Do we know what causes liver cancer ? Can liver cancer be prevented .

Although several risk factors for hepatocellular cancer are known , exactly how these may lead normal liver cells to become cancerous is only partially understood.

Cancers develop when the DNA of cells is damaged. DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than how we look. Some genes have instructions for controlling when cells grow, divide into new cells, and die. Genes that help cells grow and divide are called oncogenes. Genes that slow down cell division or cause cells to die at the right time are called tumor suppressor genes. Cancers can be caused by DNA changes that turn on oncogenes or turn off tumor suppressor genes. Several different genes usually need to have changes for a cell to become cancerous.

Certain chemicals that cause liver cancer, such as aflatoxins, are known to damage the DNA in liver cells. For example, studies have shown that aflatoxins can damage the TP53 tumor suppressor gene, which normally works to prevent cells from growing too much. Damage to the TP53 gene can lead to increased growth of abnormal cells and formation of cancers. Infection of liver cells with hepatitis viruses can also damage DNA. These viruses have their own DNA, which carries instructions on how to infect cells and produce more viruses. In some patients, this viral DNA can insert itself into a liver cell's DNA, where it may affect the cell's genes. But scientists still don't know exactly how this might lead to cancer.

Although scientists are starting to understand how liver cancer develops, much more must be learned. Liver cancer clearly has many different causes, and there are undoubtedly many different genes involved in its development. It is hoped that a more complete understanding of how liver cancers develop will help doctors find ways to better prevent and treat them.

Liver cancersymptoms

Like many types of cancer, liver cancer symptoms often do not appear in the early stages. As a result, liver cancer tends to be diagnosed at a more advanced stage.
Because there are no widely recommended routine screening tests for liver cancer, people with a family history of the disease or other risk factors should talk with their doctor about steps they can take to monitor or reduce their risk.

The symptoms of liver cancer may be different for each person and any one of these symptoms may be caused by other, benign conditions.
When present, common liver cancer symptoms may include:

• Weight loss not associated with changes in diet.
• Decrease in appetite or a feeling of fullness after a small meal.
• Nausea and vomiting not associated with other known conditions.
• General weakness and/or fatigue that is persistent, ongoing weakness or fatigue.
• Fever that is unrelated to other conditions.
• Pain occurring in the upper abdomen on the right side or near the right shoulder blade.
• Enlarged liver (hepatomegaly) felt as a mass under the ribs on the right side.
• Enlarged spleen felt as a mass under the ribs on the left side.
• Abdominal swelling (ascites) or bloating in the abdomen can occur as a mass forms.
• Jaundice, which appears as yellowing of the skin and eyes. Jaundice occurs when the liver is not functioning properly.

Many of the above mentioned symptoms are similar to other types of benign liver infections or diseases. In the case of liver cancer, the symptoms will continue to evolve and worsen as the disease advances. It is important to see a doctor for an accurate diagnosis if you have any of the above signs of liver cancer.

In rare cases, other disorders may develop as a result of liver cancer, especially in the early stages of the disease. Paraneoplastic syndromes cause symptoms in other parts of the body. Awareness of these symptoms may help with diagnosing liver cancer.

Some paraneoplastic syndromes related to liver cancer include:

• Hypercalcemia: High blood calcium levels
• Hypoglycemia: Low blood sugar levels
• Erythrocytosis: High red blood cell count
• Hypercholesterolemia: High cholesterol levels
• Gynecomastia: Breast enlargement
• Shrinking of testicles in men

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