Liver cancer is cancer that begins within the cells of your liver. Your liver may be a football-sized organ that sits within the upper right portion of your abdomen, beneath your diaphragm and on top of your stomach.
Several forms of cancer can type within the liver. the most common variety of liver cancer is hepatocellular carcinoma, that begins within the main variety of liver cell (hepatocyte). different forms of liver cancer, like intrahepatic cholangiocarcinoma and hepatoblastoma, area unit much less common.
Not all cancers that have an effect on the liver area unit thought of liver cancer. Cancer that begins in another space of the body — like the colon, lung or breast — and so spreads to the liver is termed metastatic cancer rather than liver disease. And this sort of cancer is named when the organ during which it began — like metastatic colon cancer to describe cancer that begins within the colon and spreads to the liver. Cancer that spreads to the liver is additional common than cancer that begins within the liver cells.
Read about the possible symptoms of liver cancer and when it’s a good idea to get checked out by your doctor.
This is weight loss when you aren’t dieting. Doctors usually define significant weight loss as more than 10% of your body weight – a stone for every 10 stone you weigh.
See your doctor if there is no obvious explanation for your weight loss.
A swollen tummy (abdomen)
Swelling of the abdomen can happen in liver cancer for 2 reasons:
- the liver itself can get bigger from the growing cancer. This can cause swelling over the right side of your abdomen.
- generalized swelling of the abdomen caused by a build up of fluid. This is called ascites.
- The fluid builds up because the liver is congested. This squeezes the blood vessels inside the liver and the blood that normally flows through it gets backed up in the veins. The pressure in these veins increases and forces fluid to leak from the veins into the abdomen.
- The veins may grow in size so much that they can be seen underneath the surface of the skin. Fluid also tends to leak out of the veins and into the abdominal cavity if the liver is not able to make blood proteins as it should.
You may have some discomfort or pain in the tummy (abdomen) caused by the liver getting larger. You may also have pain in the right shoulder. This is caused by the enlarged liver stimulating the nerves under the diaphragm, which are connected to nerves in the right shoulder (referred pain). Your diaphragm is a sheet of muscle just under your ribs.
Other possible symptoms include:
- loss of appetite over a period of a few weeks
- being sick
- feeling full or bloated after eating, even after a small meal
- a sudden worsening of health in somebody with known chronic hepatitis or cirrhosis
- a high temperature and sweating
Benign liver growths (non cancerous growths)
Most growths in the liver are benign. These are not cancer. Many benign growths can be treated without surgery, although some do need an operation. Benign growths of the liver do not go on to develop into cancer.
The most common types of benign growths of the liver are:
- hepatic adenoma
- focal nodular hyperplasia
Risks and causes
Liver cancer is quite rare but is increasing. We don’t know what causes most liver cancers. But there are some factors that might increase your risk of developing it.
Having any of these risk factors doesn’t mean that you will definitely develop cancer.
- Non alcoholic fatty liver disease
- Infection with hepatitis viruses
- Low immunity
- Family history
- Gallbladder removal
- Radiation from X-rays or CT scans
- Body weight
- Betel quid
In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.
Treatment options and recommendations depend on several factors:
- How much of the liver is affected by the cancer
- Whether the cancer has spread
- The patient’s preferences and overall health
- The damage to the remaining cancer-free area of the liver
When a tumor is found at an early stage and the patient’s liver is working well, treatment is aimed at trying to eliminate the cancer. The care plan may also include treatment for symptoms and side effects, an important part of cancer care. When liver cancer is found at a later stage, or the patient’s liver is not working well, the patient and doctor should talk about the goals of each treatment recommendation. At this point, the goals of treatment may focus on slowing growth of the cancer and relieving symptoms to improve quality of life.
The various disease-directed treatment options can be grouped according to whether they may cure the cancer or will improve survival but will most likely not eliminate the cancer. Descriptions of the most common treatment options, both disease-directed and those aimed at managing side effects and symptoms, are listed below. Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. It is likely to be the most successful disease-directed treatment, particularly for patients with a tumor smaller than 5 cm. If the tumor has spread outside the liver, or if the patient has other serious illnesses, surgery may not be an option. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Learn more about the basics of cancer surgery.
Two types of surgery are used to treat HCC:
- When a portion of the liver is removed, the surgery is called a hepatectomy. A hepatectomy can be done only if the cancer is in one part of the liver and the liver is working well. The remaining section of liver takes over the functions of the entire liver. The liver may grow back to its normal size within a few weeks. A hepatectomy may not be possible if the patient has advanced cirrhosis, even if the tumor is small.
The side effects of a hepatectomy may include pain, weakness, fatigue, and temporary liver failure. The health care team will watch for signs of bleeding, infection, liver failure, or other problems that need immediate treatment.
- Liver transplantation.Sometimes, a liver transplantation can be done. This procedure is possible only when the cancer has not spread outside the liver, a suitable donor is found, and very specific criteria are met in terms of tumor size and number. These criteria usually are a single tumor 5 cm or smaller or 3 or fewer tumors, all of which are smaller than 3 cm. It is important to understand that the number of donor livers available is very limited, so transplantation is not always an option.
After a transplant, the patient will be watched closely for signs that the body might be rejecting the new liver or that the tumor has come back. The patient must take medication to prevent rejection. These drugs can cause side effects, such as puffiness in the face, high blood pressure, or increased body hair.
Liver transplantation is a particularly effective treatment for people with a small tumor because transplantation removes the tumor and the damaged liver. However, there are few donors, and people waiting for a liver transplant may have to wait for a long time before a liver becomes available. During this time, the disease may get worse. The transplant center will advise you on how long the wait is likely to be and what rules are used to prioritize people on the waiting list.
Radio frequency ablation (RFA) and microwave therapy both use heat to destroy cancer cells. They may be given through the skin, through laparoscopy, or during a surgical operation while a patient is sedated. Sedation is giving medication to become more relaxed, calm, or sleepy.
Percutaneous ethanol injection
Percutaneous ethanol injection is when alcohol is injected directly into the liver tumor to destroy it. Side effects include fever and pain after the procedure. In general, the procedure is simple, safe, and particularly effective for a tumor smaller than 3 cm. However, if the alcohol escapes from the liver, a person may have brief but severe pain. This option is currently being used less often and has been largely replaced by RFA (see above).
Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist.
- Stereo-tactic body radiation therapy (SBRT).SBRT is a term that describes several methods of delivering high doses of radiation to a tumor while limiting the amount of radiation to which healthy tissues are exposed. This is important because healthy liver tissue can be damaged by radiation. SBRT effectively treats tumors that are approximately 5 cm or smaller. However, it is still considered investigational compared to thermal ablation (see above) because little long-term information about its effectiveness exists.
- Radioembolizationis similar to chemoembolization (see below), except that during radioembolization, a doctor places radioactive beads into the artery that supplies the tumor with blood. The beads deliver radiation directly into the tumor when they become trapped in the small blood vessels of the tumor.
Side effects may include damage to the stomach and lungs. However, these side effects can often be prevented. Learn more about the basics of radiation therapy.
This is a type of chemotherapy treatment that is similar to hepatic arterial infusion (see below). Chemotherapy is the use of drugs to destroy cancer cells. During this procedure, drugs are injected into the hepatic artery, and the flow of blood through the artery is blocked for a short time so the chemotherapy stays in the tumor longer. Blocking the blood supply to the tumor also destroys cancer cells.
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