What is liver cancer (hepatic cancer)?
Liver cancer is also known as Hepatic cancer. The liver is the very largest glandular organ in the body and performs various complex functions to keep the body free of toxins and harmful substances. It is located in the upper right part of the abdomen, just below the ribs. The liver is responsible for producing bile, a substance that helps you digest fats, vitamins, and other nutrients. This important organ also stores nutrients like glucose so you can feed yourself when you are not eating. It also breaks down drugs and toxins. When cancer develops in the liver, it destroys liver cells and interferes with the liver’s ability to function normally.
Liver cancer is generally classified as either primary or secondary. One type of liver cancer begins in the cells of the liver. Another type of liver cancer develops when cancer cells from another organ spread to the liver. Unlike other cells in the body, cancer cells break away from the primary site or where cancer started. Cells travel to other parts of the body through the bloodstream or lymphatic system. Cancer cells eventually accumulate in another organ in the body and begin to grow there.
This article focuses on primary liver cancer. If you have cancer in another organ before developing liver cancer, see our article on Liver Metastasis for more information on secondary liver cancer.
Different types of primary liver cancer?
The different types of primary liver cancer start from different cells that make up the liver. Primary liver cancer begins as a single lump that grows in the liver or begins simultaneously in several places in the liver. People with severe liver damage are more likely to have multiple sites of cancer growth. The main types of primary liver cancer are:
- Hepatocellular carcinoma: Hepatocellular carcinoma (HCC), also known as hepatoma. This is the most common type of liver cancer, accounting for 75% of all liver cancers. This condition develops in the hepatocytes, which are primarily liver cells. It spreads from the liver to other parts of the body such as the pancreas, intestines, and stomach. HCC is more likely to occur in people with severe liver damage from alcohol abuse.
- Cholangiocarcinoma: Cholangiocarcinoma, commonly known as cancer of the bile ducts, develops in the small tubular bile ducts of the liver. These vessels carry bile to the gallbladder to aid digestion. About 10 to 20 per cent of liver cancers are bile duct cancer. When cancer begins in a section of the vessels within the liver, it is called intrahepatic bile duct cancer. When cancer begins in a section of vessels outside the liver, it is called extrahepatic bile duct cancer.
- Angiosarcoma of the liver: Angiosarcoma of the liver is a rare form of liver cancer that begins in the blood vessels of the liver. This type of cancer develops very speedily, so it is commonly diagnosed at a more forward-looking stage.
- Hepatoblastoma: It is a very thin type of liver cancer. It is almost always seen in children, especially those under 3 years of age. With surgery and chemotherapy, the outlook for people with this type of cancer is much better. When hepatoblastoma is detected early, the survival rate is more than 90 per cent.
What are the symptoms of liver cancer?
Most people do not experience symptoms in the early stages of primary liver cancer.
When symptoms appear, they can include:
- Abdominal discomfort, pain, and tenderness
- Yellowing of the skin and whiteness of the eyes, also known as jaundice
- Chalk white stool
- Injury or easy bleeding
Risk factors for liver cancer
Doctors do not know why some people get liver cancer and others do not. However, there are some factors that increase the risk of liver cancer:
- Liver cancer is most common in people over the age of 50.
- Chronic hepatitis B or C infection can seriously damage your liver. Hepatitis is spread from person to person through direct contact with bodily fluids such as blood or semen from an infected person. It is also passed from mother to child during childbirth. You can reduce your risk of hepatitis B and C by wearing protection during sex. There is also a vaccine that can protect you from hepatitis B.
- Drinking two or more alcoholic drinks every day for many years increases the risk of liver cancer.
- Cirrhosis is a form of liver damage in which healthy tissue replaces scar tissue. The stained liver does not work properly and can eventually lead to many problems, including liver cancer. Chronic causes of cirrhosis in the United States include chronic alcohol abuse and hepatitis c. Most Americans with liver cancer have cirrhosis before having liver cancer.
- Exposure to aflatoxins is a risk factor. Aflatoxin is a toxin produced by a type of mould that grows on peanuts, grains, and corn. In the United States, food handling laws limit widespread exposure to aflatoxins. However, outside the country, exposure to aflatoxins is high.
- Diabetes and esophagitis are also risk factors. People with diabetes are overweight or balanced, which can cause liver problems and increase the risk of liver cancer.
How is liver cancer diagnosed?
The diagnosis of liver cancer begins with a medical history and physical exam. Be sure to tell your doctor if you have a history of chronic alcohol abuse or chronic hepatitis B or C infection.
- Liver function tests can help your doctor determine the health of your liver by measuring the levels of protein, liver enzymes, and bilirubin in your blood.
- The presence of alpha photoprotein (AFP) in the blood is a sign of liver cancer. This protein is usually made only in the liver and yolk before the baby is born. AFP production generally stops after birth.
- CT or MRI scans of the abdomen produce detailed images of the liver and other organs in the abdomen. They can allow your doctor to determine where the tumor is growing, determine its size, and assess whether it has spread to other organs.
- Another available diagnostic test is a liver biopsy. A liver biopsy involves the removal of a small piece of liver tissue. This is always done under anaesthesia to prevent pain during the procedure.
- In most cases, a needle biopsy is done. During this procedure, your doctor inserts a fine needle through your abdomen into your liver to obtain a tissue sample. The sample for signs of cancer is examined under a microscope.
- A liver biopsy can also be done with a laparoscope, which is a thin, flexible tube with an attached camera. The camera allows your doctor to see how your liver is doing and to perform a more accurate biopsy. The laparoscope is inserted in the abdomen. If tissue samples from other organs are needed, your doctor will make a large incision. This is called a laparotomy.
- If liver cancer is found, your doctor will determine the stage of cancer. Staging describes the severity or extent of cancer. This will help your doctor determine your treatment options and prognosis. Stage 4 is a very advanced stage of liver cancer.
How is liver cancer treated?
Treatment for liver cancer varies. It depends on:
- Number, size, and location of tumors in the liver.
- How well the liver works
- If there is cirrhosis
- Whether the tumor has spread to other organs.
Your specific treatment plan depends on these factors. Treatments for liver cancer may include the following:
- Hepatectomy: A hepatectomy is done to remove part or all of the liver. This surgery is normally done when the cancer is close to the liver. Over time, the remaining healthy tissue grows back and replaces the missing part.
- Liver transplant: In a liver transplant, the entire diseased liver is replaced with a healthy liver from a suitable donor. Transplantation can only be done if cancer has not spread to other organs. Medications are given after the transplant to prevent rejection.
- Ablation: Ablation Using injections of heat or ethanol to kill cancer cells. This is done under local anaesthesia. This will senseless the area so you don’t feel any pain. Ablation can assistance people who are not persons for surgery or transplantation.
- Chemotherapy: Chemotherapy is an aggressive form of drug therapy that kills cancer cells. Medications can be injected intravenously or intravenously. In most cases, chemotherapy can be given as a treatment for the patient. Chemotherapy is effective in treating liver cancer, but many people experience side effects during treatment, such as vomiting, loss of appetite, and chills. Chemotherapy also increases your risk of infection.
- Radiotherapy: It involves the use of high-energy radiation beams to kill cancer cells. It can be given by external or internal beam radiation. In external beam radiation, radiation is aimed at the abdomen and chest. A catheter is used to inject small radioactive spheres into the hepatic artery during internal radiation. The radiation then destroys the hepatic artery, the blood vessel that supplies blood to the liver. This reduces the amount of blood that flows to the tumor. When the hepatic artery closes, the portal vein continues to nourish the liver.
- Targeted therapy: Targeted therapy involves the use of drugs designed to kill cancer cells. These slow the growth of tumors and help shut off the blood supply to the tumor. Sorafenib (Nexavar) is approved as a targeted treatment for people with liver cancer. Targeted treatment can help people who are not candidates for a hepatectomy or liver transplant. However, targeted treatment can cause significant side effects.
- Embolization and chemo embolism: Surgical procedures for embolization and chemoembolization. They are done to block the hepatic artery. Your physician will use tiny sponges or other materials to do this. This reduces the amount of blood that flows to the tumor. In chemotherapy, your doctor injects chemotherapy drugs into the hepatic artery before injecting the cells. The blockage created keeps the chemotherapy drugs in the liver for a long time.
Prevention of liver cancer
Hepatic cancer cannot always be prevented. However, taking steps to prevent the development of conditions that can lead to hepatic cancer can lower your risk of hepatic cancer.
Get the hepatitis B vaccine
There is a vaccine for hepatitis B that all children should receive. Intravenous drug abusers should also be vaccinated against adults who are at increased risk of infection. The vaccine is usually given as a series of three injections every six months.
Take steps to prevent hepatitis C
There is no vaccine for hepatitis C, but you can reduce your risk of infection by doing the following:
- Wear protection: Always practice safer sex with all your sexual partners by using condoms. You should never have unprotected sex unless you know your partner is infected with hepatitis or other sexually transmitted infections.
- Don’t use illegal drugs: Avoid the use of illicit drugs, especially heroin or cocaine. If you can’t stop using drugs, be sure to use a clean needle every time you inject them. Never share needles with other people.
- Be careful with tattoos and piercings: Go to a reputable store whenever you get a piercing or tattoo. Ask employees about their safety practices and make sure they are using clean needles.
Reduce the risk of cirrhosis
You can reduce your risk of cirrhosis by doing the following:
- If you drink alcohol, drink in moderation: Control the amount of alcohol you drink can help prevent liver damage.
- Keep a healthy weight: Exercising for 30 minutes at least three times a week can help you maintain your weight. Eating a balanced diet is also very important for weight control. Make sure to include lean protein, whole grains, and vegetables or fruits in your meal. If you want to lose weight, increase the amount of exercise you do each day, and reduce the number of calories you eat. You may also consider meeting with a nutritionist. They help you create an eating plan and exercise routine that will allow you to reach your weight loss goals more quickly.
If you already have one of these conditions and are concerned about your risk for hepatic cancer, talk to your doctor about hepatic cancer screening.
Fight against liver cancer
The diagnosis of liver cancer is high. It is important to have a strong support network that can help you deal with any stress or anxiety you may be experiencing. You may want to speak with a counsellor who can help you work through your emotions. You may also consider joining a cancer support team where you can discuss your problems with others. You can also find information about support groups on the websites of the Trusted Source of the National Cancer Institute and the American Cancer Society.