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Liver cancer is one of the most dangerous types of cancer because it often does not show symptoms in its early stages. In Indonesia, liver cancer is the fourth leading cause of cancer-related deaths, with more than 23,000 new cases reported annually. Keep reading as this article will discuss the causes, symptoms, treatment methods, prevention strategies, and the important role of Oona Cancer Insurance in helping you manage the financial challenges associated with liver cancer.
Liver cancer is the uncontrolled growth of abnormal cells in the liver. The most common type of liver cancer is hepatocellular carcinoma (HCC), which originates from the liver’s main cells, known as hepatocytes. This disease often progresses without clear symptoms in the early stages, leading to late-stage diagnoses in many cases.
Over the past two decades, Indonesia has seen a significant increase in liver cancer cases. According to Globocan 2020, there were 21,392 new cases of liver cancer in Indonesia, accounting for 5.4% of all cancer cases in the country.
This increase is influenced by various risk factors, such as:
High prevalence of hepatitis B and C infections
Excessive alcohol consumption
Rising cases of non-alcoholic fatty liver disease (NAFLD) due to lifestyle and dietary changes
These factors highlight the importance of prevention efforts, early detection, and effective treatments to reduce the burden of this disease in Indonesia.
Liver cancer is a type of cancer with various risk factors, both from chronic infections and lifestyle habits. The following factors can increase a person’s risk of developing liver cancer:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the leading causes of liver cancer worldwide, including in Indonesia. Hepatitis B can be transmitted, for example, from mother to baby during childbirth, through unprotected sexual intercourse, and the use of unsterile needles. It is estimated that around 8 million people in Indonesia live with chronic hepatitis B infection, which increases the risk of developing liver cancer.
Hepatitis C is primarily transmitted through contaminated blood, such as unsafe blood transfusions or shared needle use. Unlike hepatitis B, there is no vaccine to prevent hepatitis C, making early detection and treatment crucial to preventing further complications. Chronic infection with these viruses can cause long-term liver inflammation, eventually leading to cirrhosis, a condition that significantly increases the risk of liver cancer.
Cirrhosis occurs when healthy liver tissue is damaged and replaced by scar tissue. Over time, this condition can impair liver function and increase the risk of liver cancer. Around 80-90% of liver cancer cases develop from patients who previously had cirrhosis.
The main causes of cirrhosis in Indonesia include hepatitis B and C infections, excessive alcohol consumption, and non-alcoholic fatty liver disease (NAFLD). Since cirrhosis often does not show symptoms in its early stages, many patients only become aware of their condition when serious complications, such as liver failure or liver cancer, start to appear.
Alcohol has toxic effects on the liver and can cause chronic inflammation, leading to cirrhosis and eventually liver cancer. Consuming more than 3-4 glasses of alcohol per day for years can significantly increase the risk of liver cancer.
In Indonesia, excessive alcohol consumption remains a major cause of liver disease, particularly among men. Reducing or avoiding alcohol consumption is one of the essential steps in lowering the risk of liver cancer.
NAFLD is a condition in which fat accumulates in the liver without any relation to alcohol consumption. The rise in obesity and type 2 diabetes cases in Indonesia has led to a significant increase in the number of NAFLD patients. Around 25-30% of the global population has NAFLD, and some of them may develop cirrhosis, which increases the risk of liver cancer.
Since NAFLD often shows no symptoms in its early stages, early detection through regular check-ups is highly recommended, especially for those with risk factors such as obesity, insulin resistance, or metabolic syndrome.
Aflatoxin is a toxin produced by the fungi Aspergillus flavus and Aspergillus parasiticus, which commonly grow on food stored in warm and humid conditions, such as:
Peanuts
Corn
Soy products
Wheat
Long-term aflatoxin exposure has been proven to increase the risk of liver cancer, especially in tropical regions like Indonesia, where high humidity can accelerate fungal growth. To reduce aflatoxin exposure:
Store food in dry and cool conditions.
Avoid consuming food that appears moldy.
Use food products that have undergone strict aflatoxin testing.
If a family member has had liver cancer, your risk of developing the disease is also higher. Genetic factors can influence how the body processes toxins and repairs cell damage, making some people more susceptible to developing liver cancer than others. If you have a family history of liver cancer, it is highly recommended to undergo regular health check-ups to detect early signs of the disease.
Liver cancer is known as a "silent killer" because it often does not show symptoms in its early stages. As a result, many patients only become aware of the disease when the cancer has reached an advanced stage and has begun to significantly affect liver function.
However, there are some signs that may indicate early liver problems. If you experience the following symptoms persistently, it is important to consult a doctor immediately:
Rapid weight loss without an obvious cause may be a sign that the body is experiencing metabolic disturbances due to liver cancer. Unintentional weight loss is often accompanied by muscle mass loss and body weakness.
Many liver cancer patients report significant changes in appetite, even when they are not undergoing treatment. This may be caused by changes in the body's metabolism as well as inflammation caused by the tumor in the liver.
The liver is located in the upper right part of the abdomen, just below the ribs. A growing tumor in the liver can cause pressure or inflammation, leading to a dull and constant pain or discomfort.
Liver cancer can interfere with the liver’s function in filtering toxins, causing digestive disorders such as prolonged nausea or vomiting without a clear cause. In some cases, patients feel full in the stomach even after eating only a small amount.
Jaundice occurs when bilirubin levels in the blood increase due to impaired liver function. The skin and the whites of the eyes turn yellow, urine becomes dark, and stools may appear pale or gray. This is one of the major symptoms indicating that the liver is no longer functioning properly.
Accumulation of fluid in the abdomen (ascites) and swelling of the legs often occur in patients with advanced liver cancer. This is caused by reduced protein production by the liver, leading to an imbalance in the body's fluid regulation. The swelling is usually painless but can cause discomfort due to pressure in the abdominal cavity.
Liver cancer patients often experience extreme fatigue even when they are not engaged in strenuous activities. This fatigue is due to metabolic disturbances, decreased energy production, and the effects of a growing tumor in the body. In some cases, patients also experience difficulty concentrating and easily feel dizzy.
In addition to the main symptoms mentioned above, advanced-stage liver cancer can also cause the following conditions:
Prolonged fever: Occurs due to secondary infections or inflammation in the body caused by cancer.
Itchy skin: Caused by increased bile levels in the blood.
Uncontrollable bleeding: The liver plays a role in producing blood clotting proteins. If the liver is impaired, patients are more prone to bruising and bleeding.
If you experience the above symptoms, especially drastic weight loss, jaundice, and abdominal swelling, seek medical attention immediately. Early diagnosis is crucial to improving the success rate of liver cancer treatment.
Additionally, for those with high-risk factors such as a history of hepatitis B or C, excessive alcohol consumption, or a family history of liver cancer, regular health check-ups are highly recommended.
To confirm a liver cancer diagnosis, doctors will perform several examinations, such as:
Blood Tests: To detect liver function and alpha-fetoprotein (AFP) levels, a liver tumor marker.
Imaging (Ultrasound, CT Scan, MRI): To observe the presence of tumors in the liver.
Liver Biopsy: Collecting a sample of liver tissue for laboratory analysis.
Liver cancer treatment depends on the stage of the disease and the patient’s overall health condition. Some commonly used methods include:
Liver resection: Removing the part of the liver affected by cancer.
Liver transplantation: Replacing the damaged liver with a healthy donor liver.
Ablation: Destroying cancer cells using heat (radiofrequency ablation) or cold (cryoablation).
Embolization: Blocking blood flow to the tumor to stop its growth.
Chemotherapy: Using drugs to kill cancer cells.
Targeted Therapy: Specialized drugs that attack cancer cells without harming healthy cells.
Immunotherapy: Boosting the immune system to fight cancer.
Preventing liver cancer is far easier than treating it. Since many liver cancer cases originate from viral infections, cirrhosis, or lifestyle factors, you can reduce your risk of developing this disease by adopting healthy habits. Here are some key preventive measures you can take:
One of the most effective ways to prevent liver cancer is through hepatitis B (HBV) vaccination.
Hepatitis B is one of the leading causes of liver cancer, especially in Indonesia, where HBV infection rates remain high.
The hepatitis B vaccine is safe and up to 98% effective in preventing infection.
Children should receive the vaccine from infancy, while adults who have not been vaccinated are also recommended to get it, especially if they have high-risk factors (such as healthcare workers or individuals with an HBV-infected partner).
Note: There is no vaccine for hepatitis C, so the best approach is to avoid its risk factors for transmission.
The use of unsterilized needles can increase the risk of contracting hepatitis B and C, which can lead to liver cancer.
Avoid sharing needles, especially for those undergoing injection treatments or intravenous drug users.
Ensure medical equipment, such as syringes, tattoo needles, or cosmetic tools that come into contact with blood (such as acupuncture needles), are used under sterile and single-use conditions.
Tip: If you need a blood transfusion, make sure the blood has undergone strict screening to prevent hepatitis C transmission.
A healthy diet can maintain liver health and reduce the risk of liver cancer.
Aflatoxins are toxic substances produced by the Aspergillus fungus, which grow on foods stored in humid conditions, such as:
Peanuts
Corn
Wheat
Contaminated soy products
Ways to Avoid Aflatoxins:
Store food in a dry and cool place.
Choose food products that have passed food safety standards.
Avoid consuming food that appears moldy or has a bitter and rancid taste.
Certain foods can help maintain liver health, such as:
Green vegetables (spinach, broccoli) rich in antioxidants.
Fruits like oranges, apples, and berries that help detoxify the liver.
High-fiber foods such as oats and legumes.
Green tea which contains catechins to protect liver cells.
Fatty fish (salmon, tuna) rich in omega-3 fatty acids to reduce liver inflammation.
Alcohol is one of the main causes of liver cirrhosis, which is the biggest risk factor for liver cancer.
Excessive alcohol consumption can damage liver cells and trigger chronic inflammation.
The safe alcohol consumption limit according to WHO is no more than one glass per day for women and two glasses for men.
If possible, completely stop alcohol consumption to maintain liver health.
Healthy Alternative: Replace alcohol with healthy drinks such as natural juices, coconut water, or herbal teas to support liver health.
Regular health check-ups are very important to detect liver disease early, especially for those who have a high risk of developing liver cancer.
Blood tests (Liver Function Test/LFT) can detect liver function disorders.
Alpha-Fetoprotein (AFP) test can help identify the presence of liver tumors in the early stages.
Liver ultrasound, CT scan, or MRI can be performed to get a more detailed view of liver conditions.
If you have a history of hepatitis B or C, consult a doctor for routine screening at least every 6 months.
People with a history of hepatitis B or C.
Those who have a family history of liver cancer.
Individuals with liver cirrhosis or other chronic liver diseases.
People who consume excessive alcohol.
Since liver cancer is often diagnosed at an advanced stage and requires expensive medical treatment, having financial protection is very important. With Oona Cancer Insurance, you can get the following benefits:
Cash benefit of up to IDR 500 million upon diagnosis of liver cancer (including early-stage cancer).
No medical check-up required, only need to answer 4 health-related questions.
Affordable premiums starting from IDR 11,500 per month.
Can be used for medical treatment, care, or other needs.
Coverage from ages 18 to 65 years, and can be extended until age 70.
Preventing liver cancer requires a comprehensive approach, including hepatitis B vaccination, avoiding hepatitis C virus exposure, maintaining a healthy diet, limiting alcohol consumption, and undergoing regular health check-ups. By implementing these measures, you can significantly reduce the risk of developing liver cancer.
However, even with preventive efforts, the risk of liver cancer still exists, especially for those with genetic factors or a history of liver disease. Therefore, protecting yourself with critical illness insurance is a wise step to avoid the financial burden caused by expensive cancer treatments.
