Liver cancer is determined by abnormal and uncontrolled growth of cells in the liver. These altered cells gradually replace normal cells, disrupting the normal function of the liver and invading other organs.
What is liver cancer ?
Liver cancer is an abnormal and uncontrolled growth of cells in the liver, abnormal cells that replace existing cells, damage liver function and invade other organs. There are two types of liver cancer, primary liver cancer and secondary liver cancer (liver metastasis).
- Metastatic secondary cancer is that they start in another part of the body and spread to the liver
- Primary liver cancer begins with cells inside the liver.
The two most common forms of primary liver cancer are:
- Hepatocellular carcinoma (HCC)
- gallbladder cancer
The most common secondary form of liver cancer is metastatic colorectal cancer. If the disease is isolated in the liver, then the patient may be a candidate for liver-oriented treatments such as surgery, resection or chemotherapy.
Causes of liver cancer
Causes of liver cancer include 5 main causes of liver cancer and 9 other risk factors, please read below:
- The exact cause of liver cancer is not known. However, most cases are related to liver scarring , also known as cirrhosis .
- According to the American Cancer Society, hepatitis C is the most common cause of liver cancer in the United States
- People with both hepatitis B or C are at significantly higher risk of liver cancer than other healthy people, as both types of disease can lead to cirrhosis.
- Certain inherited liver diseases , such as hemochromatosis , cause cirrhosis and also increase the risk of liver cancer.
Other risk factors
- Chronic infection with HBV or HCV: Chronic infection with the hepatitis B virus (HBV) or the hepatitis C virus (HCV) increases the risk of liver cancer.
- Cirrhosis: This progressive and irreversible condition causes scar tissue to form in your liver and increases the likelihood of developing liver cancer.
- Certain inherited 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 higher risk of liver cancer than people who do not have diabetes.
- Obesity: Being obese increases your risk of developing many cancers, including liver cancer.
- Excessive alcohol consumption: Consuming more than a moderate amount of alcohol daily for years can lead to irreversible liver damage and an increased risk of liver cancer.
- Genetic genetic disease : Diseases that interfere with the normal metabolism of the body have been shown to increase the risk of liver cancer.
- Use of anabolic steroids: Male hormones abused by athletes to increase muscle may slightly increase the risk of liver cancer when used long term.
- Long-term exposure to aflatoxin: aflatoxin is a substance produced by a fungus. It can be found in molded wheat, peanuts, corn, nuts, soy and peanuts. The risk of liver cancer only increases after long-term exposure.
People at high risk for liver cancer should regularly check for liver cancer. Liver cancer, if not diagnosed early, is much more difficult to cure. The only way to know if you have liver cancer early is through screening because the symptoms are mild or none.
Symptoms of cancer that starts in the liver (primary liver cancer) usually do not cause symptoms at an early stage. When you have symptoms, they may include:
- weight loss
- jaundice and eye whites
- feel sick
- swollen belly
- Anorexia or feeling full after eating a small amount
- stomach ache or your right shoulder
- a lump on the right side of your abdomen
Symptoms vary depending on where the cancer is. Some symptoms, such as itching, are caused by jaundice. Symptoms of liver cancer are often quite vague, such as feeling ill and losing appetite.
If you already have a liver condition such as cirrhosis, tell your doctor if you have any new or worsening symptoms.
Tests and procedures used to diagnose liver cancer include:
- Blood tests: Blood tests may show abnormal liver function.
- Imaging tests: Your doctor may recommend imaging tests, such as ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI).
- Take a sample of liver tissue for testing: Your doctor may recommend removing a piece of liver tissue for laboratory testing to give a definite diagnosis of liver cancer.
- During a liver biopsy: the doctor inserts a thin needle through the skin and into the liver to remove tissue samples. In the laboratory, doctors examine tissue under a microscope to look for cancer cells. Liver biopsy is at risk for bleeding, bruising and infection.
Stages of liver cancer
The stage of cancer allows the doctor to decide on the course of treatment. Liver cancer is classified into four stages:
- Stage 1: The tumor is in the liver and has not spread to an organ or place.
- Stage 2: There are several small tumors that exist in the liver or a tumor that has reached a blood vessel.
- Stage 3: There are many large tumors or a tumor that has reached the main blood vessels. Cancer may also have reached the gallbladder.
- Stage 4 (end-stage liver cancer): The cancer has spread. This means it has spread to other parts of the body.
Once the stage has been found, a course of treatment can begin.
Identify treatment for liver cancer
If your cancer is at stage A when diagnosed, it can be completely cured. The three main ways that can be achieved are:
- Removal of the affected part of the liver: is called resection
- Liver transplant: an operation to remove the liver and replace it with a healthy person
- Using heat to kill cancer cells: called microwave or radio ablation (RFA)
If your cancer is at stage B or C, treatment is usually not possible. However, chemotherapy can slow cancer progression, reduce symptoms and prolong life for months or, in some cases, years.
If your cancer is at stage D when it is diagnosed, it is often too late to slow the spread of the cancer. Instead, treatment focuses on relieving any painful and uncomfortable symptoms you may have.
Treatment for liver cancer depends on:
- Condition of the liver
- The size, location and number of tumors
- If the cancer has spread beyond the liver
- The person’s age and overall health
Treatment options if the cancer has not spread and the rest of the liver is healthy:
- Transplants: If the cancer has not spread, for some patients, a liver transplant (liver transplant) may be an option.
- Surgery: If the cancer is detected early and the rest of the liver is healthy, doctors can perform surgery to remove the tumor from the liver (partial liver resection).
- Radiofrequency ablation : Radiofrequency ablation uses a special probe to destroy cancer cells with heat.
Other treatment options if surgery and transplantation are not possible include:
For cancer that has not spread beyond the liver
- Cold surgery: using metal probes to freeze and kill cancer cells.
- Bile embolization or chemotherapy: procedures in which the blood supply to the tumor is blocked, after anticancer drugs (chemotherapy) and no (embolism) are both inserted into the vessels blood near the tumor.
- Radiation therapy: Radiotherapy uses radiation (high-energy X-rays) to kill cancer cells.
For cancer that has spread beyond the liver
- Medication: Oral medications are available for use in some cases of hepatocellular carcinoma (the most common primary liver cancer).
- Clinical trials: may be an option for some patients.
Talk to your doctor about other options that may be available.
Prospects for treatment of liver cancer
- The outlook for liver cancer is poor, because it is usually diagnosed at a later stage, at which point it has spread to other organs or parts of the liver.
- Survival rates decrease as the phase approaches Stage IV. People diagnosed at an early stage have a 31-year survival rate of 31%. Once the cancer has spread, at a later stage, the same survival rate may be as low as 3%.
- Treatment for liver cancer often involves serious surgery and is at high risk for complications. This can further affect the outlook of a person with liver cancer.
- A successful liver transplant will effectively cure liver cancer, but it is only an option for a small percentage of patients. Successful excision surgery is only one of three cases.
- However, scientists are experimenting with some promising new drugs and therapies that could help prolong the lives of people with liver cancer.
How to prevent liver cancer
How to prevent liver cancer includes 5 common things below:
- Regularly see a doctor who specializes in liver disease
- Talk to your doctor about prevention of viral hepatitis, including vaccination against hepatitis A and hepatitis B
- Take steps to prevent exposure to hepatitis B and hepatitis C.
- If you have cirrhosis or chronic liver disease, follow your doctor’s recommendations for treatment and regular check-ups for liver cancer.
- If you are overweight or obese, have diabetes, or drink a lot of alcohol, talk to your doctor
Screening for liver cancer
For the general population, screening for liver cancer has been shown to reduce the risk of dying from liver cancer, so it is often recommended. The American Association for Liver Disease Research recommends screening for liver cancer for people who are thought to be at high risk, including those who have:
- Hepatitis B one or more of the following: is Asian or African, has cirrhosis or has a family history of liver cancer
- Hepatitis C infection and cirrhosis
- Cirrhosis from other causes, such as autoimmune disease, excessive alcohol use, nonalcoholic fatty liver disease and hereditary hemochromatosis
- First biliary cirrhosis
Discuss the pros and cons of screening with your doctor. You can decide whether screening is right for you based on your risk. Screening usually includes an ultrasound exam every six months.
FDA-approved medications for liver cancer:
This page lists cancer drugs approved by the US Food and Drug Administration ( FDA ) for liver cancer. The list includes generic names and brand names. The drug name links to the NCI Cancer Drug Information summary. There may be drugs used in liver cancer not listed here:
FDA-approved medications for liver cancer:
- Cabometyx (Cabozantinib-S-Malate)
- Cyramza (Ramucirumab)
- Keytruda (Pembrolizumab)
- Lenvatinib Mesylate
- Lenvima (Lenvatinib Mesylate)
- Nexavar (Sorafenib Tosylate)
- Opdivo (Nivolumab)
- Sorafenib Tosylate
See more videos about what is liver cancer?
Source of Liver Cancer:
- Source mayoclinic.org article Liver cancer : https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659 , updated 4/5/2019.
- Source en.wikipedia.org Liver cancer article : https://en.wikipedia.org/wiki/Liver_cancer , updated November 5, 2019.
- Source Cancer.gov article Drugs Approved for Liver Cancer: https://www.cancer.gov/about-cancer/treatment/drugs/liver updated November 28, 2019 .
- A reputable source index-china.com summarizes the article What is liver cancer?: https://index-china.com/liver-cancer/, updated 13/3/2020.
Assoc.Prof.Dr. Tran Ngoc Anh is currently Hanoi Medical University Hospital, Associate Professor, Department of Internal Medicine, Gastroenterology and Head of Department of General-Uematology of Hanoi Medical University. Consulting doctor at ThuocLP Pharmacy.
Professional qualifications, Academic degrees – Education:
Graduated from General Practitioner System, Hanoi Medical University
Graduated with a Master degree in Internal Medicine, Hanoi Medical University
Graduated from the training program specialized in Gastrointestinal, Henri Mondor Institute Center, University of Paris 6, French Republic 1996-1997; 1999
Graduated from the training program specialized in Gastrointestinal, North Royal Sydney Hospital, Australia; 2002
Graduated from a training program specialized in chronic liver diseases, Pizza, Italy 2009
Graduated with a PhD in Gastrointestinal, Hanoi Medical University
Associate Professor, Gastroenterology, Hanoi Medical University
Training and Scientific Research:
Published more than 200 articles in domestic and international specialized journals
Editor of many monographs and participates in compiling 2 textbooks.
Guide many students and graduate students of Hanoi Medical University
Manager of many grassroots research projects
Certificate of Good Clinical Practice (GCP: 2012, 2015), Ministry of Health
Specialized certificates: General gastrointestinal endoscopy, Interventional gastrointestinal endoscopy, General gastrointestinal ultrasound, Interventional gastrointestinal ultrasound (Bach Mai BV), Chronic liver disease.