Liver Cancer

What is liver cancer?

Liver cancer is a growth of abnormal cells in the liver. The abnormal (cancerous) cells are able to invade surrounding liver tissue and to spread (metastasize) to other parts of the body. The abnormal growth is called a tumor.

The liver is one of the largest organs of the body and a very important part of the body.

• It helps the body get rid of harmful substances.
• It makes bile, which helps your body digest fats.
• It stores sugar, which the body uses for energy.
• It makes many proteins, which are the building blocks for all cells in the body.

There are 2 types of cancer in the liver: primary and secondary (metastatic). Primary liver cancer starts from cells in the liver. Secondary liver cancer starts in another part of the body and then spreads to the liver.

The 2 most common forms of primary liver cancer are:

• hepatoma, which usually happens if you have cirrhosis and hepatitis B or C infection
• cholangiocarcinoma, a rare tumor that develops in bile duct cells.

Secondary liver cancer is much more common in the US than primary liver cancer. Cancers that most often spread to the liver come from the lungs, breasts, or large intestine. Cancers from many other organs can also spread to the liver.

How does it occur?

Cancer in the liver usually spreads from a cancer that starts in another part of the body.

The exact cause of cancer that starts in the liver is usually not known. However, the risk of primary liver cancer is increased if:

• You have chronic hepatitis B or C infection.
• Your liver is scarred (a problem called cirrhosis). Cirrhosis is most often caused by alcohol abuse. Less often it is caused by an autoimmune disease called primary biliary cirrhosis; by having too much iron in the body, as in a disease called hemochromatosis; or by having excess fat stored in the liver called steatohepatitis.
• You have been exposed to vinyl chloride and arsenic at your workplace.
• You have used anabolic steroids (male hormones) for a long time (slightly increases the risk).

What are the symptoms?

Signs and symptoms of liver cancer are:

• pain or discomfort on the right side, especially in the upper belly or around the right shoulder blade
• a hard lump on the right side just below the rib cage
• unexplained weight loss
• loss of appetite
• fever
• swollen belly
• jaundice (yellowing of the skin and whites of the eyes).

How is it diagnosed?

Your healthcare provider will ask about your symptoms and health history. You will have a physical exam.

Tests you may have are:

• blood tests, including tests that check how well the liver is working
• ultrasound, MRI, or CT scan of the liver
• laparoscopy (a surgical procedure to look at the organs inside the belly)
• liver biopsy (the removal of cells or tissues for testing, which may be done during a laparoscopy or with a needle inserted through your skin and into the liver).

How is it treated?

The treatment depends on if the cancer is primary or secondary and how much it has grown or spread.

Possible treatments are:

• surgery to remove the tumor, which means that part of the liver is removed
• chemotherapy, which uses anticancer drugs to kill cancer cells and shrink tumors
• high-energy radio waves (radio frequency ablation)
• freezing with a cold probe
• injecting alcohol or drugs into the tumor to destroy the tumor
• injecting small particles into the liver artery to block blood flow to the tumor (a procedure called embolization)
• injecting an anticancer drug (chemotherapy) into the liver artery, followed by injection of particles to block blood flow to the tumor (a procedure called chemoembolization)
• liver transplant if the cancer is a hepatoma or cholangiocarcinoma.

How long will the effects last?

The effects of liver cancer depend on how long and fast the tumor has been growing, when it was found, and when treatment started. How old you are and if you have other health problems also affect your chances of survival. If a liver tumor (hepatoma or cholangiocarcinoma) is found at an early stage, surgery may cure it. However, surgery may not be a good option if the tumor is large, your liver is not working well, or you have cirrhosis.

The more the cancer has spread before it is found, the less the chance for cure.

How can I take care of myself?

• Be sure you understand the treatments your healthcare provider recommends. Ask questions and talk about your concerns with your provider.
• Take the medicines suggested for nausea and vomiting if you are having these side effects from your treatment.
• If possible, join a support group for cancer patients to help you during your illness.
• Contact national and local self-help organizations such as:
  • American Cancer Society, Inc.
    Phone: 800-ACS-2345 (800-227-2345)
    Web site: http://www.cancer.org
  • AMC Cancer Research Center and Foundation
    Phone: 800-525-3777
    Web site: http://www.amc.org
  • Cancer Information Service
    Phone: 800-4-CANCER (800-422-6237)
    Web site: http://www.cancer.gov/aboutnci/cis
• Try to keep a hopeful and positive outlook throughout your treatment and recovery.

What can be done to help prevent liver cancer from spreading or recurring?

You may be able to lower the likelihood of spread or recurrence of liver cancer by following these guidelines:

• See your healthcare provider right away if you notice any new or returning symptoms.
• Avoid alcohol.
• Eat small, frequent, healthy meals throughout the day. Take vitamin and mineral supplements with iron, folic acid, and thiamine, if recommended by your provider.
• Exercise according to your healthcare provider's recommendations.
• Don’t use illegal drugs.