general, FibroScan examines the liver for fibrosis as well as more severe scarring or cirrhosis. This technique can be used to find any problem, including liver cancer, that might have an impact on the health of the liver.
How Is a FibroScan Done?
A FibroScan is carried out similarly to a typical ultrasound examination. Before the test, the patient must fast for three hours as part of preparation. This means that for several hours prior to the test, the patient may only ingest clear liquids like water. The following procedures happen before, during, and after a FibroScan:
-
Before the Test: Before the procedure, the patient is generally asked to change into loose clothes to facilitate easy movements during the test. The probe is focused around the right upper abdomen region (where the liver is present). The patient is also asked to rest and relax for a few minutes before the test for more accurate readings.
-
During the Test: The scanning of the liver is typically done in 5 to 10 minutes. The patient will lie on their back with their right arm raised above their head during the procedure. Before placing the probe on the upper right abdomen, above the liver, the healthcare professional will apply gel to the probe and the skin. As the probe takes pictures and measurements of the liver, it might give off vibrations.
-
After the Test: A recovery period is unnecessary after a FibroScan because it is a noninvasive diagnostic procedure. The patient is immediately discharged after the test, and they can return to work or school right after. The reports are given within a few hours or days, depending on the laboratory.
Can FibroScan Detect Liver Cancer?
A FibroScan may be a good diagnostic modality for detecting liver cancer. However, the main application of this technique is not in the detection of cancer. Instead, the scan measures how stiff the liver tissue is and monitors changes in stiffness over time. Fibrosis is associated with the most common type of liver cancer - hepatocellular carcinoma.
One study centered on cancer detection in cirrhotic hepatitis C patients. This study found that those who went under a FibroScan and had a liver hardness of more than 24 kPa were prone to be given a cancer diagnosis. The scientists came to the conclusion that FibroScan might be a helpful tool for identifying hepatocellular carcinoma.
Another study found that patients with FibroScan readings above 20 kPa were at an increased risk of developing hepatocellular carcinoma within three years. The greatest risk group had values between 30 and 40 kPa, further demonstrating that the degree of liver stiffness (as determined by FibroScan) may be directly correlated with the chance of developing liver cancer.
What Are the Other Tests to Diagnose Liver Cancer?
Other tests that can diagnose liver cancer are:
-
Imaging Tests: Imaging tests like CT (computed tomography) scans, MRI (magnetic resonance imaging), and conventional ultrasounds are useful in diagnosing liver diseases. An abnormality in the liver, such as a mass or fibrosis, can be found by imaging studies.
-
Other Laboratory Tests: The tumor marker test for alpha-fetoprotein (AFP) checks for AFP in the blood. Increased amounts could indicate cancer. In addition, the alanine aminotransferase (ALT) enzyme is measured during a liver function test. When a person has liver cancer, this enzyme's level in the blood is typically high.
-
Biopsy: During a liver biopsy, a sample of the liver's tissue is taken and examined under a microscope to check for cancerous cells. A liver biopsy is typically done if the patient has a mass on the liver or the results of other liver tests are suspicious.
Conclusion:
Overall, researchers have concluded that FibroScan might be a useful instrument for identifying primary liver cancer. But right now, it works best when used as an instrument in the diagnosing procedure. It can assist in determining which individuals require a biopsy to find out if they have liver cancer.
