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Liver Cancer

What is liver cancer?

  • Liver cancer is an abnormal growth of tissue in the liver. The liver is an organ on the upper right part of the abdomen (stomach), just below the right lung and behind the ribs. The job of the liver is to make enzymes and bile that help digest food and remove harmful material from the blood. Vitamins A, D, E, K, and B12, iron, and copper are also stored by the liver. Another job of the liver is to make clotting factors in the blood to stop bleeding.

  • Normally, hepatocytes (liver cells) divide or split in a planned way, making more cells only when needed. Cancer occurs when abnormal cells grow and divide without control or order, often making too much tissue (tumor). Cancer cells may grow into nearby healthy tissue. They may also break away from the tumor and spread through the blood stream or lymphatic system to other parts of the body. When cancer spreads, it is called metastasis. Once cancer cells spread, the cancer is harder to control.

What causes liver cancer?

Liver cancer may be primary or secondary.

  • A primary liver cancer starts in the liver itself. No one knows for sure what causes it. The following may put you at higher risk for having primary liver cancer:

    • Chemicals: Frequent exposure to chemicals, such as arsenic, may damage your liver cells.

    • Cirrhosis: This disease happens when liver cells are damaged and replaced with scar tissue. Drinking too much alcohol may lead to cirrhosis. Alcohol is found in beer, wine, and liquor (such as vodka or whiskey) and other adult drinks.

    • Hemochromatosis: This is a rare disease which causes large iron deposits in the body.

    • Hepatitis: Hepatitis leading to liver cancer is usually caused by the hepatitis B or C virus.

    • Toxins: Frequent intake of aflatoxin may lead to liver cancer. Aflatoxin is a type of poison that may be found in moldy peanuts and grain.

  • Secondary liver cancer is cancer that started in another part of the body and has spread to the liver. This may be caused by a gastrointestinal cancer, such as cancer of the colon or rectum, breast cancer, or lung cancer.

What are the signs and symptoms of liver cancer?

Liver cancer does not usually cause symptoms in its early stages. The tumor may have grown and spread outside the liver by the time you have symptoms. You may have one or more of the following:

  • Abdominal pain, especially in the upper right part of your abdomen.

  • Feeling more tired and weak than usual.

  • Fluid in the abdomen.

  • Losing weight without trying.

  • Loss of appetite for food, nausea (upset stomach), or vomiting (throwing up).

  • Yellowing of the skin or the whites of the eyes.

How is liver cancer diagnosed?

You may have one or more of the following:

  • Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.

  • Alpha-fetoprotein test: This test measures the level of a substance called alpha-fetoprotein (AFP) in the blood. People with liver cancer often show high levels of AFP in the blood.

  • Liver biopsy: A liver biopsy is when a small piece of your liver is removed and sent to a lab for tests. Caregivers will clean your skin, and you may be given medicine to numb (lose feeling) in the area. A needle is put through the wall of your abdomen or between your ribs. The needle is put into the liver and a small piece is taken out. A bandage will be placed over the area.

  • Computerized tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your abdomen, including your liver. You may be given dye through an IV before the pictures are taken so that your organs show clearly. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies or health problems.

  • Magnetic resonance imaging test: This test is also called an MRI. It uses magnetic waves to look at the liver.

How is liver cancer treated?

  • Liver cancer treatment depends on the size of the tumor, and whether the cancer has spread or not. You may have one or more of the following treatments:

    • Surgery: A part of your liver may be surgically removed. You may also have a liver transplant if your liver has severe disease. The diseased liver is removed and replaced with a healthy and donated liver.

    • Ablative therapy: Ablation destroys or kills cancer cells. This may be done by injecting alcohol into the cancer cells. High intensity radio waves or laser light may also be used to heat and kill cancer cells.

  • If the tumor cannot be operated upon, other treatments are done. These treatments may decrease your pain or decrease the size of your tumor for surgery at a later date.

    • Chemoembolization: Drugs used for chemotherapy are mixed with another oily chemical. The mixture is then injected into branches of the liver blood vessel, which supplies blood to the cancer.

    • Chemotherapy:

      • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

      • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

    • Cryosurgery: During cryosurgery, a chemical called liquid nitrogen is put on the area to be removed. This freezes and kills the tissue. The dead tissue later falls off. Once the tissue thaws, the area may hurt and swell for a short time. You may need cryosurgery more than once.

    • Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.

How can I decrease my risk of getting liver cancer?

  • Do not drink too much alcohol. How often you drink is as important as how much you drink. If you drink alcohol, discuss your drinking with your caregiver.

  • Get checked for a disease called hemochromatosis. Do this especially if you have a close family member with this disease.

  • Prevent liver cancer caused by hepatitis B and C. These viruses are spread through blood transfusions, dirty IV needles of drug abusers, and by unprotected sex. Do the following to prevent hepatitis B and C:

    • Avoid body piercing and tattooing.

    • Do not have unprotected sex (sex without a condom) unless you know that your partner is not infected.

    • Get vaccinated against hepatitis B virus.

    • Do not use injectable street drugs. If you have a problem with drug abuse, get help by talking to your caregiver. Use only sterile needles when needed to inject medicine, and safely discard the needles. Ask your caregiver how to discard needles safely.

Where can I find support and more information?

Liver cancer is a life-changing disease for you and your family. Accepting that you have liver cancer is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a cancer support group. This is a group of people who also have liver cancer. Contact the following for more information:

  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • Cancer Information Service
    Cancer Information Service
    Phone: 1- 800 - 422-6237
    Web Address: http://www.nci.nih.gov
  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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