Overview

Liver cancer is cancer that starts in the cells of your liver. Your liver is a football-sized organ located in the upper right part of your abdomen, below your diaphragm, and above your stomach.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

Symptoms

Liver cancer is cancer that starts in the cells of your liver. Your liver is a football-sized organ located in the upper right part of your abdomen, below your diaphragm, and above your stomach.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

A person with liver cancer may experience abdominal pain, unexplained weight loss, and fatigue.

Symptoms of liver cancer usually do not appear until the disease has reached an advanced stage.

Liver cancer can cause the following:

  1. jaundice, where the skin and eyes turn yellow
  2. abdominal pain
  3. pain near the right shoulder blade
  4. unexplained weight loss
  5. an enlarged liver, spleen, or both
  6. swelling of the abdomen or a buildup of fluid
  7. tired
  8. nausea
  9. vomiting
  10. Back ache
  11. itch
  12. fever
  13. a feeling of fullness after a small meal
  14. Liver cancer can also cause swelling of the veins visible under the abdominal skin, as well as bruising and bleeding.

It can also lead to high calcium and cholesterol levels and low blood sugar.

Treatment

Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, general health and personal preferences.
Surgery

The operations used to treat liver cancer include:

Surgery to remove the tumor. In some situations, your doctor may recommend surgery to remove cancer from the liver and a small part of the healthy liver tissue around it if your tumor is small and your liver function is good.

Liver transplant surgery. During a liver transplant, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery is only an option for a small percentage of people with early stage liver cancer.

Localized treatments
Localized treatments for liver cancer are those given directly to cancer cells or to the area around cancer cells. Localized treatment options for liver cancer include:

Heating of cancer cells. Radiofrequency ablation uses electrical current to heat and destroy cancer cells. Using an imaging test as a guide, such as an ultrasound, the doctor inserts one or more thin needles into small incisions in your abdomen. When the needles reach the tumor, they are heated by an electric current, destroying the cancer cells. Other procedures for heating cancer cells can use microwaves or lasers.

Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly on the liver tumors. Ultrasound images are used to guide the cryoprobe and monitor cell freezing.
Injection of alcohol into the tumor. When injecting alcohol, pure alcohol is injected directly into the tumors, either through the skin or during an operation. Alcohol causes the death of tumor cells.

Injection of chemotherapeutic drugs into the liver. Chemoembolization is a type of chemotherapy treatment that delivers strong anti-cancer drugs directly to the liver.

Place beads filled with radiation into the liver. Tiny spheres containing radiation can be placed directly into the liver where they can deliver radiation directly to the tumor.

Radiotherapy

This treatment uses high power energy from sources such as x-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct energy to the liver, while sparing the surrounding healthy tissue.
Radiation therapy may be an option if other treatments are not possible or if they have not helped. For advanced liver cancer, radiation therapy can help control symptoms.

During external beam radiation therapy, you bind yourself on a table and a machine directs the energy beams to a specific point in your body.
A specialized type of radiation therapy, called stereotaxic body radiation therapy, involves simultaneously focusing several beams of radiation at a point on your body.

Targeted drug therapy

Targeted drug treatments focus on specific abnormalities found in cancer cells. By blocking these abnormalities, targeted drug therapies can cause cancer cells to die.
There are many targeted drugs available to treat advanced liver cancer.
Some targeted therapies only work in people whose cancer cells have certain genetic mutations. Your cancer cells can be tested in a lab to see if these drugs can help.

Immunotherapy

Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because cancer cells make proteins that blind cells in the immune system. Immunotherapy works by interfering with this process.

Chemotherapy

Chemotherapy uses drugs to kill fast growing cells, including cancer cells. Chemotherapy can be given into a vein in your arm, as a pill, or both.

Causes

Liver cancer occurs when liver cells develop changes (mutations) in their DNA. The DNA of a cell is the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that the cells can start to grow out of control and eventually form a tumor – a mass of cancer cells.

Sometimes the cause of liver cancer is known, such as with chronic hepatitis. But sometimes liver cancer occurs in people without an underlying disease and the cause is unclear.

Types

There are two main types of primary liver cancer: hepatocellular carcinoma and cholangiocarcinoma (cancer of the bile ducts).
Secondary metastatic liver cancer occurs when cancer spreads to the liver from other parts of the body.
Hepatocellular carcinoma
Hepatocellular carcinoma, the formation of cancer cells in liver tissue, is the most common type of liver cancer.
Fibrolamellar hepatocellular carcinoma (FHCC) is an extremely rare form of this disease. Fibrous bands throughout tumor cells help doctors diagnose CHF Canada.
Learn more about hepatocellular carcinoma at the UPMC Liver Cancer Center.
Cholangiocarcinoma (cancer of the bile ducts)
Cholangiocarcinoma is cancer of the liver that occurs in the ducts that drain bile from the liver to the small intestine.
It is a rare form of primary liver cancer. Doctors diagnose between 2,000 and 3,000 people each year in the United States.
Learn more about cholangiocarcinoma at the UPMC Liver Cancer Center.

Metastatic liver cancer

Metastatic cancer of the liver is a secondary cancer. This happens when cancer cells have spread to the liver elsewhere in the body.
Doctors call this secondary cancer of the liver the same type of cancer as primary cancer.
For example, if colorectal cancer spreads to the liver, the cancer cells in the liver are actually colorectal cancer cells. Doctors call it metastatic colorectal cancer, not liver cancer.

The most common types of liver metastases are:

Diagnosis

Tests and procedures used to diagnose liver cancer include:

Treatment

cancer treatment, 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 include a variety of other healthcare professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Treatment options and recommendations depend on several factors:
What part of the liver is affected by cancer

When a tumor is found at an early stage and the patient’s liver is functioning well, treatment is aimed at trying to remove the cancer. The plan of care may also include treating symptoms and side effects, an important part of cancer care. When liver cancer is detected at a later stage or the patient’s liver is not functioning well, the patient and the doctor should talk about the goals of each treatment recommendation. At this point, treatment goals may focus on slowing the growth of cancer and relieving symptoms to improve quality of life.

When to see a doctor

Make an appointment with your doctor if you experience any signs or symptoms that worry you.

Health condition

More than half of all people diagnosed with primary liver cancer suffer from cirrhosis – a scarring disease of the liver often caused by alcohol abuse. Hepatitis B and C and hemochromatosis can cause permanent damage and liver failure. Liver cancer can also be linked to obesity and fatty liver disease.

Risk factors

Factors that increase the risk of primary liver cancer include:
Chronic infection with HBV or HCV. Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk for liver cancer.
Cirrhosis. This progressive, irreversible disease causes scar tissue to form in your liver and increases your chances of developing liver cancer.
Certain hereditary liver diseases. Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson’s disease.
Diabetes. People with this blood sugar disorder have a greater risk of liver cancer than those who do not have diabetes.
Non-alcoholic fatty liver disease. A buildup of fat in the liver increases the risk of liver cancer.
Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on poorly stored crops. Crops, such as grains and nuts, can be contaminated with aflatoxins, which are found in foods made from these products.
Excessive consumption of alcohol. Consuming more than a moderate amount of alcohol per day for many years can lead to irreversible liver damage and increase your risk of liver cancer.

Duration

With treatment, the median survival for stage C liver cancer is between 6 and 11 months.