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National Cancer Prevention Month
Written for patients and their families — plain language, real answers.

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Covering: Oesophageal  |  Stomach  |  Liver  |  Gallbladder  |  Bile Duct
Pancreatic  |  Small Bowel  |  Colon  |  Rectal  |  Anal  |  GIST  |  NETs

IMPORTANT NOTICE This blog is for general health education only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always speak with your own doctor or specialist about your personal health situation.

Warning Signs: When to See a Doctor

No matter which GI cancer we’re talking about, certain symptoms should always prompt a visit to your doctor without delay. They don’t automatically mean cancer — but they always deserve investigation:

Red Flag Symptoms — Never Ignore These     Unexplained weight loss or loss of appetite   Difficulty swallowing or pain when swallowing   Persistent indigestion, heartburn, or abdominal pain   Vomiting blood, or vomit that looks like coffee grounds   Black, tarry, or bloody stools   New jaundice — yellowing of skin or whites of the eyes   Dark urine and pale/clay-coloured stools   A change in bowel habits lasting more than 3 weeks   Unexplained new anaemia (low blood count)   New-onset diabetes after age 50, especially with weight loss   A lump or swelling in the abdomen   If you have any of these — please make an appointment with your GP today. Early detection genuinely saves lives.

About This Guide This guide is brought to you by PancreaCare by Advitya Healthcares.This is one section from a 12-part GI cancer series, and each section follows the same structure—what it is, why it happens, how to lower your risk, how it’s diagnosed, how it’s treated (including what surgery involves), and what recovery looks like—so you can use the headings to jump to what you need, or read straight through, because knowledge is the best first step.

Liver Cancer (Hepatocellular Carcinoma)

What Is It?

The liver is your body’s largest internal organ — a powerhouse that filters blood, processes nutrients, produces bile for digestion, and detoxifies harmful substances. Primary liver cancer (hepatocellular carcinoma or HCC) starts in the liver cells themselves.

It is different from secondary (metastatic) liver cancer, where cancer has spread to the liver from elsewhere. HCC almost always develops against a background of long-standing liver damage and scarring (cirrhosis).

Why Does It Happen? (Causes & Risk Factors)

Liver cancer rarely appears in a healthy liver. It almost always grows on damaged ground:

• Hepatitis B virus (HBV) infection — a preventable cause thanks to vaccination
• Hepatitis C virus (HCV) infection — now very effectively treated with direct-acting antivirals
• Alcoholic liver disease leading to cirrhosis
• Non-alcoholic fatty liver disease (NAFLD) linked to obesity and type 2 diabetes
• Cirrhosis from any cause is the single biggest risk factor
• Aflatoxin exposure (a mould toxin found in improperly stored grains/nuts in some regions)
• Haemochromatosis (iron overload) and other metabolic liver diseases

How Can I Lower My Risk?

Protecting your liver is the key to preventing liver cancer:

• Get vaccinated against Hepatitis B — the vaccine is safe, effective, and widely available
• Get tested for Hepatitis B and C if you may have been exposed — both are treatable
• Maintain a healthy weight and manage diabetes — reversing fatty liver is possible
• Limit or avoid alcohol if you have any liver disease
• Be cautious with herbal supplements and unregulated medications — many are toxic to the liver
• Attend regular liver screening if you have cirrhosis: ultrasound every 6 months ± AFP blood test

How Is It Diagnosed?

Liver cancer is often diagnosed on a routine scan before symptoms appear in high-risk patients. When symptoms do occur (weight loss, right-sided abdominal pain, jaundice), further investigation is needed:

• Liver ultrasound: first-line screening tool
• Triphasic CT or MRI of the liver: can often diagnose HCC without biopsy based on specific enhancement patterns
• AFP (alpha-fetoprotein) blood test: a tumour marker supporting diagnosis
• Liver biopsy: when imaging findings are unclear
• Assessment of liver function: critical to guide what treatment is safe

How Is It Treated?

Treatment depends on the stage of the tumour and the health of the remaining liver:

• Surgical resection: removing the tumour with a margin of normal liver — best option for early tumours in patients with good liver function
• Liver transplantation: can cure both the cancer and the underlying cirrhosis — reserved for patients meeting specific criteria (Milan criteria)
• Ablation (RFA/MWA): using heat delivered via a probe to destroy the tumour — for small tumours not suitable for surgery
• TACE (transarterial chemoembolisation): blocking the tumour’s blood supply while delivering chemotherapy directly to it
• TARE (transarterial radioembolisation/SIRT): targeted radiation beads delivered via blood vessels
• Systemic therapy: targeted agents (sorafenib, lenvatinib) or immunotherapy (atezolizumab + bevacizumab) for advanced disease

The Surgery: Liver Resection (Hepatectomy) A hepatectomy removes the tumour along with a margin of healthy liver tissue. The liver has a unique ability to regenerate — up to 70% can be safely removed in a healthy liver. In cirrhotic livers, the extent of surgery is carefully limited based on liver reserve. The operation can be done open or laparoscopically (keyhole). Hospital stay is typically 4-7 days. Liver Transplantation: Both the cancerous liver and the diseased underlying liver are removed and replaced with a healthy donor liver — offering the best long-term outcomes for eligible patients.

Aftercare & Recovery

Long-term liver health management is just as important as the cancer treatment itself:

• Lifelong abstinence from alcohol
• Treating the underlying cause (e.g. antiviral therapy for hepatitis B/C)
• Regular surveillance scans every 3-6 months
• Managing complications of cirrhosis: fluid (ascites), varices, encephalopathy
• Nutritional support — liver disease often affects appetite and nutrient absorption
• Liver transplant recipients: lifelong immunosuppression and monitoring