The liver is the body’s largest internal organ, sitting in the upper right portion of the abdomen beneath the diaphragm and above the stomach. Primary liver cancer, meaning cancer that began in the liver, accounts for 42,000 new cases in the United States annually.
Several types of cancer can form in the liver, however not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body, such as in the colon or breast, and then spreads to the liver is called metastatic cancer rather than liver cancer. This type of cancer is named after the organ in which it began; for example, metastatic colon cancer describes cancer that begins in the colon and spreads to the liver. Cancer that spreads to the liver is more common than cancer that initially begins in the liver cells.
Most early stages of primary liver cancer do not have warning signs or symptoms. When signs and symptoms do appear, they may include unexplained weight loss, loss of appetite, upper abdominal pain, nausea and vomiting, abdominal swelling or hard lump, yellow discoloration of the skin and the whites of the eyes (jaundice) or white, chalky stools.
It is not always clear what causes liver cancer, but there are some risk factors:
- Chronic infection with the Hepatitis B virus (HBV) or the Hepatitis C virus (HCV)
- Cirrhosis, a condition causing formation of scar tissue in the liver
- Excessive alcohol consumption
- Exposure to aflatoxin, a poison produced by molds that can grow on improperly stored foods such as grains and nuts
Once primary liver cancer has been diagnosed through blood tests, imaging tests or biopsies, staging tests may be used to help determine the size and location of the cancer and whether it has spread to other areas of the body. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans.
There are a number of treatment options for liver cancer, conditional to the progression of the disease. Surgery may be used to remove small tumors, depending on the tumor location and overall functionality of the liver. As much as 80% of the liver can be removed during surgery, and over time the liver can actually regrow its missing part. Liver transplant surgery is potential option for a small percentage of people with early-stage liver cancer, when the disease has not spread outside of the liver and a suitable donor can be found.
Localized treatments, meaning administered directly to the cancer cells, include heating or freezing of the cancer cells, injecting alcohol (ethanol) into the tumor, injecting chemotherapy drugs into the tumor, placing beads filled with radiation in the liver and traditional radiation therapy.
Preventative measures to help reduce the risk of liver cancer include drinking alcohol in moderation, maintaining a healthy weight, getting vaccinated against hepatitis B and taking precautions to prevent hepatitis C (practice safe sex and use clean needles for IV drugs, piercings and tattoos).