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Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It begins in liver cells called hepatocytes and most often develops in people with chronic liver disease, especially cirrhosis caused by hepatitis B or hepatitis C infection. The liver sits under the right rib cage and plays a vital role in digestion, detoxification and metabolism. In HCC, genetic changes cause liver cells to grow uncontrollably, forming a tumor that can damage healthy liver tissue, invade blood vessels and spread (metastasize) to other organs. Why HCC is dangerous Often causes no symptoms in early stages Commonly occurs in people whose liver function is already poor Frequently diagnosed at an advanced stage Treatment options depend on tumor stage and liver reserve Causes HCC develops when DNA changes occur in hepatocytes, leading to uncontrolled growth. The most common underlying causes include: Cirrhosis Chronic hepatitis B or C Long-standing liver inflammation or injury In some cases, HCC develops without known liver disease, though this is less common. Risk factors Chronic hepatitis B or C Cirrhosis (any cause) Metabolic dysfunction–associated steatotic liver disease (MASLD/MASH) Diabetes and obesity Heavy alcohol use Smoking Inherited liver diseases (hemochromatosis, Wilson’s disease) Aflatoxin exposure (mold-contaminated grains and nuts) Older age Symptoms Early HCC usually has no noticeable symptoms. When symptoms appear, the disease is often advanced and may include: Unintentional weight loss Loss of appetite Upper abdominal pain or mass Abdominal swelling Jaundice (yellowing of skin and eyes) Worsening symptoms of cirrhosis Early warning signs may be detected through: Rising alpha-fetoprotein (AFP) levels New liver nodules on ultrasound during surveillance How HCC spreads Advanced HCC may spread to: Lungs Abdominal lymph nodes Bones Adrenal glands Brain Treatment options Treatment depends on tumor stage and liver function and may include: Surgical resection Liver transplantation Ablation therapies Embolization (TACE, TARE) Radiation therapy Targeted therapy Immunotherapy Prevention You can reduce the risk of HCC by: Preventing or treating hepatitis B and C Getting vaccinated against hepatitis B Avoiding heavy alcohol use Maintaining a healthy weight Managing diabetes and metabolic disease Avoiding smoking Treating cirrhosis early Screening People at high risk (cirrhosis, hepatitis B or C) may benefit from screening every 6 months with: Liver ultrasound AFP blood test Screening can detect HCC earlier, when treatment is more effective. When to see a doctor See a healthcare professional if you have: New or worsening liver-related symptoms Unexplained weight loss or abdominal pain Known liver disease and changes in health status Early detection is critical for improving outcomes in hepatocellular carcinoma.

Acute Myeloid Leukemia (AML) in Children Leukemia is a type of cancer that affects the blood, specifically the white blood cells, and begins in the bone marrow. Leukemias are classified based on: How fast they progress (acute or chronic) Which blood cells they affect (myeloid or lymphoid) Acute myeloid leukemia (AML) is a fast-growing leukemia that affects myeloid white blood cells. Although AML is more common in adults, it can also affect children. Approximately 17% of all AML cases occur in childhood. In healthy children, the bone marrow produces immature cells called stem cells, which gradually mature into healthy blood cells. In AML, a genetic mutation disrupts this process, causing immature myeloid cells to grow uncontrollably. These abnormal cells crowd out healthy blood cells, leading to serious complications. Childhood AML can occur at any age but is most commonly diagnosed in: Children under 2 years old Teenagers Signs and Symptoms of AML in Children Children with AML may show some or many of the following symptoms. The presence of symptoms varies from child to child. Common symptoms include: High or persistent fever, sometimes following an infection Fatigue, weakness, and shortness of breath Pale skin due to anemia (low red blood cell count) Easy bruising or bleeding Skin rash Unexplained weight loss and loss of appetite Bone or joint pain, often below the ribs Frequent infections Other possible signs: Blue or purple painless lumps in the neck, armpits, groin, or abdomen Blue-green painless lumps around the eyes Persistent headaches or migraines These symptoms are not exclusive to AML, but persistent or worsening signs should always be evaluated by a doctor. Causes and Risk Factors AML is caused by genetic mutations in bone marrow cells. In most children, AML develops sporadically, without a known cause. However, certain factors increase the risk. Known risk factors include: Previous cancer treatment, especially high-dose chemotherapy or radiation therapy Exposure to tobacco or alcohol before birth Certain genetic and inherited conditions, including: Down syndrome Fanconi anemia Aplastic anemia Myelodysplastic syndrome (MDS) Li-Fraumeni syndrome Neurofibromatosis type 1 Noonan syndrome Shwachman-Diamond syndrome Ataxia-telangiectasia Diamond-Blackfan anemia Dyskeratosis congenita Having a risk factor does not mean a child will develop AML, but children with known risk factors should be monitored closely. Diagnosis of AML in Children Diagnosing AML requires several specialized tests. 1. Blood Tests Complete Blood Count (CBC) with peripheral blood smear This test measures red blood cells, white blood cells, and platelets and examines their appearance under a microscope. 2. Bone Marrow Aspiration and Biopsy A sample of liquid and solid bone marrow is taken (usually from the hipbone) and examined to confirm leukemia. 3. Lumbar Puncture (Spinal Tap) Performed to check whether leukemia has spread to the central nervous system (brain and spinal cord). 4. Specialized Laboratory Tests These tests help determine the exact AML subtype and guide treatment: Cytochemistry Flow cytometry and immunohistochemistry Fluorescent in situ hybridization (FISH) to detect chromosomal changes Treatment of AML in Children Treatment should begin as soon as possible after diagnosis. Therapy is personalized based on the AML subtype and the child’s overall health. Chemotherapy The main treatment for childhood AML, typically given in phases: Induction Phase Intensive chemotherapy to destroy as many leukemia cells as possible. Consolidation Phase Chemotherapy given in cycles to eliminate remaining cancer cells. Maintenance Phase Used in selected high-risk cases to prevent relapse. Targeted Therapy Targeted drugs attack specific genes or proteins that leukemia cells need to survive, sparing healthy cells as much as possible. Radiation Therapy Radiation is not routinely used for AML but may be needed if: Leukemia spreads to the brain or other organs Preparation is required before a bone marrow transplant Bone Marrow (Stem Cell) Transplant High-dose chemotherapy can damage the bone marrow. In such cases, a bone marrow transplant replaces damaged marrow with healthy stem cells, allowing the body to produce normal blood cells again. Key Takeaway Acute myeloid leukemia in children is a serious but treatable disease. Advances in diagnosis, chemotherapy, targeted therapy, and bone marrow transplantation have significantly improved outcomes. Early diagnosis and treatment at a specialized center are critical for the best possible prognosis.