Liver cancer is the growth and spread of unhealthy cells in the liver. Cancer that starts in the liver is called primary liver cancer. Cancer that spreads to the liver from another organ is called metastatic liver cancer. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer.
About 30,000 Americans are diagnosed with primary liver cancer each year. Primary liver cancer is one of the cancers on the rise in the United States. Primary liver cancer is about twice as common in men than in women.
ALF Patient Advocate Susan Ventura sat down with ALF National Medical Advisory Committee member Dr. Catherine Frenette, hepatologist at Scripps MD Anderson Center in San Diego to ask her our most frequently asked questions about cirrhosis and liver cancer. Make sure to watch this important, informative interview!
- Liver Cancer claims nearly 29,000 liver per year, or more than 79 Americans each day.
- The disease has been slowly but steadily rising for several decades in the U.S.
- Long-term infection with the Hepatitis B or C virus is the most common risk factor for Liver Cancer
- Liver Cancer is seen more often in men than in women.
What are the risk factors and causes of liver cancer?
- Long-term hepatitis B and hepatitis C infection are linked to liver cancer because they often lead to cirrhosis. Hepatitis B can lead to liver cancer without cirrhosis.
- Excessive alcohol use.
- Obesity and diabetes are closely associated with a type of liver abnormality called nonalcoholic fatty liver disease (NAFLD) that may increase the risk of liver cancer, especially in those who drink heavily or have viral hepatitis.
- Certain inherited metabolic diseases.
- Environmental exposure to aflatoxins.
- Many other liver diseases, including autoimmune diseases like PBC, and other rare diseases such as Tyrosinemia, Alpha1-antitrypsin deficiency, Porphyria cutanea tarda, Glycogen storage disease, and Wilson disease can lead to cirrhosis, which increases the risk of liver cancer.
Learn more about the progression of liver disease here and talk to your doctor about whether or not your risk of liver cancer is increased and warrants additional screening.
What are the symptoms of liver cancer?
Symptoms may include fatigue, bloating, pain on the right side of the upper abdomen or back and shoulder, nausea, loss of appetite, feelings of fullness, weight loss, weakness, fever, and jaundice (yellowing of the eyes and the skin).
How is liver cancer diagnosed?
A physical examination or imaging tests may suggest liver cancer. To confirm a diagnosis, doctors may use blood tests, ultrasound tests, computed tomography (CT) scans, magnetic resonance imaging (MRI), and angiograms. Your doctor may also need to do a liver biopsy. During a biopsy, a small piece of liver tissue is removed and studied in the lab.
How is liver cancer treated?
Liver cancer treatment depends on:
- The liver’s condition
- The size, location and number of tumors
- If the cancer has spread outside the liver
- The person’s age and overall health
Treatment options if the cancer has not spread and the rest of the liver is healthy are:
- Transplant If the cancer has not spread, for some patients a liver transplant (replacement of the liver) may be an option.
- Surgery If the cancer has been found early and the rest of the liver is healthy, doctors may perform surgery to remove the tumor from the liver (partial hepatectomy).
- Radiofrequency Ablation Radiofrequency ablation uses a special probe to destroy cancer cells with heat.
Other treatment options if surgery and transplant are not possible include:
For cancer that has not spread outside the liver:
- Cryosurgery uses a metal probe to freeze and destroy cancer cells.
- Bland embolization or chemoembolization are procedures in which the blood supply to the tumor is blocked, after giving anticancer drugs (chemoembolization) and one without (bland embolization). Both are given in blood vessels near the tumor.
- Radiation therapy Radiation therapy uses radiation (high-energy x-rays) to destroy cancer cells.
For cancer that has spread outside the liver:
- Oral medication is available for use in some cases of hepatocellular carcinoma (the most common type of primary liver cancer).
- Clinical trials may be an option for some patients.
- Talk to your doctor about other options that may be available.
What is the outlook for patients with liver cancer?
A successful liver transplant will effectively cure liver cancer, but it is an option for only a small percentage of patients. Surgical resections are successful in only about one out of three cases. However, scientists are experimenting with several promising new drugs and therapies that could help prolong the lives of people with liver cancer.
What’s the best way to reduce the risk of liver cancer?
Steps to reduce the risk of liver cancer include:
- Regularly see a doctor who specializes in liver disease
- Talk to your doctor about viral hepatitis prevention, including hepatitis A and hepatitis B vaccinations
- Take steps to prevent exposure to hepatitis B and hepatitis C. You can find out more about how to prevent hepatitis B here, and how to prevent hepatitis C here.
- If you have cirrhosis or chronic liver disease, follow your doctor’s recommendations for treatment and be screened regularly for liver cancer
- If you are overweight or obese, diabetic, or drink heavily, talk to your doctor
- How many tumors do I have?
- What size are these tumors?
- Are there other tests I will need such as biopsy, imaging scans or PET scans?
- Has the cancer remained in the liver or has it spread?
- What treatment options do I have?
- How effective is the treatment for liver cancer?
- Is it possible for my tumors to return?
- Would I benefit from participation in a clinical trial? If so, where can I find more information about trials?
- Is transplant a possibility for me?
- How severe is the liver damage?
- What treatment do you recommend? Will this slow down the progression of the disease?
- Will any medication be prescribed? What are the side effects?
- Should I change my diet?
- Are there any supplements you would suggest that I take?
- What can be done to relieve my symptoms?
- If cirrhosis develops, is transplantation my only option?
There are many different types of liver disease. But no matter what type you have, the damage to your liver is likely to progress in a similar way.
Whether your liver is infected with a virus, injured by chemicals, or under attack from your own immune system, the basic danger is the same – that your liver will become so damaged that it can no longer work to keep you alive.
Cirrhosis, liver cancer, and liver failure are serious conditions that can threaten your life. Once you have reached these stages of liver disease, your treatment options may be very limited.
That’s why it’s important to catch liver disease early, in the inflammation and fibrosis stages. If you are treated successfully at these stages, your liver may have a chance to heal itself and recover.
Talk to your doctor about liver disease. Find out if you are at risk or if you should undergo any tests or vaccinations.
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