What is Liver Cancer

Liver cancer is an abnormal growth of cells (tumor) in the liver that is cancerous (malignant). The liver is located on the upper right side of the abdomen, just below the ribs. It is the largest organ in the body. The liver:

• Breaks down and stores nutrients, such as sugar and iron.
• Makes the parts of your blood that help your blood clot and prevent excessive bleeding.
• Cleans (filters) alcohol, drugs, and harmful substances out of the blood.
• Helps absorb fats and other nutrients.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:

• Males.
• Asian Americans and Pacific Islanders.
• People with scarring of the liver (cirrhosis). Cirrhosis may be caused by:
  • Excessive alcohol use.
  • Hepatitis B or hepatitis C.
  • Smoking.
• People with certain liver diseases, such as Wilson disease.
• People with nonalcoholic fatty liver disease.
• People with diabetes.
• People who are overweight.
• People who are exposed to aflatoxins. These are substances made by certain types of mold that grow on food products, such as corn and peanuts.
• People who are exposed to vinyl chloride. This chemical is used to make certain plastics.
• People who use anabolic steroids. This is a hormone that is used to increase muscle mass.
• People who drink water that has been contaminated with arsenic.
• People who have a disease called schistosomiasis.

What are the signs or symptoms?

This condition often causes few or no symptoms in the beginning. As the cancer grows, symptoms may include:

• Weight loss without dieting.
• Loss of appetite.
• Nausea or vomiting.
• Feeling itchy.
• A hard lump or mass under your ribs.
• Abnormal bruising or bleeding.
• Feeling very weak and tired.
• Pain on the right side of your abdomen, shoulder blade, or back.
• Feeling full after eating a small amount.
• Abdominal bloating.
• Fever.
• Skin or eyes that look yellow in color (jaundice).
• Dark-colored urine.
• White, chalk-like stools.

Liver cancer may cause other conditions to develop, such as:

• Hypercalcemia. This is high calcium levels in the blood, which may cause weakness, constipation, or feelings of confusion.
• Hypoglycemia. This is low blood sugar, which may cause fatigue, mental confusion, and sweating.
• Enlarged breasts (gynomastia), if this applies.
• Shrinking of the testicles, if this applies.
• Looking and feeling flushed due to a high amount of red blood cells.
• High cholesterol levels.

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. You may also have tests, including:

• Blood tests.
• Imaging tests, such as:
  • CT scan.
  • MRI.
  • Ultrasound.
  • Angiogram. This is a type of X-ray that uses dye.
  • Bone scan.
• Laparoscopy. This is when your health care provider uses a small, lighted camera (laparoscope) to look at your liver and other organs.
• Examination of a tissue sample (biopsy) taken from your liver.

If liver cancer is confirmed, it will be staged to determine its severity and extent. Staging is an assessment of:

• The size of the tumor.
• If the cancer has spread.
• Where the cancer has spread.

How is this treated?

Treatment for liver cancer depends on the type and stage of the cancer, how well your liver is working, and your overall health. Treatment may include one or more of the following:

• Surgery to remove as much of the cancer as possible. Sometimes the whole liver is removed and replaced with a healthy liver (liver transplant).
• Chemotherapy. This uses medicines to kill the cancer cells.
• Targeted therapy. This treatment targets specific parts of cancer cells and the area around them to block the growth and spread of the cancer.
• Immunotherapy. This is also called biological therapy. This strengthens your body’s defense (immune) system to destroy or stop the growth and spread of cancer cells.
• Radiation therapy. This procedure uses high-energy X-rays to kill the cancer cells.
• Ablation. This destroys the tumor cells using high-energy radio waves or a type of alcohol (ethanol). This may be done if you have a few small tumors or if surgery is not an option.
• Microwave therapy. This uses heat to destroy cancer cells.
• Cryosurgery. This is also called cryotherapy. This procedure uses cold to freeze and kill the cancer cells.
• Embolization. This is a procedure that blocks the blood flow to the liver tumor.
• Chemoembolization. This procedure combines embolization with tiny beads that deliver chemotherapy directly to the site of the tumor.
• Radioembolization. This procedure combines embolization with tiny beads that deliver radiation directly to the site of the tumor.

Depending on the treatment you receive, your health care provider may also recommend that you receive the hepatitis A and hepatitis B vaccines.

Follow these instructions at home:

• Consider joining a support group.
• Talk to your health care provider about:
  • Advice to help you manage side effects of treatment.
  • The best diet for you. This may include eating more fruits and vegetables.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not drink alcohol.

Contact a health care provider if:

• You cannot eat because you feel nauseous.
• You feel weaker or more tired than usual.
• Your pain gets worse.
• You feel depressed or anxious.

Get help right away if:

• You feel faint or very weak.
• You feel confused.
• You feel very sleepy during the daytime.
• Your pain in your abdomen increases suddenly.
• Your abdomen or legs start to swell.
• You have nausea, vomiting, diarrhea, or constipation that does not go away.
• You have a fever, chills, or body aches.
• You notice unusual bleeding or bleeding that does not stop quickly.
• You have maroon, black, or bloody stools.
• Your eyes or skin becomes more yellow in color.