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There are approximately 42,000 cases of liver cancer in the United States each year. According to the National Cancer Institute, cases of liver cancer in this country have tripled since 1980. And deaths from liver cancer have almost doubled over the same period.
Researchers don’t fully understand why cases are rising, but this increase could be due to liver damage linked to two common aspects of modern life: alcohol consumption and diets high in fat and sodium.
What is liver cancer?
A diagnosis of liver cancer indicates cancer that originates in the liver. It is a malignant (cancerous) tumor that has developed in your liver, the body’s largest internal organ.
The liver has many important functions. These include:
- Support digestion by breaking down and storing important nutrients
- Produce clotting factors to prevent excessive bleeding anywhere in the body
- The bile ducts supply the intestines with digestive fluid called bile to process fats and other nutrients
- Breaking down alcohol, medications and toxins in the blood so that they can leave the body via urine or stool
If the cancer begins in the liver, it is called primary liver cancer. When cancer spreads from the liver to another organ, it is called secondary liver cancer or liver metastasis. Colorectal cancer is the type most likely to metastasize (spread) to the liver. Other cancers that commonly spread to the liver include cancers of the esophagus, stomach, kidney, pancreas, lung, and breast, and melanoma.
In this case, your doctor will continue to treat your original cancer and the liver metastases.
What different types of liver cancer are there?
There are several types of primary liver cancer, but the most common form in adults is hepatocellular carcinoma (HCC). HCC begins in hepatocytes, the cells that make up most of the liver.
What are the risk factors for liver cancer?
Any disorder or activity that can damage your liver increases your risk of developing primary liver cancer.
Risk factors for liver cancer include:
- Long-term hepatitis B or C infections
- Steatohepatitis associated with metabolic dysfunction (EADM), previously known as nonalcoholic fatty liver disease
- High consumption of alcoholic beverages
- obesity
- Type 2 diabetes
- Tobacco use
If liver damage occurs over many years, it leads to cirrhosis or permanent scarring in the liver. Liver cirrhosis can lead to liver failure and, over time, liver cancer. Hepatitis, alcohol consumption and metabolic factors are the most common causes of liver cirrhosis.
Can liver cancer be prevented?
Fortunately, you can reduce most risk factors for primary liver cancer. Here are some measures you can implement:
- Get vaccinated against hepatitis B
- Avoid hepatitis C infections by having safe sex and only getting tattooed or pierced at top-notch establishments that practice safety measures.
- Reduce or eliminate alcohol consumption
- Exercise regularly
- Try to be at a healthy weight
- don’t smoke
Talk to your doctor if you need help treating any of these risk factors for liver cancer.
What are the symptoms of liver cancer?
As with other gastrointestinal cancers, most people do not show any signs or symptoms of early-stage liver cancer. However, if this were the case, symptoms would include:
- Loss of appetite and weight loss for no apparent cause
- Nausea or vomiting
- fatigue
- Fever
- Bruises that occur easily
- Dark urine or light stools
- Pain on the right side just below the ribs
- Itching all over the skin
- Yellowing of your skin or the whites of your eyes (jaundice)
Can liver cancer be diagnosed early with screening tests?
Currently, routine screening for liver cancer is not recommended for people who are not at increased risk of this disease. However, if you have a condition that increases your risk of liver cancer, especially cirrhosis or hepatitis B or C, talk to your doctor to see if screening is right for you.
If your doctor recommends checkups, they will include blood tests every six months to assess the health of your liver and an ultrasound scan of your abdomen.
How is liver cancer treated?
If you are diagnosed with liver cancer, your doctor will likely be able to offer you several treatment options. Your treatment options depend on the size, stage and location of the tumor in the liver.
Common treatment options for liver cancer include:
- Operation: A partial hepatectomy is surgery to remove part of the liver and may be an option for people with small, early-stage liver tumors. A liver transplant is another option. This operation involves replacing a diseased liver with a healthy liver from a donor. For people with advanced cirrhosis or when a tumor cannot be removed surgically, a transplant may be an option.
- Localized treatments: These options treat the tumor cells directly.
- Ablation: It destroys tumors using heat through radiofrequency or microwave ablation, extreme cold (cryoablation), or alcohol injected directly into the tumor.
- Embolization: It attacks the tumor specifically via its blood supply. In chemoembolization, chemotherapy is delivered through the artery that supplies blood to the tumor, while in radioembolization, radioactive particles are delivered through the artery. Embolization can also block blood flow to the tumor, which kills cancer cells.
- Targeted therapy: If your tumor contains abnormal cells that respond to a certain targeted therapy, this medication kills those cells. Several targeted therapies have been approved for liver cancer, such as kinase inhibitors and monoclonal antibodies.
- Immunotherapy: These drugs use your own immune system to attack cancer cells. Immune checkpoint inhibitors, a type of immunotherapy used to treat liver cancer, are given as an intravenous infusion.
- Chemotherapy: Chemotherapy kills rapidly dividing cells and could be used for liver cancer that cannot be treated with surgery or local therapies. It can be given by injection into a vein or infusion into the hepatic artery, a main artery that connects directly to your liver.
- Radiotherapy: Uses powerful energy beams to treat cancerous tumors
- Traditional radiation therapy (photon therapy): It directs beams of high-energy X-rays at the tumor, which penetrate into the body, pass through the tumor and leave the body on the other side.
- Proton therapy: It uses protons to specifically attack the tumor. The protons release their energy at the cancer site and then stop, minimizing damage to nearby healthy cells and tissues.
This educational resource was created with support from Merck.
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