About Liver Cancer
First hearing the words "you have liver cancer", can be a life altering experience and can start a cascade of emotions. By spending time researching treatment options for either yourself or a loved one, you are ensuring you will be receiving the best care available today based on individual needs. This section contains general information about liver cancer.
Unresectable liver cancer
Liver cancer is a disease in which liver cells become "malignant," that is, they become abnormal and grow uncontrollably, forming a tumor. When the cancer originates in the liver it is called "primary" liver cancer. The medical terminology for it is HCC (hepatocellular carcinoma). HCC is often unresectable, that is, it cannot be surgically removed. Tumors in the liver that originated in other organs, such as the colon, rectum, breast, head or neck, are called liver metastases or secondary liver cancer as they have spread to the liver from these other organs.
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How does liver cancer affect the body?
The liver is one of the largest and busiest organs in the body. Located in the upper right side of the abdomen under the rib cage, the liver performs several vital functions for the body. For example, it plays an important role in food digestion, storage of energy-rich carbohydrates and the extraction of energy from the food molecules that remain after digestion. The liver also filters and stores blood and breaks down potentially toxic substances. Thus, the liver plays many vital roles in the body's response to various nutritional and physiological needs and challenges.
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Symptoms of liver cancer
The first symptoms of liver cancer, as with other types of cancer, are often vague. A person may feel poorly, loose his or her appetite, suffer weight loss, fever, weakness and a general feeling of being rundown.
Over time, the person may feel a pain in the upper abdomen on the right side that may radiate to the back and shoulder, notice a lump in the upper abdomen and suffer feelings of fullness and bloating.
As liver function becomes more impaired the person may have bouts of fever and nausea and develop jaundice (yellowing of the skin and whites of the eyes) and dark urine.
A person with these symptoms, however, may not have liver cancer, since these same symptoms can be caused by a benign (noncancerous) liver tumor or by other conditions. Therefore, a doctor should be consulted to determine the exact cause of these symptoms.
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Causes of primary liver cancer (HCC)
Unlike most cancers, the cause of HCC can often be identified in individual patients. Hepatitis B virus infections in youth may eventually cause HCC in adulthood; and people who suffer cirrhosis of the liver (i.e., scarring of the liver due to repeated injury) from hepatitis B are at much higher risk of developing HCC than those patients with less severe liver disease. Recently, long-term infection with hepatitis C virus has also been found to be a risk factor for HCC.
Other causes of HCC include cirrhosis caused by alcohol abuse, chronic hepatitis, long-term blockage of the outflow of bile from the liver and some viral forms of autoimmune liver disease.
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Diagnosis of liver cancer
The diagnosis of liver cancer begins much like the diagnosis of any disease. First, the doctor takes a medical history, then does a physical examination. Based on findings from that history and examination the doctor then orders certain tests:
- Blood tests to determine how well the liver is functioning.
- Blood tests to look for tumor markers that is, substance like alpha-fetoprotein (AFP) that are often at abnormally high levels in patient with liver cancer, as well as some other cancers.
- Chest and abdominal x-rays.
- Angiogram: A procedure in which a flexible plastic tube (catheter) is inserted into the main blood vessel that takes blood to the liver. Dye is then injected through the tube so that the blood vessels in the liver can be seen on an x-ray. Angiography can help a doctor tell whether the cancer is primary or seconday liver cancer. This test is usually done in the hospital.
- CT scan: Computer-processed x-ray pictures of the liver.
- MRI scans: Images produced with radiowaves and magnetic fields.
- Liver scans that use radioactive material to help identify abnormal spots in the liver.
- Liver biopsy: A procedure in which a small sample of the liver is removed through a needle or during an operation and checked under a microscope for the presence of cancer cells. This procedure can confirm the presence of liver cancer.
- Laparoscopy: A procedure in which the doctor makes a small cut in the abdomen and inserts a small tube-shaped instrument that has a light on one end. The doctor may also take a small sample of the liver for inspection under a microscope.
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Why surgery may not be an option
Primary or secondary liver cancer can form large, hard-to-remove tumors that have spread widely throughout the liver by the time the condition is diagnosed. In addition, the liver can be very damaged by both the cancer and underlying infections or other conditions that contributed to the cancer. This makes some forms of primary or secondary liver cancer unsuitable for treatment with surgery and hence, unresectable.
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