Liver Cancer

The liver is crucial to our survival. (Read about "The Liver") It performs a number of tasks that keep our body working correctly. It is unusual, in that it gets blood from two sources. (Read about "Vascular System") Blood comes from the lungs bringing oxygen and from the intestine bringing nutrients. The liver is often called a giant filter and in many ways, it is. As nutrients pass through, they are changed so they can be used by the body. Toxins are also changed, so they can be better handled and/or removed by the body. Alcohol for instance, is metabolized by the liver.

Because of all it does, we could not live without a liver. But the liver is not indestructible. The American Cancer Society (ACS) says that over 16,000 people discover they have liver cancer each year. Although the survival rate is very low, usually less than 10 percent according to the National Cancer Institute (NCI), researchers are making progress in developing treatments for liver cancer. (Read about "Cancer: What It Is")

Types of cancer

There are different types of primary liver cancer, including:

• Hepatocellular (HCC), which accounts for 84 percent of cases, according to ACS. HCC starts in the hepatocytes, the main liver cells.
• Cholangiocarcinoma, which accounts for about 13 percent of liver cancers. It starts in the small bile ducts of the liver.
• Angiosarcoma is a rare cancer that starts in the blood vessels of the liver, accounting for less than one percent of cases according to NCI.
• Hepatoblastoma another rare cancer often found in children that ACS says can often be treated successfully. (Read about "Cancer & Children")

Metastatic liver cancer is cancer that has spread to the liver from another part of the body. Metastatic cancer is usually named after the organ from which it originated.

The liver weighs about three pounds and is located inside the rib cage under the right lung. Because of its location, it is difficult to discover liver cancer early. (Read about "Cancer Check-ups") This is one of the reasons for the low survival rate. ACS says there are seldom symptoms in the early stages. Some symptoms of liver cancer as it develops however can include weight loss, pain in the stomach area and jaundice. (Read about "Jaundice") The only sure way to know if you have liver cancer is a biopsy. (Read about "Biopsy")

Risk factors

Liver cancer is relatively rare in the United States, accounting for about one and a half percent of all cancers, according to NCI. The rate is much higher in certain areas of Africa and East Asia. The rate there is growing while it is dropping in the United States, according to ACS.

NCI suspects that the high rate of Hepatitis B and C (Read about "Hepatitis B" "Hepatitis C") in those areas is a major factor. Hepatitis is considered a risk factor for liver cancer. Other risk factors according to ACS and NCI include:

• Ethnicity - African Americans and Hispanics have twice the rate of liver cancer of whites. The highest rates are found in Asian Americans. (Read about "Minority Health")
• Sex - men have twice the rate of women.
• Cirrhosis, a scaring of the liver. (Read about "Cirrhosis")
• Exposure to aflatoxin, a fungus that infects grain products. (Read about "Microorganisms")
• Chemical exposure to such things as vinyl chloride and thorium dioxide.
• Anabolic steroids, which are sometimes taken for medical reasons but are also abused by athletes to build muscle. (Read about "Anabolic Steroids")
• Arsenic, which sometimes shows up in drinking water.
• Smoking has been linked in some studies but not all. (Read about "Quit Smoking")
• Older forms of birth control pills no longer in use

Many risk factors can be controlled. There are now vaccines for Hepatitis B and other healthy habits that can be used to avoid infection. A healthy life style of not abusing alcohol, stopping smoking and avoiding dangerous chemicals and other substances can lower a person's risk.

Diagnosis and treatments

The process used to find out if cancer has spread within the liver or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. (Read about "CT Scan - Computerized Tomography")
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. (Read about "MRI - Magnetic Resonance Imaging")
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. (Read about "PET - Positron Emission Tomography")
• Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. (Read about "Endoscopy")

Treatments for liver cancer depend on the extent of the cancer and if it has spread. (Read about "Cancer Treatments") Surgery, with the removal of the entire tumor, has the potential to cure liver cancer, according to ACS. If the cancer has spread or is made up of a number of tumors, surgery may not be able to get all of the cancer. There is also a form of surgery called cryosurgery where the tumors are destroyed by freezing them. Another treatment is called ethanol ablation where alcohol is injected into the tumors to kill the cancer cells. NCI says radiofrequency thermal ablation, which uses intense heat to destroy tumors, can also be used, particularly on liver lesions that are too difficult or too spread out to remove with surgery.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. ACS says a method called hepatic artery infusion, where the cancer drugs are injected directly into the artery taking blood to the liver, is often used. (Read about "Infusion Therapy")

Radiation therapy - using high-energy rays - may be used, especially to shrink a liver tumor or provide relief from symptoms such as pain. (Read about "Radiation Therapy") Three-dimensional radiation therapy is a type of external-beam radiation treatment that uses computers to target the exact location of a tumor, thus reducing damage to surrounding tissue. Targeted drug therapy may also be an option in cases of advanced liver cancer.

For some liver cancers, a liver transplant may be an option. (Read about "Transplants") In addition to transplanting an entire liver, there may also be an option for a partial transplant from a living donor who is a close relative.

More Cancer Information:

    Cancer Check-ups

    Cancer Support

    Cancer Treatments

    Reduce Cancer Risks

    Cancer Glossary

For a list of individual types of cancer, see Cancer: What It Is

Related Information:

    Digestive System

    Alcoholism