Liver cancer can be described as the growth of malignant cells in the liver, the largest internal organ in the body.
Liver cancer is often a complication of liver diseases such as hepatitis or cirrhosis.
The liver is a large, complex organ with a number of vital functions, including bile production and removing alcohol and toxins from the blood.
The liver is a common site for metastatic cancer, which is cancer that has spread from its area of origin (e.g., breast cancer, lung cancer).
The liver continuously filters blood that circulates through the body, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. The liver performs many other important functions, such as removing toxins and other chemical waste products from the blood and readying them for excretion. Because all the blood in the body must pass through it, the liver is unusually accessible to cancer cells traveling in the bloodstream.
There are several types of primary liver cancer, which originate in the liver and are much less common than metastatic or secondary liver cancer.
Liver cancers are seldom diagnosed early because they may have no symptoms. Possible indicators include weight loss, lack of appetite, jaundice and abdominal pain or swelling.
A number of diagnostic tests may be suggested by the physician to confirm liver cancer, including ultrasound, blood tests, CAT scan, MRI and biopsy.
If the cancer is confined to one part of the liver and is detected early, it may be curable by surgery. Other possible treatments include radiation, chemotherapy and ablation, a procedure that involves the use of alcohol, radio waves or cold to destroy tumors. In some cases, a liver transplant may be necessary.
Treatment for the disease varies depending on the type and severity of the liver cancer. A treatment plan will be designed by the patient’s cancer care team that will likely include a cancer physician or an oncologist, a liver specialist or hepatologist and surgeon.
The survival rate reveals that about 9 percent of Americans with liver cancer will live five years or more. Records predict that this survival rate has doubled in recent decades, and researchers hope to increase it further through improved methods of diagnosis, treatment and prevention. Children rarely get liver cancers but some who develop a form of the disease. This is highly curable.
There are several ways to help prevent liver cancer. These involve measures to control risk factors such hepatitis, alcoholism and exposure to certain chemicals.
Liver cancer also occurs as metastatic cancer, which happens when tumors from other parts of the body spread (metastasize) to the liver. This type of liver cancer is most common in the United States i.e. most cancer found in the liver spread there after originating elsewhere. Rather than being called liver cancer, this type of cancer in the liver is named after the organ in which it began — such as metastatic colon cancer in cancer that starts in the colon and spreads to the liver.
Because liver cancer is rarely discovered early and is difficult to control with current treatments, the prognosis is often poor. Although when treatments fail to provide much improvement, they do often control pain and improve quality of life.
Cause of Liver Cancer
Primary liver cancer also called as hepatocellular carcinoma tends to occur in livers damaged by birth defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, hemochromatosis a condition were too much iron is in the liver and cirrhosis.
People diagnosed with primary liver cancer, more than 50% of them have cirrhosis (a scarring condition of the liver often caused by alcohol abuse, hepatitis B and C, and hemochromatosis that can cause permanent damage and liver failure), and those who suffer from a genetic condition hemochromatosis, or iron overload, are at even greater risk.
Many cancer-causing substances are associated with primary liver cancer, including some herbicides and chemicals such as vinyl chloride and arsenic. Smoking along with alcohol consumption as well, also increases risk. Aflatoxins, cancer-causing substances made by a type of plant mold, have also been implicated. Aflatoxins can contaminate wheat, peanuts, rice, corn and soybeans. These are rare problems in most developed countries
like the US.
Liver Cancer Symptoms or Signs of Liver Cancer
Several types of tumors, cancerous and not cancerous can form in the liver. The liver cancer is seen in some parts of Asia and Africa and is rare in the USA. It occurs more frequently in males than females. There are no early warning liver cancer symptoms or signs of liver cancer.
Most of the time liver cancer does not cause symptoms in the early stages. The symptoms below could be caused by liver cancer. But they can also be caused by other cancers or conditions. Most specific liver cancer symptoms or signs or liver cancer are mentioned as below:
- Unknown weight loss (without trying or without any reason)
- Continuous lack of appetite
- Feeling of full stomach even after a very small meal
- Liver swelling or a mass that can be felt in the area of the liver
- Pain in the right upper abdominal area, abdominal fullness or bloating or ongoing stomach pain
- Swelling in the area of the stomach
- Yellow-green color to the skin and eyes (jaundice)
- Weakness ,becoming sicker if you have chronic hepatitis or cirrhosis
- Swollen breasts in males.
- Intestinal bleeding
- Blood clotting problems, bruises on the skin.
If any of these symptoms prevail or if there is any reason to suspect liver cancer, then one or more methods may be used to find out if the disease is really present.
Liver Cancer Treatment
Liver cancer treatment depends on the size of the tumor and whether there is cirrhosis.
Cirrhosis as mentioned is a scarring condition of the liver often caused by alcohol abuse, hepatitis B and C, and hemochromatosis that can cause permanent damage and liver failure.
People without cirrhosis can do well if the tumor is removed or with treatments that destroy the tumor without surgery.
A procedure called radiofrequency ablation is used for this type of condition which includes injecting the tumor with alcohol or heating them to high temperature. If there is cirrhosis, or a very large tumor, most experts recommend liver transplantation as the main treatment.
At a stage were no other treatment gives hope surgery, either to remove the tumor or to do a liver transplant, offers the only chance to cure liver cancer. If all of the cancer that the surgeon can see at the time of the operation can be removed, then you can expect the best outlook for survival.
Complete removal of most liver cancers is not possible. Often the cancer is large, is found in many different parts of the liver, or has spread beyond the liver. Also, many people with cirrhosis do not have enough healthy liver left to make surgery an option.
A liver transplant, a complete transplant of the organ has become an option for people with small liver cancers.
For now, this method is reserved for those with a few small tumors but whose cancer cannot be totally removed, either because of the location of the tumors or because not enough normal liver remains. The 5-year survival rate for these patients is around 70%. Not only is the risk of a second new liver cancer eliminated, but the new liver will function normally.
Not many livers are available for patients with liver cancer because they are most often used for more curable diseases. Patients often must wait a long time, often too long, for a liver to be found. For that reason, some doctors suggest a limited resection first and then a transplant if the cancer comes back.
Treatment that uses high-energy rays (such as x-rays) to kill or shrink cancer cells is called as Radiation therapy. External beam radiation delivers radiation from outside the body to the cancer.
Although liver cancer cells can be killed by radiation, this treatment can’t be used at very high doses because normal liver tissue is also killed. This type of radiation may be used to shrink a liver tumor or to provide relief from symptoms such as pain, but it does not cure the liver cancer and may not help people to live longer.
A newer type of radiation treatment uses computers to map the exact location of a tumor. This lowers the damage to normal tissue and allows higher doses to be used.
Also, studies are going on to find out if using radiation along with certain chemotherapy drugs might work in treating liver cancer.
The use of drugs to kill cancer cells is Chemotherapy. Usually the drugs are given into a vein or by mouth. Once the drugs enter the bloodstream, they spread throughout the body. This makes them useful for cancer that has spread to distant organs.
Liver cancer does not respond to most chemotherapy drugs.
The most successful single drug has been doxorubicin (Adriamycin). But most studies have not shown that chemotherapy helps liver cancer patients to live longer.
Side effects of Chemotherapy:
Chemotherapy can have side effects such as the following:
- A sensation of vomiting or vomiting or nausea
- Continuous loss of appetite ,desire to eat is lost
- hair fall
- mouth sores
- a higher chance of infection due to shortage of white blood cells
- bleeding or bruising after small cuts or injuries due to shortage of blood platelets
- weakness, tiredness and shortness of breath due to fall of red blood cell count
Most side effects go away once treatment is over. If side effects persist long even after the treatment is complete then, be sure to report to your doctor. There are often ways to help.
Liver Cancer Prognosis
As liver cancer is rarely discovered early and is difficult to control with current treatments, the prognosis is often poor. No completely accurate screening test for liver cancer exists.
Liver cancer can be cured only when it is found at an early stage (before it has spread) and only if the patient is healthy enough to have an operation. However, treatments other than surgery may be able to control the disease and help the patients live long and feel better.
When a cure or control of the disease is not possible, some patients and their doctors choose palliative therapy. Palliative therapy aims to improve the quality of a person’s life by controlling pain and other problems caused by the disease.
The doctor may refer patients to doctors who specialize in treating cancer, or patients may ask for a referral. Specialists who treat liver cancer include surgeons, transplant surgeons, gastroenterologists, medical oncologists, and radiation oncologists.
Liver Cancer Survival Rate
Very small numbers of liver cancers are found in the early stages and can be removed by surgery. Less than 30% of patients having surgery are able to have their cancer completely removed. The overall 5-year relative survival rate from liver cancer is about 9%. One reason for this low liver cancer survival rate is that most patients with liver cancer also have cirrhosis of the liver, which itself can be fatal.
The 5-year relative survival rate is the percentage of patients who are still alive at least 5 years after the cancer is found. Those who die of other causes are not counted. Of course, patients might live more than 5 years after diagnosis.
Liver Cancer Prevention
In almost all the cases it’s not possible to prevent the spread of cancer from another site to the liver. Thus making it very difficult for liver cancer prevention And it may not always be possible to prevent primary liver cancer. But definitely one can reduce risk by taking steps to protect from hepatitis B and C, cirrhosis and other liver diseases.
The single most effective way to prevent hepatitis B is to receive the hepatitis B vaccine, which provides more than 90 percent protection for both adults and children. Protection lasts years and may even be life long. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems. Infants often receive the vaccine in the first year of life — typically at 2, 4, and 9 months of age.
Because no vaccine for hepatitis C exists, the following measures also can play a key role in protecting one’s health from liver cancer:
- Educate on what viral hepatitis is and how it’s transmitted.
- Know the health status of any sexual partner. Don’t engage in unprotected sex. Be absolutely certain that partner isn’t infected with HBV, HCV or any other sexually transmitted disease. Use a new latex condom every time having vaginal or anal sex.
- To inject drugs use a clean needle: The best way to protect from HCV is not to inject drugs. But if that isn’t an option, then make sure any needle used is sterile. Contaminated drug paraphernalia is responsible for about half of all new hepatitis C cases.
- Avoid body piercing and tattooing, avoid or limit alcohol, avoid medications that may cause liver damage, avoid mixing alcohol and acetaminophen (Tylenol, others) — a combination known to cause liver damage, avoid exposure to environmental toxins.
- Liver filters every substance ingested, inhaled or applied to the skin. For that reason, as much as possible avoid exposure to toxic substances, including pesticides on foods and suspected carcinogens in shampoos and cosmetics.