Liver cancer is cancer that begins in the tissues of the liver, though it may also result from cancer spreading to the liver from other parts of the body. Liver cancer is the fourth most common form of cancer in the world, accounting for 610,000 deaths each year, according to the World Health Organization.
The rates of hepatocellular carcinoma (HCC), the most common type of liver cancer, have increased by 3.5 percent annually in the United States to 3.2 cases per 100,000 people in 2006, according to 2010 data from the Centers for Disease Control and Prevention. Overall, the National Cancer Institute estimates that there will be 24,120 new cases of liver cancer and 18,910 deaths resulting from liver cancer in the United States. Hepatitis and cirrhosis can both increase the risk of liver cancer.
Most people in the early stages of primary liver cancer do not experience any signs or symptoms, according to the Mayo Clinic. However, symptoms, if they do appear, can include a hard lump or pain on the right side of the abdomen, abdominal swelling, loss of appetite, unexplained weight loss, nausea and jaundice.
Diagnosis & Tests
Physicians conducting routine physical examinations may be able to detect an enlarged, tender liver, and they can further confirm their findings through abdominal ultrasound and CT scans, according to the National Institutes of Health. However, enlarged liver and abnormal liver function can be indicative of other liver diseases and the doctor will need to narrow down the diagnosis by performing further tests. Laparoscopy, a surgical procedure where a thin, lighted scope is inserted into the abdomen through a small incision, allows the physician to visually examine the organ for any physical signs of disease, according to the National Cancer Institute. A liver biopsy, where a sample of the liver tissue is removed and examined for abnormal growth, may be performed during the laparoscopy.
If the patient is diagnosed with liver cancer, further tests might need to be done to see if the cancer has spread to other parts of the body.
Treatments & Medications
In addition to various treatments currently being studied in clinical trials, the common treatments available to combat liver cancer are surgery, radiation therapy and chemotherapy. The type of treatment will depend on the type and the stage of cancer being treated, according to the National Cancer Institute.
For patients with early-stage liver cancer, surgery may involve a partial hepatectomy, where the diseased portion of the liver is removed, or liver transplant surgery, where the entire diseased liver is removed and replaced. However, surgery may not be the appropriate course of action for those who have cirrhosis or have too much damaged tissue, according to the Mayo Clinic.
External radiation therapy, which is the more common form of radiation therapy, uses X-rays or other high-energy rays to kill cancer cells and shrink tumors, according to the National Cancer Institute. There’s also internal radiation therapy, where the radioactive substance is sealed in needles, wires, or catheters and then placed at a spot close to the tumor.
Chemotherapy uses drugs to kill or temporarily slow the growth of cancer cells. The drug can be released through an implanted pump or injected into a vein or the hepatic artery to deliver a high concentration of the drugs directly to cancer cells in the liver, according to the National Cancer Institute.
Chronic hepatitis B and hepatitis C infections account for approximately 78 percent of hepatocellular carcinoma (HCC) worldwide, according to the CDC. Vaccinations against hepatitis B have proven to be an effective way to prevent HCC. Although there is no vaccine against hepatitis C yet, one can still reduce the risk of infection by avoiding IV drugs, practicing safe sex and only getting tattoos and piercings from clean, reputable shops, according to the Mayo Clinic.
High-risk patients with chronic hepatitis B and C infections or cirrhosis should be screened for HCC once or twice a year, according to a 2008 review published in the journal Gastroenterology. Screening usually involves an abdominal ultrasound to detect any physical anomalies, and blood tests to monitor for elevated levels of alpha-fetoprotein, a protein that’s usually produced by the fetus, but can signal the presence of HCC if it’s found in adults. Randomized trials have shown that regular surveillance of hepatitis B patients can reduce HCC-related deaths by 37 percent, according to the Gastroenterology review.