About liver cancer

What is liver cancer?

Liver cancer is a condition that happens when normal cells in the liver become abnormal and grow out of control into cancer.

Malignant or cancerous cells that arise out of liver cells are called hepatocellular carcinoma, and cancer that arises in the ducts of the liver is called cholangiocarcinoma.

What is metastatic liver cancer?

Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. Metastatic cancer in the liver is a condition where cancer from other organs has spread to the liver. Here the liver cells are basically normal. Metastatic cancer has the same name and same type of cancer cells as the original cancer. The most common cancers that spread to the liver are breast, colon, bladder, kidney, ovary, pancreas, stomach, uterus, and lungs. Metastatic liver cancer is a rare condition that occurs when cancer originates in the liver and spreads to other organs in the body.

Some people with metastatic tumors do not have symptoms. Their metastases are found by X-rays or other tests. Abdominal swelling or jaundice (yellowing of the skin) can indicate cancer has spread to the liver.

What are the symptoms for liver cancer?

Yellowish color to the skin symptom was found in the liver cancer condition

Most people don't have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

  • Losing weight without trying
  • Loss of appetite
  • Upper abdominal pain
  • Nausea and vomiting
  • General Weakness and fatigue
  • Abdominal swelling
  • Yellow discoloration of your skin and the whites of your eyes (jaundice)
  • White, chalky stools

When to see a doctor

Make an appointment with your doctor if you experience any signs or symptoms that worry you.

What are the causes for liver cancer?

It's not clear what causes most cases of liver cancer. But in some cases, the cause is known. For instance, chronic infection with certain hepatitis viruses can cause liver cancer.

Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.

What are the treatments for liver cancer?

The treatment chosen depends upon how much the cancer has spread and the general health of the liver. For example, the extent of cirrhosis (scarring) of the liver can determine the treatment options for the cancer. Similarly, the spread and extent of spread of cancer beyond the liver tissue plays an important part in treatment options.

Surgery: Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. Surgical options are reserved for smaller sizes of cancer tumors.

Liver transplant: The doctor replaces the cancerous liver with a healthy liver from another person. It is usually used in very small unresectable (not able to be removed) liver tumors in patients with advanced cirrhosis.

Ablation therapy: This is a procedure that can kill cancer cells in the liver without any surgery. The doctor can kill cancer cells using heat, laser, or injecting a special alcohol or acid directly into the cancer. This technique may be used in palliation when the cancer is unresectable.

Embolization: Blocking the blood supply to the cancer can be done using a procedure called embolization. This technique uses a catheter to inject particles or beads that can block blood vessels that feed the cancer. Starving the cancer of the blood supply prevents the growth of the cancer. This technique is usually used on patients with large liver cancer for palliation.

Radiation therapy: Radiation uses high-energy rays directed to the cancer to kill cancer cells.

Chemotherapy: Chemotherapy uses a medicine that kills cancer cells. The medicine can be given by mouth or by injecting it into a vein.

Sorafenib is an oral medication that can prolong survival (up to 3 months) in patients with advanced liver cancer.

What is the follow-up after treatment for liver cancer?

Patients are advised to follow up with the doctor for lab tests and office visits. Patients with chronic liver disease should avoid alcohol and any drugs that can harm the liver. Patients with liver transplants will need to take antirejection drugs for the rest of their life to prevent their body from rejecting the new liver.

What is the prognosis of liver cancer? What are the survival rates for liver cancer?

The prognosis for liver cancer depends on multiple factors such as the size of the liver cancer, the number of lesions, the presence of spread beyond the liver, the health of the surrounding liver tissue, and the general health of the patient.

The overall five-year survival rate for all stages of liver cancer is 15%. One of the reasons for this low survival rate is that many people with liver cancer also have other underlying medical conditions such as cirrhosis. However, the five-year survival rate can vary depending on how much the liver cancer has spread.

If the liver cancer is localized (confined to the liver), the five-year survival rate is 28%. If the liver cancer is regional (has grown into nearby organs), the five-year survival rate is 7%. Once the liver cancer is distant (spread to distant organs or tissues), the five-year survival rate is as low as two years.

Survival rate can also be affected by the available treatments. Liver cancers that can be surgically removed have an improved five-year survival rate of over 50%. When caught in the earliest stages, and the liver is transplanted, the five-year survival rate can be as high as 70%.

Are there alternative and complementary therapies for liver cancer?

Currently, there are no approved alternative or complementary treatment options for liver cancer. Research on the use of complementary and alternative medicine for liver cancer is limited. Studies suggest that certain alternative therapies may offer benefits for people being treated for all types of cancer, including liver cancer. Some alternative treatments have been found to alleviate unwanted side effects of conventional cancer treatments such as nausea and vomiting.

Acupuncture: Studies have shown acupuncture can help with nausea and vomiting among people with cancer.

Herbal therapy: Milk thistle has been used for centuries to treat liver problems. Mistletoe may also show promise in liver cancer in experimental studies.

Some herbal preparations, such as those mentioned above, may be helpful in treating symptoms associated with liver cancer. Even so, people who have liver cancer need to take extra precautions before taking an herbal remedy.

A person with cancer of the liver may have a harder time processing alcohol than people without liver disease and should avoid alcohol-containing products. Since many herbal preparations in extract form are alcohol-based, people with liver cancer should always check the ingredients for the presence of any alcohol before taking these herbs.

Additionally, some herbal supplements, such as gingko biloba, can cause excess bleeding. Because the liver releases important substances that help the blood to clot, liver cancer can decrease the body's ability to stave off bleeding. As a result, people with liver cancer should discuss any new medications, including herbal supplements, with their doctor before taking them.

What are the risk factors for liver cancer?

Factors that increase the risk of primary liver cancer include:

  • Chronic infection with HBV or HCV. Chronic infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.
  • Cirrhosis. This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.
  • Certain inherited liver diseases. Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson's disease.
  • Diabetes. People with this blood sugar disorder have a greater risk of liver cancer than those who don't have diabetes.
  • Nonalcoholic fatty liver disease. An accumulation of fat in the liver increases the risk of liver cancer.
  • Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops such as corn and peanuts can become contaminated with aflatoxins, which can end up in foods made of these products. In the United States, safety regulations limit aflatoxin contamination. Aflatoxin contamination is more common in certain parts of Africa and Asia.
  • Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.

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