What Is Liver Cancer?

The liver continually filters the blood circulating through the body, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. The liver performs many other important functions, such as removing toxins and other waste chemicals from the blood and preparing them for excretion. Because all the blood in the body must pass through it, the liver is unusually accessible to cancer cells that travel through the bloodstream.

Types of liver cancer
Primary liver cancer is cancer that begins in liver tissue. There are two main types of primary liver cancer: hepatocellular carcinoma and cholangiocarcinoma (cancer of the bile ducts). Secondary metastatic liver cancer occurs when cancer spreads to the liver from other parts of the body.

Hepatocellular Carcinoma
Hepatocellular carcinoma, the formation of cancer cells in liver tissues, is the most common type of liver cancer. Fibrolamellar hepatocellular carcinoma (CCHF) is an extremely rare form of this disease. Fibrous bands along the tumor cells help doctors diagnose CCHF.

Cholangiocarcinoma (bile duct cancer)
Cholangiocarcinoma is a liver cancer that occurs in the ducts that drain bile from the liver to the small intestine. It is a rare form of primary liver cancer.

Metastatic liver cancer

Metastatic liver cancer is secondary cancer. It occurs when cancer cells have spread to the liver from other parts of the body.Doctors refer to this secondary liver cancer as the same type of cancer as primary cancer. For example, if colorectal cancer spreads to the liver, the cancer cells in the liver are colorectal cancer cells. Doctors call this metastatic colorectal cancer, not liver cancer.

The most common types of liver metastases are:

• Colorectal cancers

• Gastrointestinal cancers

• Melanoma

What are the symptoms of liver cancer?

Many 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 whites of the eyes, which is called jaundice

•  white and chalky stools

• nausea

• vomiting

• bruising or bleeding easily

• weakness

Who is at risk for liver cancer?

Doctors are not sure why some people get liver cancer and others do not. However, certain factors are known to increase the risk of developing liver cancer:

• Liver cancer is more common in people over 50 years of age.

• A long-term infection with hepatitis B or C can seriously damage your liver. Hepatitis is spread from person to person through direct contact with an infected person's body fluids, such as their blood or semen. It can also be passed from mother to child during childbirth. You can lower your risk of getting hepatitis B and C by wearing protection during sex. There is also a vaccine that can protect you against hepatitis B.

• Drinking two or more alcoholic drinks every day for many years increases your risk of liver cancer.

• Cirrhosis is a form of liver damage in which healthy tissue is replaced by scar tissue. A scarred liver cannot function properly and can ultimately lead to numerous complications, including liver cancer. Long-term alcohol abuse and hepatitis C are the most common causes of cirrhosis in the United States. Most Americans with liver cancer have cirrhosis before developing liver cancer.

• Exposure to aflatoxins is a risk factor. Aflatoxin is a toxic substance produced by a type of mold that can grow on peanuts, grains, and corn. In the United States, food handling laws limit widespread exposure to aflatoxins. However, outside the country, exposure to aflatoxins can be high.

• Diabetes and obesity are also risk factors. People with diabetes tend to be overweight or obese, which can cause liver problems and increase the risk of liver cancer.

How is liver cancer diagnosed?

Tests and procedures used to diagnose liver cancer include:

•Blood test. Blood tests can reveal abnormalities in liver function.

• Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, a CT scan, and an MRI.

• Removing a sample of liver tissue for analysis. Sometimes it is necessary to remove a piece of liver tissue for laboratory tests to make a definitive diagnosis of liver cancer.

During a liver biopsy, your doctor inserts a fine needle through your skin and into your liver to obtain a tissue sample. In the laboratory, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries the risk of bleeding, bruising, and infection.

Determine the extent of liver cancer.

Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CT scans, MRI scans, and bone scans.

There are different staging methods for liver cancer. For example, one method uses the Roman numerals I through IV and another uses the letters A through D. Your doctor uses the stage of your cancer to determine your treatment options and prognosis.

Liver Biopsy
In a percutaneous liver biopsy, the doctor inserts a needle through the skin in the upper abdomen to take a small piece of liver tissue.

It is one of the most common type of liver biopsy and is performed routinely. Generally doctors may perform an external ultrasound link or computed tomography (CT) scan to make sure the needle is in the right place. If liver cancer is found, the stage of cancer will be determined, which can help your doctor determine the treatment options available and the prognosis.

How is liver cancer treated?

Hepatectomy
A hepatectomy is done to remove part of the liver or the entire liver. This surgery is usually done when the cancer is confined to the liver. Over time, the remaining healthy tissue will grow back and replace the missing part.

Liver transplant
A liver transplant involves replacing the entire diseased liver with a healthy liver from a suitable donor. A transplant can only be done if cancer has not spread to other organs. Medications to prevent rejection are given after transplantation.

Ablation
Ablation involves the use of injections of ethanol or heat to kill cancer cells. It is performed under local anesthesia. This numbs the area to prevent pain. Ablation can help people who are not candidates for surgery or transplantation.

Chemotherapy
It is an aggressive form of drug therapy that kills cancer cells. Medications are injected intravenously or intravenously. In most cases, chemotherapy can be given as an outpatient treatment. Chemotherapy can be effective in treating liver cancer, but many people experience side effects during treatment, such as vomiting, decreased appetite, and chills. Chemotherapy can also increase your risk of infection.

Radiation therapy

Radiation therapy involves the use of high-energy radiation beams to kill cancer cells. It can be given by external beam radiation or by internal radiation. In external beam radiation, radiation is aimed at the abdomen and chest. Internal radiation involves the use of a catheter to inject small radioactive spheres into the hepatic artery. The radiation then destroys the hepatic artery, a blood vessel that supplies blood to the liver. This decreases 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 that are designed to affect cancer cells where they are vulnerable. They slow tumor growth and help cut off the blood supply to the tumor. Sorafenib (Nexavar) has been approved as a targeted therapy for people with liver cancer. Targeted therapy can be helpful for people who are not candidates for a hepatectomy or liver transplant. However, targeted therapy can have significant side effects.

Embolization and chemoembolization

Embolization and chemoembolization are surgical procedures. They are made to block the hepatic artery. Your doctor will use small sponges or other particles to do this. This reduces the amount of blood that flows to the tumor. In chemoembolization, your doctor injects chemotherapy drugs into the hepatic artery before injecting the particles. The blockage created keeps the chemotherapy drugs in the liver for a longer period.

How can liver cancer be prevented?

Liver cancer cannot always be prevented. However, you reduce your risk of liver cancer by taking steps to prevent the development of conditions that can lead to liver cancer.

• Get the Hepatitis B Vaccine

There is a vaccine for hepatitis B that all children should receive. Adults who are at high risk of infection (such as those who abuse intravenous drugs) should also get vaccinated.

The vaccine is usually given as a series of three injections over 6 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:

• Use protection

Always practice safe sex by using a condom with all of your sexual partners. You should never have unprotected sex unless you are sure your partner is not infected with hepatitis or any other sexually transmitted infection.

• Don't use illegal drugs

Avoid using illegal drugs, especially those that can be injected, such as heroin or cocaine. If you can't stop using drugs, be sure to use a sterile needle every time you inject it. Never share needles with other people.

• Be careful with tattoos and piercings. 

Go to a reputable shop every time you get a piercing or tattoo. Ask employees about their safety practices and make sure they use sterile needles.

• Reduce your risk of cirrhosis

You can reduce your risk of cirrhosis by doing the following:

• Drink alcohol only in moderation

Limiting the amount of alcohol you drink can help prevent liver damage. Women should have no more than one drink a day and men should have no more than two drinks a day.

• 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 important for weight control. Make sure to incorporate lean protein, whole grains, and vegetables or fruits in most of your meals.

If you need 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 can help you create an eating plan and exercise routine that will allow you to reach your weight loss goals more quickly.

Liver cancer survival rate:

Percentage means how many out of 100. The 5-year overall survival rate is 18%, compared to just 3% 40 years ago. Survival rates depend on several factors, including the stage of the disease. For 44% of people diagnosed at an early stage, the 5-year survival rate is 33%.

How can liver cancer be found early?

Computed tomography (CT)

Computed tomography is an x-ray test that produces detailed images of your body. A CT scan of the abdomen can help find many types of liver tumors. It can provide specific information about the size, shape, and location of any tumor in the liver or elsewhere in the abdomen, as well as nearby blood vessels.

Does liver cancer spread quickly?

Liver cancer can spread rapidly depending on the type of cancer. Hemangiosarcoma and angiosarcoma types of liver cancer spread rapidly, whereas hepatocellular carcinoma spread late in the disease.

Is liver cancer a death sentence?

The good news is that while liver cancer was once considered a death sentence, there is now an effective treatment when HCC is found at an early stage.

Individuals at risk for HCC: 

Cirrhosis is the number one cause of HCC.

Is liver cancer curable if caught early?

If your cancer is early and the rest of your liver is healthy, surgery (partial hepatectomy) can cure it. Only a small number of people with liver cancer fall into this category. Important factors that can influence the outcome are the size of the tumors and whether nearby blood vessels are affected.