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Liver Cancer

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Overview of Liver cancer

Liver cancer is the cancer of the liver, where the cells of the liver turn out abnormal and multiply erratically. If the cancer begins in the cells of the liver itself, then it is termed as primary liver cancer.

Following are some of the types of primary liver cancer.

  • Hepatocellular carcinoma: This is the cancer of the hepatocyte. Hepatocyte is the main functional cell of the liver.
  • Cholangiocarcinomas: This is the cancer of the bile ducts.
  • Adenocarcinomas: This is the cancer of some glands present within the liver.
  • Sarcomas and angiosarcomas: This is the cancer of the connective tissue present within the liver.
  • Hemangioendotheliomas: This is the cancer of the blood vessels present within the liver.
The cancer affecting the liver is usually metastatic cancer or the secondary liver cancer. Here the tumors from different parts of the body metastasize to the liver. Colon cancer, lung cancer, breast cancer are some of the common cancers that spread to the liver.

The prognosis of primary liver cancer is poor since diagnosis is difficult in the initial stages. Management is mostly, symptomatic to make the patient feel comfortable. 

Occurance of liver in different groups: Hepatocellular carcinoma is responsible for 85–90% cases of primary liver cancer. More than 560,000 people develop liver cancer each year globally and almost equal number of peoples looses their life.1 Males are higher risk when compared to females and the average ratio lies between 2:1 and 4:1. This is because men are more prone to infections of hepatitis B virus and hepatitis C virus. Along with this, if there are in the habit of consuming alcohol and smoking, they are at very high-risk. Prevalence rates of liver cancer differ within the population of the same region. This may be due to interethnic variability and exposing to risk factors like hepatitis C virus.2,3


Signs and Symptoms of liver cancer

Liver cancer does not show any signs and symptoms until the disease is in the advanced stage. Early detection of liver cancer is very rare.

When the person develops symptoms, it may include:

  • Abdominal fullness or bloating (due to collection of fluid in the abdominal cavity)
  • Loss of appetite
  • Loss of weight
  • Yellow discoloration of the skin and white part of the eye 

Risk factors for liver cancer

Major risk factors of liver cancer include:

  •  Hepatitis B virus infection4
  • Hepatitis C virus infection5
  • Persons with viral hepatitis and coinfected with human immunodeficiency virus6
  • Alcoholic liver disease
  • Nonalcoholic fatty liver disease
  • Aflatoxin B1 (toxic chemical produced by a fungus) food contamination
  • Tobacco usage


Minor risk factors of liver cancer include:

  • Hereditary hemochromatosis
  • Alpha-1 antitrypsin deficiency
  • Autoimmune hepatitis
  • Porphyria

Non-environmental endogenous factors like body mass index and high levels of androgen hormones also pose risk of developing liver cancer.4


Diagnosis of liver cancer

Liver cancer is diagnosed based on the symptoms and the risk factors.

Once suspected, a thorough physical examination is conducted and diagnostic tests include the following.

This diagnostic test uses sound waves to produce images of the internal structures of the liver.

Computed Tomography (CT)
This involves taking many small X-ray pictures using a machine that rotates around a patient. CT scan gives a more detailed image compared to ultrasound.

Magnetic Resonance Imaging (MRI)
This uses electromagnetic waves to get image of the internal organs.

In biopsy, the physician uses a needle or a small pair of scissors to remove the piece of tumor on which microbiological tests are conducted to determine whether the tumor is malignant or benign.

Apart from this, many blood tests are conducted to suspect liver cancer, like presence of high levels of Alfa-fetoprotein in the blood, which increases the risk of liver cancer.1         

Liver biopsy

Treatment of liver cancer

The following methods are considered for treating liver cancer.

This proves to be the best method for curing liver cancer. This can be opted only when the cancer has not spread beyond the liver. Partial removal (partial hepatectomy) or removal of whole liver followed by liver transplantation is done depending on the location of the tumor, size of the tumor and overall health of the patients.

This can be opted for removing of the tumor, which has not spread beyond the liver. This technique seems to be useful as very little normal tissue is affected by the treatment, thereby reducing the side-effects of the treatment.

Radio frequency Ablation:
This technique involves inserting a probe into the tumor and killing the cancer cells using electrodes and can be performed through the skin.1

Ethanol Injections:
In this technique, high concentration ethanol injections are used to kill the tumor. Small tumors are treated through procedure.

Chemotherapy is used to treat the cancer, which has spread outside the liver.

Hepatic Artery Chemoembolization:
In this procedure, chemotherapeutic drugs are injected through a catheter into the hepatic artery. This blocks the blood supply through the artery and the tumor is disrupted.2

Radiation Therapy:
In radiation therapy, high energy X-rays are passed to the cancer affected areas. These damage the DNA of the cells. The damage is more to the cancer-affected cells when compared to the normal cells.        


Prevention of liver cancer

The following ways can be opted to prevent liver cancer.

  • Prevention from hepatitis B infection by being vaccinated
  • Prevention from hepatitis C infection through:
    1. Gaining knowledge as to how the disease is transmitted
    2. Using sterilized needles for injections
    3. Taking care in handling blood products
  • Avoid alcohol
  • Avoid medications that cause liver damage
  • Avoid exposure to environmental toxins

Written by: Healthplus24 team
Date last updated: September 29, 2012

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