Liver Cancer Treatment in Singapore

Primary Liver Cancer

This type of liver cancer begins within the liver tissue and can manifest in various types, with hepatocellular carcinoma (HCC) being the most common. Hepatocellular carcinoma (HCC), also known as hepatoma, is particularly common among people aged 50 and above, especially those with cirrhosis.

Stage I (T1, N0, M0)

At stage I liver cancer, the tumour is localised within the liver and is small in size, without any involvement of nearby lymph nodes.

Stage II (T2, N0, M0)

In stage II liver cancer, the tumour has grown into blood vessels but remains confined within the liver without spreading cancer cells to nearby lymph nodes or distant sites.

Stage III (T3 or T4, N0 or N1, M0)

At stage III liver cancer, several tumours or at least one large tumour has either grown extensively within the liver (T3 or T4) or cancer cells have spread to lymph nodes near the liver (N1) but have not metastasised to distant organs.

Chronic Viral Hepatitis

The most common risk factor for liver cancer is chronic viral infection. Typical examples are the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV can be transmitted through blood transfusions, sharing contaminated needles during drug use, unprotected sexual contact or from mother to child during childbirth.

Liver Cirrhosis

Cirrhosis is when liver cells are scarred due to long-term liver damage and inflammation. Some people who develop liver cancer already have underlying cirrhosis.

Non-Alcoholic Fatty Liver Disease (NAFLD)

This disease occurs due to the buildup of fat in the liver, which can result in inflammation, liver damage, and potentially liver cancer.

Genetics

People with a family history of liver cancer may face a higher risk of developing liver cancer.

Type 2 Diabetes

Individuals with Type 2 diabetes have a higher risk of developing liver cancer due to higher insulin levels or liver damage resulting from diabetes.

Ultrasound

Ultrasound is usually employed as a preliminary screening tool in people with known risk factors such as chronic hepatitis or liver cirrhosis. This method may be able to detect abnormal growths, but cannot immediately diagnose cancer.

CT scan

For liver cancer diagnosis, doctors usually perform a contrast-enhanced multiphase CT scan to better assess the tumour. CT scans can help evaluate the size, shape and number of liver tumours, and detect involvement of nearby lymph nodes.

PET-CT scan

PET-CT scans may be used in selected cases, particularly for cancer staging or to identify whether the cancer has spread beyond the liver, which CT or MRI alone may not always detect.

Biopsies

A liver biopsy involves the removal of a small amount of liver tissue. This procedure may be performed when imaging findings are inconclusive or when confirmation is required.

Surgery

Surgery is often considered for localised liver cancer, with the goal of removing cancerous tissue and improving long-term outcomes. A gastroenterologist may refer patients to a surgeon for further evaluation and determine whether surgery is appropriate. Common surgical options include:

• Hepatectomy – This procedure involves removing part of the liver containing the tumour. It is typically suitable for patients with hepatocellular carcinoma (HCC) who do not have severe underlying liver disease, such as advanced cirrhosis.
• Liver Transplantation – This may be considered for patients with early-stage tumours that meet specific criteria, such as a single small tumour or a limited number of small tumours, with no spread beyond the liver or involvement of blood vessels.

Localised Therapies

These techniques are often used for small liver tumours that are not suitable for surgery or for patients who are not candidates for surgery due to health reasons. Radiofrequency ablation (RFA) is a type of local therapy that uses high-frequency electrical currents to destroy cancer cells.

Seeking Treatment for Hepatitis B and C Infections

Consult a doctor for appropriate medication and preventive strategies for hepatitis B or C.

Vaccination Against Hepatitis B Virus

The hepatitis B vaccine reduces the risk of developing liver cancer, especially for those at higher risk of exposure.

Smoking Cessation and Alcohol Moderation

These can reduce risks for liver cancer as excessive smoking and alcohol consumption can contribute to liver damage.

Weight Management

Maintain a healthy weight to reduce the risk of obesity-related conditions, including fatty liver disease and liver cancer.

Maintaining an Active Lifestyle

Aerobic exercises such as brisk walking, jogging, cycling, swimming, and dancing increase blood flow to the liver, which helps in detoxifying the body and removing harmful substances.

Consuming a Healthy, Balanced Diet

Fruits, vegetables, whole grains, and lean proteins provide essential nutrients and antioxidants that support liver function and reduce cancer risk.