Liver cancer is a type of cancer that originates in your liver cells. Your liver, an organ about the size of a football, is in the upper right side of your abdomen, above your stomach and below your diaphragm. It assists with digestion and detoxification.
Types of liver cancer
Primary liver cancer is a malignant tumor that originates in the liver. There are several types:
- Hepatocellular carcinoma (HCC) or hepatoma is the most prevalent form of primary liver cancer, and it begins in the liver’s major cell type, the hepatocytes.
- Intrahepatic cholangiocarcinoma, also known as bile duct cancer, begins in the lining cells of the bile ducts (which connect the liver to the bowel and gall bladder).
- Angiosarcoma is a cancer that originates in blood vessels. This is an uncommon form of liver cancer affecting adults over 70.
Secondary liver cancer begins in another place in the body but spreads to the liver. It is named after the initial place where it originated, such as colon cancer with secondary liver sites.
Liver cancer has a 19% five-year survival rate.
Liver cancer symptoms
Liver cancer may not show any visible or palpable signs in its early stages. However, when the disease spreads, individuals may have one or more of these typical signs. It’s crucial to keep in mind that these symptoms might be caused by other medical issues. Consult your physician if you have any of the following sings:
- Tenderness on the right side of the upper abdomen.
- Back pain or discomfort near the right shoulder blade.
- Abdominal edema is brought on by an accumulation of fluid (ascites).
- A firm mass immediately below the ribs on the right side.
- Jaundice (yellowing of the skin and whites of the eyes).
- Easy bleeding or bruising.
- Unusual weakness and tiredness.
- Fever.
- Loss of weight for unknown reasons.
- Nausea and vomiting.
Liver cancer causes
Liver cancer develops when liver cells’ DNA undergoes alterations (mutations). DNA is the genetic code that each cell in your body uses to carry out all its chemical processes. These instructions vary because of DNA mutations. One outcome is that cells might start to proliferate out of control and subsequently form a tumor, which is a collection of malignant cells.
It’s sometimes possible to determine liver cancer causes, such as chronic hepatitis infections. However, it occasionally affects people who have no underlying diseases, and its exact etiology is unknown.
Risk factors
The following factors increase the chance of primary liver cancer:
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Chronic infection with B or C virus (HBV or HCV).
A chronic hepatitis B or C virus infection raises your chance of developing liver cancer.
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Cirrhosis.
Your risk of developing liver cancer grows because of this untreatable, progressive disorder that makes scar tissue accumulate in your liver.
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Inherited liver diseases.
Hemochromatosis and Wilson’s disease are two liver conditions that can raise the risk of developing liver cancer.
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Diabetes.
The chance of liver cancer is higher in those suffering from this blood sugar issue than in people without diabetes.
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Non-alcoholic fatty liver condition.
Fat accumulation in the liver raises the chance of liver malignancy.
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Exposure to aflatoxins.
Aflatoxins are poisons that are created by mold on crops that have been improperly stored. Aflatoxin contamination of crops, including grains and nuts, can lead to aflatoxins appearing in meals prepared from these ingredients.
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Excessive alcohol consumption.
Drinking large amounts of alcohol every day for a long period of time might cause irreversible liver damage and raise your risk of liver cancer.
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Being obese or being overweight.
Liver cancer diagnosis
Tests to identify both primary and secondary liver cancers include:
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Blood tests.
Blood tests can examine your blood clotting capacity, liver function, the presence of hepatitis B or C, genetic issues, and specific substances known as tumor markers.
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Ultrasound.
Ultrasound is the most often used tool for detecting primary liver cancer. It creates images of the liver and can identify the amount and location of diseased tissue in your liver.
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CT scan.
CT scans create three-dimensional images of many organs simultaneously and can help surgeons in planning procedures. It can also detect the spread of the disease.
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MRI.
An MRI scan can show the amount of a tumor and if it has affected the major blood vessels around the liver by creating comprehensive cross-sectional images of the body.
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PET-CT scan.
PET-CT scans generate three-dimensional, colored pictures that indicate the location of any tumors in the body and are more frequently employed for secondary tumors in the liver.
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Biopsy.
A biopsy is the removal of a small sample of tissue for microscopic analysis.
A biopsy can be performed using either fine needle aspiration, which uses local anesthesia and a small needle to extract the cells, or laparoscopy, which is performed while the patient is under general anesthesia and enables the physician to view the liver and adjacent organs as well as collect tissue samples.
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Other tests.
If you have secondary liver cancer, you might need further testing to determine where the primary cancer developed if this was not previously known.
Liver cancer stages
Stages of hepatocellular carcinoma include the following:
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Stage I (very early stage) or Stage 0:
You have a solitary liver tumor less than 2 centimeters in size. You have normal bilirubin levels, according to blood testing.
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Stage II (early stage) or Stage A:
You have one tumor that is 5 cm or smaller or many tumors that are each 3 cm or smaller. Your blood vessels may have become affected by the tumor.
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Stage III (intermediate stage) or Stage B:
You could have more than one tumor at this stage, as well as one that is larger than 5 cm. Your lymph nodes, major blood vessels, or another organ might have been affected by the tumor’s spread.
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Stage IV (advanced stage) or Stage C:
Cancer has metastasized to other areas of your body, including your lungs, bones, and lymph nodes.
Treatment of liver cancer
Primary liver cancer treatments are determined by the severity (stage) of the condition, your age, general health, and personal preferences.
Surgery
The following methods are used to treat liver cancer:
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Surgery to remove the tumor.
If your tumor is tiny and the liver function is excellent, your doctor may, in certain cases, advise a method to eliminate the liver cancer and a small part of the healthy liver tissue that surrounds it.
Whether this is a choice for you also depends on where the cancer is located, how effectively your liver works, and how healthy you are in general.
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Liver transplant surgery.
The damaged liver is removed through a liver transplant procedure and replaced with a healthy one from a donor. Only a limited number of patients with early-stage liver cancer have the option of undergoing liver transplant surgery.
Localized treatments
Localized liver cancer therapies are those that are given specifically to the cancer cells or the region around the cancer cells. Options for localized liver cancer treatments include:
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Heating cancer cells.
Electric current is used in radiofrequency ablation to heat and kill cancer cells. The doctor makes a few tiny incisions in your belly and places one or more fine needles using an imaging test, like an ultrasound, as a guide. When the needles get close to the tumor, an electric current heat them up, killing the cancer cells. Lasers or microwaves may be used in further treatments to heat the cells of the cancer.
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Freezing cancer cells.
Extreme cold is used in cryoablation to kill cancer cells. Your doctor will use a tool called a cryoprobe during the surgery to apply liquid nitrogen straight to liver tumors. To direct the cryoprobe and track the freezing of the cells, ultrasound pictures are employed.
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Chemotherapy drugs are injected into the liver.
Chemoembolization is a form of chemotherapy in which potent anti-cancer medications are injected directly into the liver.
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Alcohol injection into the tumor.
Pure alcohol is injected into tumors, during alcohol injection, either via the skin or through surgery. Alcohol results in the death of malignant cells.
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Placing beads filled with radiation in the liver.
The liver can be implanted with tiny radiation-containing spheres that can deliver radiation directly to the tumor.
Radiation therapy
This therapy shrinks tumors by destroying cancer cells with a powerful energy from sources like protons and X-rays. The energy is carefully directed toward the liver, while the surrounding healthy tissue is spared.
If alternative treatments are not possible or have not worked, radiation therapy may be a possibility. Radiation treatment may help manage the symptoms of advanced liver cancer.
A stereotactic body radiotherapy is a special form of radiation treatment that involves directing several radiation beams simultaneously to a single location on your body.
Targeted drug therapy
Targeted medication therapies concentrate on certain defects that are prevalent in cancer cells. Targeted medication therapies can kill cancer cells by preventing these mutations.
Many targeted medications are available to manage advanced liver cancer.
Many targeted treatments are only effective in patients whose cancer cells carry certain genetic abnormalities. In a lab, the cancer cells may be examined to determine if these medications are beneficial.
Immunotherapy
Your immune system is used in immunotherapy to fight cancer. Because cancer cells synthesize proteins that make immune system cells blind, your body’s immune system may fail to combat your cancer. Immunotherapy must affect that process to work.
Advanced liver cancer patients are often the only ones who receive immunotherapy therapies.
Chemotherapy
Drugs are used in chemotherapy to destroy rapidly proliferating cells, especially cancer cells. Chemotherapy can be given orally, intravenously, or both ways through a vein in the arm.
Advanced liver cancer is usually treated with chemotherapy.
Palliative (supportive) care
Palliative care is a form of specialized medical treatment that concentrates on relieving pain and other severe disease symptoms. Specialists in palliative care collaborate with you, your loved ones, and your other medical professionals to add an extra layer of support to your continuing treatment. While receiving more invasive therapies like surgery, radiation therapy, or chemotherapy, supportive care can be employed.
Patients with cancer may feel better and survive longer when supportive care is utilized in addition to all other necessary therapies.
Prevention of liver cancer
The following strategies can help you reduce your risk of developing liver cancer:
- Get a Hepatitis B vaccination. All newborns should take the Hepatitis B vaccination, and adults who may be at higher risk should also receive it.
- Get checked for hepatitis C, and if you do, get treatment.
- Maintain a healthy weight.
- Avoid smoking or stop if you do.
- Aim to limit your alcohol consumption.