Liver Cancer - Summary, Symptoms, Treatments

What is liver cancer?

The liver is the body’s largest internal organ and one we cannot live without due to its many important functions. It is shaped like a cone and located beneath the rib cage in the upper right part of the belly. Liver cancer occurs when cells begin to grow out of control. The most common form of liver cancer is hepatocellular carcinoma (HCC), which begins in the main liver cells called hepatocytes.
 
Cancer that begins in another area of the body, such as the colon, breast, pancreas or lungs, and spreads to the liver is much more common than cancer that begins in the liver cells (primary liver cancer). The liver is a frequent site for metastases (spread of cancer cells) because it filters a large volume of blood and is rich in nutrients that can support tumor growth.
 
Liver cancer is among the most common cancers worldwide and occurs about three times more often in men than in women. Primary liver cancer occurs most often in adults age 60+ and the risk increases with age. Liver cancer in children is uncommon. It is also more common in American Indians and Alaskan Natives.

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What are the signs and symptoms of liver cancer?

The following can indicate liver cancer:
 

• Pain at the top right of the abdominal area, near the right shoulder blade or in the back
• A hard lump under the ribs on the right side of the body
• Unexplained weight loss
• Fatigue or weakness
• Jaundice, yellowing of the skin or eyes

Talk with your health care provider if you experience any of these.

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How is liver cancer diagnosed?

Diagnosing liver cancer begins with a physical examination and discussion of the person’s health history to evaluate the symptoms. Blood tests can measure levels of alpha-fetoprotein, measure how well the liver is working and test for hepatitis B or C infection. If these test results indicate cancer, specialized imaging tests, such as ultrasound, computed tomography scans (CT scans) and/or magnetic resonance imaging scans (MRI scans) produce highly detailed, 3D images and can help to make an accurate diagnosis. If any abnormal areas are seen, a small sample of tissue (known as a biopsy) can be taken during this procedure for examination under a microscope to confirm that cancer is present.

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What causes liver cancer?

A number of risk factors are associated with liver cancer, including:
 

• Chronic hepatitis B or C viruses damage liver cells over time. Long-term infection leads to inflammation, scarring (cirrhosis) and mutations. Worldwide, hepatitis B is the leading cause of liver cancer.
• Long-term alcohol abuse can lead to an accumulation of extra fat in the liver (fatty liver), alcoholic hepatitis and cirrhosis, which significantly increases liver cancer risk.
• Fat buildup in the liver, often linked to obesity, diabetes and metabolic syndrome, can lead to cancer.

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Is liver cancer genetic?

Most liver cancers are not inherited. It is best to discuss any potential genetic predisposition with your doctor.
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Is liver cancer curable?

Liver cancer can be curable, especially when it is caught early and the liver is still functioning well. The earlier liver cancer is found, the better the chances are for a more positive outcome.
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How is liver cancer treated?

Different types of liver cancer respond differently to different types of treatment. Treatment options for liver cancer depend on a number of factors, including the specific type and stage of cancer, possible side effects, and the patient’s overall health and personal preference. Each patient and each cancer is unique. At FCS, physicians develop a personalized treatment plan in partnership with patients.
 
Treatment options for liver cancer include:

• Surgery to remove the tumor from the liver.
• Radiation therapy to shrink or destroy tumors.
• A growing number of targeted therapies are used to disrupt the pathways for growth of cancer cells.
• Immunotherapies help the body’s own immune system recognize and attack cancer cells and may be used alone or in combination with other treatments.

When liver cancer is detected early, treatment aims to cure the disease and minimize long-term symptoms and side effects. Participation in clinical trials for new therapies or combinations of treatments can be an option, especially for advanced stages of cancer.

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Are there screening tests for liver cancer?

There are screening tests for liver cancer, but they are generally recommended only for people at high risk. Adults with certain chronic conditions, including hepatitis infection or cirrhosis or other risk factors, should talk with their doctor about regular screenings for liver cancer. Screening options include blood testing for alpha-fetoprotein, a substance that may be produced by cancer cells, as well as imaging tests, such as ultrasound, CT/CAT scans or magnetic resonance imaging. Early detection increases the chance of successful treatment.

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