Detecting cancer in a silent organ

Fear takes over when patients hear liver surgery. Often, patients imagine the procedure as extremely risky, but medicine has improved. Today, with meticulous planning and using simple scans like MRI and CT scans to map the liver in advance, and in some cases deliberately blocking a small portion of its blood supply ahead of time, so that the remaining liver strengthens before surgery. With the deployment of state-of-the art tools in the operating room, there is less loss of blood and clear view. Why people feel fine and why that can be dangerous Surprisingly, those diagnosed with liver cancer always say, they feel fine. Thats because the liver is resilient; it can keep working yet compensate for damage, even when a large part is compromised. Its difficult to accept when you feel healthy. This underlines why liver cancer often remains silent for a long time, especially among those with liver conditions or fatty liver disease. Regular scans and blood tests in such vulnerable groups make a significant difference. Minimally invasive surgery is it possible for liver cancer? Absolutely yes. In many cases, laparoscopic surgery is suitable. With a tiny camera and minor cuts, we achieve faster recovery, less pain and shorter hospital stay. Often, the camera gives a clear view of deep parts of the liver, but its not for everyone. Factors like size, location, and type of tumour defines whether its appropriate. That said, priority must be safe and complete removal, and not the size of the cut. The surgeons balancing act A surgery mainly demands patience, timing, and the right judgement. It isnt just about a cut. For a surgeon, the hardest part is balance. A surgeon must decide how much of the liver is to be removed and how much of it must be left behind: if too little the cancer can recur; if too much the liver may fail. So not all cases we see are the same, each is unique. Each of it requires detailed planning, sometimes prepared for a quick decision while at the surgery if the liver appears weaker than expected. Other treatment paths A liver cancer may not always require surgery. Its not always the first best option, especially if the larger part of the liver is damaged or the cancer has spread. In such cases, treatments such as ablation, chemo-embolisation, targeted drugs, or immunotherapy may be used first to control the disease. If the liver improves, then we may consider surgery later. The goal is tailoring the best chance for a longer, better life. Simple steps that matter In many cases, liver cancer is preventable. Many arise from long-term issues such as viral hepatitis, fatty liver, or heavy alcohol use, but these can often be prevented. Vaccination against hepatitis B, timely treatment of infections, healthy diet, controlling weight, and avoiding excessive alcohol all protect the liver. People with diabetes or obesity should also undertake periodic liver-function tests. Prevention may not sound dramatic, but it saves lives quietly. Lessons from survivors Survivors teach me strength. Ive seen patients arrive very ill, undergo surgery, change their lifestyles completely, and go on to live many years. Some begin exercising, stop drinking, eat carefully, and embrace life with more positivity. Their courage inspires us. Medicine and surgery can treat the disease, but the patients mindset is what keeps them alive and well. Dr Dinesh, senior consultant - Surgical Gastroenterology & GI Oncology, SIMS Hospital