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Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

Cancer that spreads to the liver is more common than cancer that begins in the liver cells. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. This type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver.

Types

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Risk factors

The risk of hepatocellular carcinoma, the most common type of liver cancer, is higher in people with long-term liver diseases. It’s also higher if the liver is scarred by infection with hepatitis B or hepatitis C. Hepatocellular carcinoma is more common in people who drink large amounts of alcohol and who have an accumulation of fat in the liver.

Diagnosis

Tests and procedures used to diagnose hepatocellular carcinoma include:

• Blood tests to measure liver function
• Imaging tests, such as CT and MRI
• Liver biopsy, in some cases, to remove a sample of liver tissue for laboratory testing

Treatment

Which treatment is best for you will depend on the size and location of your hepatocellular carcinoma, how well your liver is functioning, and your overall health.

Hepatocellular carcinoma treatments include:

• Surgery. Surgery to remove the cancer and a margin of healthy tissue that surrounds it may be an option for people with early-stage liver cancers who have normal liver function.
• Liver transplant surgery. Surgery to remove the entire liver and replace it with a liver from a donor may be an option in otherwise healthy people whose liver cancer hasn’t spread beyond the liver.
• Destroying cancer cells with heat or cold. Ablation procedures to kill the cancer cells in the liver using extreme heat or cold may be recommended for people who can’t undergo surgery. These procedures include radiofrequency ablation, cryoablation, and ablation using alcohol or microwaves.
• Delivering chemotherapy or radiation directly to cancer cells. Using a catheter that’s passed through your blood vessels and into your liver, doctors can deliver chemotherapy drugs (chemoembolization) or tiny glass spheres containing radiation (radioembolization) directly to the cancer cells.
• Radiation therapy. Radiation therapy using energy from X-rays or protons may be recommended if surgery isn’t an option. A specialized type of radiation therapy, called stereotactic body radiotherapy (SBRT), involves focusing many beams of radiation simultaneously at one point in your body.
• Targeted drug therapy. Targeted drugs attack specific weaknesses in the cancer cells, and they may help slow the progression of the disease in people with advanced liver cancers.
• Immunotherapy. Immunotherapy drugs use your body’s germ-fighting immune system to attack the cancer cells. Immunotherapy may be an option for treating advanced liver cancer.
• Clinical trials. Clinical trials give you a chance to try new liver cancer treatments. Ask your doctor whether you’re eligible to participate in a clinical trial.

Symptoms

Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

When to see a doctor

Make an appointment with your doctor if you experience any signs or symptoms that worry you.

The International Agency for Research on Cancer (IARC) has classified outdoor air pollution as a Group 1 carcinogen. Increasing evidence has suggested that the association may not be limited to lung cancer, but also cancer of other sites.

Indoor emissions from the household combustion of coal are a Group 1 carcinogen. The household combustion of biomass fuels and emissions from high-temperature frying have been concluded to be possibly carcinogenic to humans by the IARC. It is estimated that 3.8 million premature deaths (8% from lung cancer) are attributable to household air pollution from cooking with kerosene or solid fuels each year.

The Global Burden of Disease Study also suggested that indoor air pollution is associated with the risk of esophageal squamous cell carcinoma. The forgotten 2.6 billion people who have less access to cleaner fuels, mostly in low- and middle-income countries (LMICs), Kenya included suffer an increasing cancer burden and are also exposed to a huge amount of air pollution. The vicious cycle of climate change, air pollution, and cancer will keep rolling and provide a devastating cancer burden without intervention.

Cancer has become the leading cause of premature death in many countries in recent decades. Previous studies showed plenty of evidence that control of modifiable risk factors would reduce the cancer burden. Since modifiable risk factors could be eliminated by changing the lifestyles of individuals, a greater uptake of modifiable risk factors is critical to reducing cancer burden and inequality in cancer survival.

However, climate change has widen cancer inequities through its complex connections with modifiable risk factors which include; abnormal temperature, UV, air pollution, natural disasters, food (diet), water, infections, and inefficient physical activities.

The associations between climate change and modifiable risk factors have no doubt expanded the inequities. People who face overlapping modifiable risk factors, but who are unable to change or adapt, are at the highest risk in the climate change–cancer linkage. Individual actions to avoid exposure to modifiable risk factors is highly recommended, limited benefits would be achieved unless the nations strive to ensure the basic needs of the people.

Cancer is the second cause of globally ranked premature death after cardiovascular disease and has become the top cause in many countries in recent decades.  Apart from lifestyle factors, air pollution and other environmental risks are also the main factors associated with cancer. The inequality that exists in overall cancer survival between different countries is predominantly due to the disparities in health awareness; early diagnoses; screenings; and accessible, affordable, and high-quality healthcare for patients with cancer.

Data from the United States suggests that 42% of cancer incidence and 45% of cancer mortality were attributable to modifiable risk factors, a kind of behavior or exposure factors related to cancer risk that we could reduce or control, such as poor diet and physical inactivity.5 Findings from a population-based cohort study suggested that modifiable risk factors could explain 46% of inequities in cancer morbidity and mortality.6 Inequities exist in cancer burden because cancer survival and mortality burden are closely related to the treatment ability and care. The reduction of cancer burdens attributable to avoiding modifiable risk factors would provide an equitable strategy for cancer prevention and control. Therefore, it is critical to provide a supportive environment and educational programs on how to avoid modifiable risk factors is critical. However, climate change is challenging this approach and will widen cancer inequality.

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Potential Critical Connections of Climate Change and Cancer Risk

The potential linkage between climate change and factors that can modify cancer incidence and threaten cancer survival are shown in Figure​

Figure1

1. The combustion of fossil fuel seems to be the start of a vicious cycle since it increases greenhouse gas emissions (CO2, CH4, etc.) that aggravate climate change and produce air pollution. According to previous studies, cancers potentially associated with modifiable risk factors are highlighted in Figure​

Figure2

2.

Figure 1

Potentially critical connections between climate change and cancer risk. UV: ultraviolet radiation; the dashed line indicates that high temperatures could amplify, or enhance, the effects of ambient air pollution. Natural disasters include heat waves, cold spells, wildfires, droughts, floods, hurricanes, typhoons, etc.

Figure 2

Potential associations between climate-change-related risk factors and cancer.

The International Agency for Research on Cancer (IARC) has classified outdoor air pollution as a Group 1 carcinogen. Increasing evidence has suggested that the association may not be limited to lung cancer, but also cancer of other sites.7 Increased incidence and shorter survival of cancer affected by air pollution were observed in previous studies.7 In addition to the greenhouse gases emitted by the combustion of fossil fuels contributing to climate change, climate change may worsen air quality by changing the ventilation, dilution, precipitation and other removal processes, and the amplification of atmospheric chemistry.8 Accumulative evidence suggests that climate change is expected to increase particulate matter ≤ 2.5 μm (PM2.5)-related mortalities even under the scenario of a moderate projection of greenhouse gas emissions.9 Though the interplay of climate change and air pollution on health has been well documented, the evidence for cancer warrants investigation.10

Besides outdoor air pollution, household air pollution is also a part of the linkage.11 There are still millions of people who are not able to cook with clean energy, which results in severe indoor air pollution as well as greenhouse gases, that is, the major factor affecting climate change.12 Indoor emissions from the household combustion of coal are a Group 1 carcinogen. The household combustion of biomass fuels and emissions from high-temperature frying have been concluded to be possibly carcinogenic to humans by the IARC. It is estimated that 3.8 million premature deaths (8% from lung cancer) are attributable to household air pollution from cooking with kerosene or solid fuels each year. The Global Burden of Disease Study also suggested that indoor air pollution is associated with the risk of esophageal squamous cell carcinoma.13 “The forgotten 2.6 billion people” who have less access to cleaner fuels, mostly in low- and middle-income countries (LMICs), suffer an increasing cancer burden and are also exposed to a huge amount of air pollution. The vicious cycle of climate change, air pollution, and cancer will keep rolling and provide a devastating cancer burden without intervention.

With the accumulation of greenhouse gases, global warming, and changing meteorological factors, there is an increasing frequency of abnormally hot and cold temperatures, which are the direct expression of climate variability. Although it is not clear whether it is the increased temperature of warm months, carcinomatous meningitis was observed to have a higher incidence in these months.14 Evidence from more studies is warranted to confirm the causal association. The direct effects of extreme temperatures like heat waves may worsen the conditions of cancer patients because of their impaired thermoregulation and immune function.15 Occupational heat exposure, exacerbated by climate change,16 is also associated with several cancers, e.g., female breast cancer.17 The climate-change-induced ozone depletion led to increasing ultraviolet radiation (UV) exposure, which will lead to increased risks of melanoma and other skin cancers (e.g., squamous cell skin cancer).18 In consequence, melanoma survivors have an increased risk of developing second primary cancers, such as prostate cancer.19

The changing temperature and precipitation will also lead to changes in natural disasters and food production, which may increase the risk of cancer indirectly. Take wildfires as an example of a natural disaster that has shown an increasing trend in frequency and duration globally.20 Long-term exposure to wildfires has been suggested to increase the incidence of lung cancer and brain tumors.21 Extreme weather and natural disasters caused by climate change may reduce people’s physical activity by limiting active venues and suitable temperatures. Less physical activity could increase the risks of colon, female breast, and uterine cancers.5 Furthermore, inactivity-induced excess body weight also increases the risk of cancers of the gastrointestinal tract, genital organs, and female breast.

Less food availability and deteriorating food security induced by climate change have been observed. A modeling study revealed that by 2050, the global food availability would decrease by about 3.2%, and a 4.0% fruit and vegetable consumption reduction would be attributable to climate change.22 Parental malnutrition and exposure to air pollution exacerbated by climate change are significantly associated with serious adverse pregnancy outcomes,23,24 which are associated with higher breast cancer risk in early adult life.25 Lower consumption of fresh vegetables and fruit would also increase the risk of cancer from the respiratory and digestive tracts. Polycyclic aromatic hydrocarbons (PAHs) from high-temperature pyrogenic processes and vehicular emissions, which are related to the higher risk of breast cancer and colorectal cancer,27 were also found in commonly consumed leafy vegetables.26 The increase in the temperature led by climate change may increase appetite suppression and reduce conception rate of livestock because of heat stress, as well as reduce milk production.28 Lower dairy product consumption has been observed in line with increased breast cancer and colorectal cancer.27 Temperature and moisture significantly influenced aflatoxin production.29 Aflatoxin B1 production in maize will have consequences on aflatoxin M1 contamination in milk30 and might increase the liver cancer risk.31 Similarly, the diversity, distribution, and biology of fish populations are also affected by climate change. It is estimated that for every 1 °C of global warming, global fish catches are expected to decline by 3 million tonnes.32 Liver and colorectal cancer risks will be increased27 due to the lack and unaffordable fish consumption, especially in low-income countries.33 Climatic variability has always been the main factor responsible for fluctuations in coffee productivity worldwide.34 Coffee consumption is suggested to reduce the risk of oral and liver cancers.27 Apart from food, water quality is also affected. Climate change is likely to exacerbate the increasing bromide levels in public water systems, which would increase the excess lifetime bladder cancer risk35 and the cyanotoxins in drinking water that are associated with liver and colorectal cancer.36

Kidney cancer is cancer that begins in the kidneys. Your kidneys are two bean-shaped organs, each about the size of your fist. They’re located behind your abdominal organs, with one kidney on each side of your spine.

In adults, renal cell carcinoma is the most common type of kidney cancer. Other less common types of kidney cancer can occur. Young children are more likely to develop a kind of kidney cancer called Wilms’ tumor.

The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) scans are being used more often. These tests may lead to the accidental discovery of more kidney cancers. Kidney cancer is often discovered at an early stage, when the cancer is small and confined to the kidney.

Symptoms

Kidney cancer usually doesn’t have signs or symptoms in its early stages. In time, signs and symptoms may develop, including:

• Blood in your urine, which may appear pink, red or cola colored
• Pain in your back or side that doesn’t go away
• Loss of appetite
• Unexplained weight loss
• Tiredness
• Fever

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

Dispelling Myths and Misconceptions about Cancer in Children

The National Cancer Institute of Kenya – NCI Kenya

Myth: Children do not develop cancer

Fact:

Cancer can develop at any age, including in newborns. While the likelihood of cancer generally increases with age, approximately 400 000 children globally (aged 0–19 years) develop cancer each year. That is equivalent to about one in 500 children in their lifetime

Myth: Childhood cancers are preventable

Fact:

Unlike adult cancers, almost all childhood cancers arise during growth and development and cannot be prevented. Rather than prevention programmes, effective childhood cancer control must focus on avoiding missed/ delayed diagnosis, ensuring access to highquality multidisciplinary care, reducing and managing disease- and treatmentrelated complications, ensuring treatment completion and sustained follow-up of longterm survivors.

Myth: Most children with cancer die of their disease

Fact:

More than 8 of 10 children are cured when they receive the best available treatment services and care (Section 1.2.2). Research and innovation remain important priorities for further improvements in childhood cancer care.

Myth: Childhood cancer is one disease, treated with a standardized approach

Fact:

There are many different cancers of children and young people that develop at different ages, in many parts of the body and with different patterns of spread. The diagnosis and treatment must be adapted to the individual and follow evidence-based standards of care.

Myth: Childhood cancer chemotherapy is expensive

Fact:

Most children can be cured using inexpensive generic medicines and affordable multimodality therapy (Section 1.5).

Myth: Even if children survive cancer, they are left with permanent and severe disabilities

Fact:

While treatment can cause health care needs in some survivors, many children cured of cancer go on to lead long, happy, healthy and productive lives.

LUNG CANCER

Cancer which begins in the cells of the lung. It causes difficulty breathing, coughing up blood, chest pain, hoarseness, headache and weight loss.

It is mainly of two types:

• Non-small cell lung cancer- is the most common type
• Small cell lung cancer- is the aggressive form and is observed in smokers

COMMON CAUSES

The causes include:

The primary reason for lung cancer is cigarette smoking. There are chances that nonsmokers also get lung cancer. Smoke that enters the lungs causes damage to the lung tissue. The body will try to repair the damage, but due to the continuous exposure, it will fail.

Another causative agent is a radioactive gas called radon. Radioactive gas can enter through small holes in the buildings. Genetic mutation can increase the risk of developing lung cancer.

The risk factors include:

• Smoking
• Radiation therapy
• Asbestos and other heavy metals like cadmium, selenium, etc., can also increase the risk.
• Family history of lung cancer

SYMPTOMS

The symptoms include:

1. Chest pain that worsens when you breathe deeply, laugh, or a cough.
2. Hoarseness
3. A lingering or worsening cough
4. Shortness of breath
5. Wheezing
6. Weakness and fatigue
7. Loss of appetite and weight Loss
8. Coughing up phlegm or blood
9. Muscle Weakness
10. Nausea
11. Vomiting
12. High blood pressure
13. High blood sugar
14. Confusion
15. Seizures
16. Coma

DIAGNOSIS

Diagnosis includes physical examination and medical history.

X-ray – X-ray of chest is taken to identify the presence of tumor.

CT scan – CT scan of the lungs is performed to identify the location and size of the tumor mass.

Magnetic resonance imaging (MRI) – MRI of the lungs can detect the severity and spread of cancer cells.

Positron emission tomography (PET) – To observe the function of lungs and its tissues.

Sputum cytology – Sputum tests may be performed in certain cases to look for cancerous cells.

Biopsy – A small sample of the lung tumor cells is obtained to determine if they are cancerous.

TREATMENTS

Treatment involves surgery, chemotherapy and radiation therapy.

COMPLICATIONS

If untreated it may lead to

• Shortness of breath: it is common as the cancer cells grow and block the airways
• Inhaling air becomes as the lungs cannot expand fully due to fluid accumulation
• Bleeding in the airways causes coughing up blood
• In certain cases severe bleeding may occur
• Lung cancer metastasis to other parts can cause pain

PREVENTION

• Quit smoking: Smoking is the common cause
• Avoid passive smoking
• Avoid carcinogens at work: stay away from harmful chemicals

Contrary to many adult cancers, lifestyle-related risk factors (such smoking) don’t significantly increase a child’s risk of developing cancer. Radiation exposure is one environmental element that has been linked to a higher risk of several paediatric malignancies. However, there are some situations where radiation exposure may be inevitable, such as when a youngster requires radiation therapy to treat another malignancy.

It’s crucial to understand that there is very nothing you or your child could have done to stop cancer from occurring if it occurs.

1. Set an example: Parents who eat well and have healthy lifestyles have children who also do the same according to American research

2. Don’t ever smoke. Kids look up to their parents and copy them. Never allow anyone in your family to smoke and don’t allow smoking in your home. Children are damaged by secondary smoke.

3. Breast feed them longer. (And have a natural birth). With nine months at least – it builds their immune systems for life (and will also help protect mum from breast cancer).

4. Tell them to eat their greens! Cabbage, broccoli, and watercress, and cauliflower, kale: Masses of vitamins and minerals and new research shows some, like vitamin K, are just no longer eaten in sufficient quantities by our youngsters.

5. Tell them to eat fruit! One American study showed that those kids who didn’t eat fruit at all, always went on to develop cancer later in life.

6. Give them cod liver, or fish oil every day. It has massive health benefits, aids depression, calms aggression and even increases their IQ’s.

7. Cut out salt and sugar. Don’t bring the foods home. Salt poisons healthy cells and sugar feeds cancer cells. So cut down on processed or packaged foods, soy sauce, Chinese food, canned food – eat fresh. Remember refined wheat, white bread and white pasta are just sugar by another name.

8. Cut down on cows’ dairy. There are increasing numbers of studies, for example from the world famous Karolinska Institute, linking dairy and cancer risk. And that means cheese and pizzas too! Milk actually suppresses their appetites. There is clear research on levels of saturated fats in the teenage years being linked to cancers later in life.

9. Don’t live near a main road, or a petrol station if you can help it. Both have been associated with an increased risk of cancers like child leukaemia. And avoid living near pylons, phone masts or power cables: The International Leukaemia Conference warned of risks to children.

10. Don’t allow them mobile phones (and don’t have cordless phones at home). Thinner skulls, nervous systems and brains still forming – we don’t have the space to list all the research raising possible risks. Turn the WiFi off at night and don’t leave them playing on the tablet, phone or laptop for hours.

11. Don’t use in-home herbicides or pesticides. They increase the risk of child cancers like lymphoma, and leukaemia. For example, head lice shampoos, garden sprays, flea sprays or flea collars on your animals: Linked to increased risk of child brain tumours and leukaemias

12. Let them eat dirt. Seriously, too much irradiated, bacteria-free food, and sterile environments gives them weak immune systems – they need the fresh food, the outdoor life of their grandparents and to catch minor illnesses to develop an effective immune system. Children brought up on farms and children with a pet in the house have stronger immune systems. Fact.

13. Avoid antibiotics and mercury based vaccines. Antibiotics kill off friendly bacteria in the body, the front line of the immune system, and part of their immune memory. No child should have an antibiotic unless absolutely essential. Mercury-based vaccines can also damage the immune systems of the young

14. Grow your own toxin-free vegetables, or go organic. More vitamins, more minerals, more omega 3, less pesticides. Changes in chemical composition of kid’s urine were noted within 5 days. Do you have fruit trees in your garden?

15. Go toxin-free in your kitchen and bathroom. Don’t use perfume or perfumed products on your skin when pregnant! Don’t let them use alcohol-based mouthwash or fluoride toothpaste. The EU considered banning over 1000 ’chemicals of concern’ currently found in everything from shampoo to baby wipes, and anti-perspirants to household cleaners.

16. Make them take exercise. Watching TV or playing computer games are unlikely to move their lymph or oxygenate their blood!! They will end up obese very quickly – like nearly 40% of kids

17. Ditch the junk food. Forget the fast food ’restaurants’, the bag snack after school, cut the fizzy soft drinks, the ice cream, the cakes and the biscuits. Mum it is your responsibility. Bring only whole foods and nourishment into the house. 

18. Beware exotic holidays. It is much easier than you realize to contract a parasite. If you go on one, buy a natural parasite purge (tend to be garlic/clove based) for your family.

19. Teach them to practice safe sex. Sexually transmitted bacteria and viruses are now known to cause cancers like cervical and ovarian.

20. Create a happy, laughter filled house. Laughing moves their lymph and boosts their immune systems. And don’t ever make them feel guilty. Guilt and depression are two significant causes of cancer.