What is liver cancer?
Cancer in the liver can occur because of spread from a cancer located elsewhere in the body (known as metastatic cancer) or because cells in the liver itself become cancerous (known as primary cancer of the liver). While metastatic cancer in the liver is far more common than primary cancer, each year primary liver cancer is diagnosed in about 15,000 men and 6,000 women in the United States (Source: NCI).
This article will focus on primary liver cancer, or cancers that develop in the liver. Other names for this cancer is hepatocellular cancer and hepatoma. Scarring, or cirrhosis, of the liver is one of the main risk factors for the development of liver cancer. Chronic infection with hepatitis B or C is another risk factor for hepatocellular cancer.
The liver, which mostly rests under the ribs on the right side of the body, produces substances that aid in digestion as well as other substances required for body function. The liver also removes toxins from the blood. Symptoms of liver cancer can include pain or fullness in the right upper abdomen, yellowing of the skin and whites of the eyes (jaundice), unexpected weight loss, night sweats, and easy bruising.
When caught early, surgical removal of the cancer has the potential to offer a cure for liver cancer. Liver transplant may be needed if a large portion of the liver needs to be removed.
Among the functions of the liver is the production of factors required for blood clotting. If the amount of these factors drops too low, bleeding, including internal bleeding, may occur easily. Seek immediate medical care (call 911) for severe symptoms, such as heavy bleeding, severe sweating, difficulty breathing, pale or blue lips and fingernails, rapid heart rate (tachycardia), confusion, loss or change in level of consciousness, or vomiting blood.
Seek prompt medical care if you have experienced unexpected weight loss, night sweats, easy bleeding, jaundice, or a sense of fullness in the abdomen.
What are the symptoms of liver cancer?
Cancer of the liver can cause it to become larger and can interfere with some of its vital functions. Liver enlargement may cause a sense of fullness or pain in the abdomen. Yellowing of the skin and eyes (jaundice) and easy bleeding are both symptoms that may signal impairment of liver function. Symptoms of liver cancer can be progressive, worsening over time.
Common symptoms of liver cancer
Common liver cancer symptoms include:
- Abdominal pain or fullness, especially in the right upper abdomen
- Dark urine
- Easy bleeding or bruising
- Enlarged liver
- Generalized muscle weakness and reduced muscle mass
- Night sweats
- Pale stool
- Swelling and fluid collection in the abdomen (ascites)
- Unexplained weight loss
- Yellowing of the skin and whites of the eyes (jaundice)
Serious symptoms that might indicate a life-threatening condition
In some cases, liver cancer can be life threatening, especially if internal bleeding or liver failure should occur. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:
- Bloody stool (the blood may be red, black, or tarry in texture)
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
- Chest pain, chest tightness, chest pressure, palpitations
- Rapid heart rate (tachycardia)
- Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing
- Severe abdominal pain
- Uncontrolled or heavy bleeding, hemorrhage
- Vomiting blood
What causes liver cancer?
While the specific cause of liver cancer is not known, liver cirrhosis, or scarring, is associated with the vast majority of cases. In the United States, the most common cause of liver cirrhosis is chronic alcohol use or abuse, although cirrhosis due to other chronic diseases can occur. Hepatitis B or C viral infections are also associated with liver cancer, even when cirrhosis is not present. Other risk factors have also been identified.
Although hepatitis B and hepatitis C infections are both contagious, liver cancer is not. Hepatitis B and C infections are primarily spread through sharing needles for drug use and sharing personal care items or having sexual contact with an infected person.
What are the risk factors for liver cancer?
A number of factors increase the risk of developing liver cancer. Not all people with risk factors will get liver cancer. Risk factors for liver cancer include:
- Advanced age
- Alcohol use
- Cirrhosis (scarring) of the liver from any cause
- Conditions that cause excess iron accumulation in the blood
- Exposure to a mold toxin known as aflatoxin
- Hepatitis B or C viral infections
- Male gender
- Occupational exposure to vinyl chloride
- Wilson’s disease, a genetic disorder that causes iron buildup in the liver
Reducing your risk of liver cancer
You may be able to lower your risk of liver cancer by:
- Aggressive medical management of viral hepatitis
- Avoiding sharing needles
- Avoid exposure to know liver toxins (vinyl chloride)
- Getting vaccinated against hepatitis B
- Maintaining a healthy weight
- Reducing alcohol consumption
- Using safer-sex methods
How is liver cancer treated?
Goal of cancer treatment
The goal of liver cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.
It is important to continue regular visits with your medical care team so that progression or recurrence can be identified early and to watch for and treat any complications that might result from the disease or its treatments.
Common treatments for liver cancer
Several different therapies are available to treat liver cancer including:
- Ablation using different techniques to destroy cancer cells
- Chemotherapy to attack cancer cells
- Cryosurgery to freeze and destroy cancer cell
- Embolization to block blood flow to the tumor by injecting a substance into an arter
- Liver transplantation in selected patients
- Participation in a clinical trial testing promising new treatments for liver cancer
- Radiation therapy to attack cancer cells
- Surgery to remove the cancer
- Targeted therapy to attack cancer cells
Some complementary treatments may help some people to better deal with liver cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.
Complementary treatments may include:
- Massage therapy
- Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
In cases in which liver cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.
What are the potential complications of liver cancer?
Complications of untreated liver cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of liver cancer include:
- Adverse effects of anticancer treatment
- Bleeding esophageal varices (life-threatening rupture and hemorrhage of swollen veins in the esophagus)
- Internal bleeding
- Liver failure
- Spread of cancer