Liver
What is Liver Cancer?
Cancer that begins in the liver is referred to as primary liver cancer. Eighty-four percent of primary liver cancer develops from cells within the liver. Rarely, cancer may form in the liver's blood vessels, glands, and connective tissue. Most frequently, however, cancer of the liver has spread from another organ. This type of disease is called metastatic cancer.
Primary cancer of the liver is a rare malignancy in the United States, but in parts of Asia and Africa, it is one of the most common malignancies. Due to its low incidence in America, its lack of symptoms, and its frequently accelerated growth rate, primary liver cancer is generally not diagnosed until it is at an advanced stage. Cancer of the liver is ranked among the top 10 causes of cancer-related deaths in males.
Liver Cancer Risk Factors
- Individuals who are male.
- Individuals who are age 60-plus.
- Individuals with a personal or family history of liver cancer.
- Individuals with a personal or family history of chronic hepatitis B or C virus infection.
- Individuals with a personal history of chronic liver disease (cirrhosis).
- Individuals with a personal history of exposure to substances such as aflatoxin, vinyl chloride, nitrosamines, arsenic, anabolic steroids, and oral estrogen compounds.
- Individuals with a personal history of tobacco use.
Liver Cancer Symptoms
If the area around your liver (below the right side of your rib cage) is swollen, hard, and/or tender to touch, and/or you experience discomfort in its general vicinity (the right side of your upper abdomen and/or shoulder blade), you should seek advice from a physician.
Yellowing of the skin and the whites of your eyes (jaundice), along with other less specific signs, such as weakness, lack of appetite, feeling of fullness after a small snack, and/or fever, may also indicate disease.
Patients with chronic liver disease (cirrhosis) tend to exhibit rapid onset of symptoms. In the absence of cirrhosis, signs may be more subtle.
Liver Cancer Diagnosis
- Physical examination: It is generally difficult for a doctor to feel for external signs of liver cancer because of its location under the rib cage.
- Ultrasound, CT and/or MRI: Using sound waves, x-rays, and/or radio and magnetic waves, Color Doppler Ultrasound, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) produce a picture of the liver that is used to determine the presence of cancer and spread of disease.
- Angiogram: Dye is injected through a tube (catheter) inserted into the liver's main blood vessel so that the disease status of the blood vessels in the liver can be seen on an x-ray.
- Laparoscopy: A thin-lighted tube is inserted into the abdomen via a small incision so the doctor can see the liver and other organs.
- Biopsy: A biopsy is the only way to definitively diagnose the presence of cancer. There are several types of biopsy procedures. A needle may be inserted into the abdomen to remove a small amount of tissue (needle biopsy) or a biopsy specimen may be taken during a laparoscopy. The tissue is studied under a microscope for evidence of cancer.
- Blood tests: Certain blood tests (such as alpha-fetoprotein, or AFP) may also help a doctor diagnose primary liver cancer.
Liver Cancer Treatment
Surgery offers the best chance for cure in patients with liver cancer. If a tumor is limited to one of the two lobes of the liver, surgical resection can usually be performed. If both lobes of the liver are diseased, a trisegmentectomy may be undertaken. This is an extensive procedure that can remove up to two-thirds of liver tissue. Because the remaining section must take over the complete organ function, patients with inflammation or scarring (cirrhosis) of the liver are generally not eligible for this procedure.
For tumors that are unresectable because of their size and location (near blood vessels), sophisticated techniques such as cryosurgery or radiofrequency ablation may be utilized.