Liver Cancer

What is liver cancer?

Liver cancer is an abnormal growth of cells in the liver. Often 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 produces 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. Primary liver cancer starts from cells in the liver. The 2 most common forms of primary liver cancer are:

• hepatoma, which is usually associated with cirrhosis and hepatitis B or C infections
• cholangiocarcinoma, a rare tumor developing in bile duct cells.

Cancer in the liver is called secondary when a cancer starts in another part of the body and spreads to the liver. The secondary type is much more common in the US than primary liver cancer. The most common body areas where cancer starts and then spreads to the liver are the lungs, breasts, and large intestine.

How does it occur?

Cancer in the liver is usually the secondary type and caused by the spread of cancer from another part of the body.

The exact cause of cancer that starts in the liver (primary cancer) is usually not known. Medical problems that seem to increase the risk of primary liver cancer are:

• chronic hepatitis B and C infections
• scarring of the liver (cirrhosis), which most often results from alcohol abuse and less often by having too much iron in the body, as in a disease called hemochromatosis.

Also, long-term use of anabolic steroids (male hormones) can slightly increase the risk of liver cancer. Exposure to vinyl chloride and arsenic is rare but these chemicals can increase the risk.

What are the symptoms?

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
• jaundice (yellowing of the skin and whites of the eyes).

How is it diagnosed?

To diagnose liver cancer, your healthcare provider will ask about your symptoms and health history. You will have a physical exam.

Your provider may also order these tests:

• blood tests, including tests that check how well the liver is working
• ultrasound, radionuclide scan, 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 may mean that part of the liver is also removed
• chemotherapy, which uses anticancer drugs to kill cancer cells and shrink tumors (It may be given by mouth, by vein, or directly into the hepatic artery.)
• high-energy radio waves (radio frequency ablation)
• freezing with a cold probe
• injecting alcohol or drugs into the tumor to destroy the tumor
• liver transplant if the cancer is a hepatoma.

How long will the effects last?

The effects of liver cancer depend on how long and fast the tumor has been growing and when it was found and when treatment started. How old you are and if you have other health problems are also important. If a liver tumor (hepatoma) 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 chance for cure. Survival after diagnosis is often only several months but may be longer.

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 suggested medicines for nausea and vomiting to help with possible side effects of cancer-fighting treatments.
• 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://cis.nci.nih.gov
• Maintain 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 reduce the likelihood of spread or recurrence of liver cancer by following these guidelines:

• See your healthcare provider right away if you notice a return of any previous symptoms or develop any new ones.
• Avoid alcohol.
• Eat small, frequent, well-balanced meals throughout the day. Take vitamin and mineral supplements with iron, folic acid, and thiamine, if recommended by your provider.
• Make sure that restaurants and grocery stores where you buy food, and areas where you prepare food, are safe and clean.
• Exercise according to your healthcare provider's recommendations.
• Do not use illegal drugs.