What Is Liver Cancer: Get the Facts

Liver cancer happens when the liver's normal cells change in behavior and appearance. As a result, the abnormal liver cells divide and grow uncontrollably. Liver cancer is also referred to as "hepatic cancer", which can either be primary or secondary.  

The liver is a large organ that is located in the upper abdominal portion directly under your diaphragm and above the stomach. The main function of the liver is to filter all the blood that circulates all through your body. The liver converts drugs and nutrients, which are absorbed from the gastrointestinal tract making them ready to be used as chemicals. The liver is also a special organ that performs other crucial functions in the body such as removing waste products and toxins from your blood and make them ready for excretion. Since blood from different parts of your body has to pass through the liver, it has the likelihood of accessing cancer cells and carcinogens traveling through your blood.

Your liver can be affected by either primary cancer, which usually arises from the liver cells (hepatocytes) or secondary cancer that develops in other parts of the body and then spreads to the liver. According to statistics, more than 50 percent cases of liver cancer in developing countries is primary liver cancer. This data may be as a result of a hepatitis prevalence caused by contagious viruses, which is a predisposing factor to liver cancer. Primary liver cancer has also been seen to affect twice as many men compared to women who are 67 years and above.

Since the liver is made up of different cell types, there is a likelihood of developing different types of tumors. Some of these tumors can be benign, meaning, they cannot spread to other body parts. Other liver tumors can be cancerous and may spread to other parts of the body through a process called "metastasis".

The common types of liver benign tumors are as follows:

• Fibroma
• Hemangioma
• Cysts
• Hepatic adenoma
• Lipoma
• Leiomyoma
• Focal nodular hyperplasia (FNH)

All of the tumors listed above are not treated the same way as liver cancer. In case they cause bleeding or pain, they need to be surgically removed. The common cancers of the liver are:

• Hepatocellular Carcinoma (HCC) - This is the most common type of hepatic cancer.

• Cholangiocarcinoma - This form of cancer is regarded as the cancer of the bile duct. However, if it becomes metastatic, it invades the liver before other organs.

Causes of Liver Cancer

The causes of liver cancer have not yet been identified, but some factors have been linked to it. These factors include:

• Excessive alcohol drinking - Individuals who drink alcohol excessively have an increased risk of developing liver cancer. For example, people who drink at least two alcoholic drinks a day for more than 10 years raise their risk of developing hepatocellular cancer.

• Anabolic Steroids - These steroids are mostly used by weightlifters and athletes to help burn calories. The frequent use of these steroids can increase the risk of liver cancer development.

• Aflatoxin - It is a toxin produced by a fungus that grows in grains and cereals. Long-term exposure to aflatoxin raises the risk of developing liver cancer.

• Liver Cirrhosis - It is "scarring" of the liver, which can severely damage your liver leading to the development of liver cancer.

• Obesity - Being obese increases the risks of getting liver cancer among other types of cancers. Studies have shown that people who are obese can produce excessive hormones such as insulin and estrogen due to their numerous fat tissues. The abnormal production of these hormones can cause the growth and development of cancer.

Other risk factors for liver cancer are:

• Diabetes
• Family history or inheritance
• Deficiency of L-carnitine
• Low immunity
• Liver diseases such as hepatitis B and hepatitis C
• Gender
• Smoking cigarettes
• Arsenic (mostly from polluted drinking water)
• Liver failure
• Iron storage disease

Signs and Symptoms

You are not likely to experience any signs and symptoms when your liver cancer is still in its early stages. However, as cancer grows, you can experience the following signs and symptoms:

• Sharp pain in the upper right part of the abdomen
• Formation of a lump or a feeling of heaviness in your upper belly 
• Unexplained weight loss
• Jaundice that changes the normal color of your tongue, skin, and eyes
• Vomiting or emesis
• Fever
• Increased body temperature
• Nausea
• Fatigue
• General itching on your upper belly 
• Hepatomegaly (abnormal enlargement of the liver)

Diagnosis

Before any laboratory test or scans, your doctor will perform a physical examination and ask you the following questions:

• Do you have signs of decreased appetite?
• Have you experienced weight loss?
• Do you have any pain in your belly?
• Are you feeling exhausted, weak, or tired?

After the physical examination, your doctor will use either of the tests discussed below to diagnose liver cancer (hepatocellular cancer).

1. Imaging Tests

Your healthcare provider is likely to perform an MRI, CT, or ultrasound scan to check for any tumors in your liver.

• MRI scan - An MRI is a scan that uses strong magnets plus radio waves to take an image of your liver.

• CT scan - A CT scan uses a powerful X-ray that takes detailed pictures of your liver or the insides of your body.

• Ultrasound - An ultrasound, on the other hand, uses sound waves to create an image of your liver.

All these images created by CT, ultrasound, or MRI scans are interpreted by a radiologist, and then the results are given back to your doctor.

2. Blood Tests

Blood tests are used to aid in the diagnosis of liver cancer. Your doctor will take a small sample of your blood to test for a protein called alpha-fetoprotein (AFP). According to scientific research, unborn fetuses have high levels of AFP, which goes down with age or immediately after birth. In case your blood is found with AFP protein, then it could be a positive indication of liver cancer.

3. Liver Biopsy

In a liver biopsy, your doctor will take a small sample of your liver tissue and then examine it under a powerful microscope to look for tumors or cancer cells. A liver tissue sample can be prepared by making a small cut in your belly and then a needle is put on your belly to take a small amount of tissue. Anesthesia is administered to block pain during the process.

Treatment

There are many treatment options that you can discuss with your doctor after a liver cancer diagnosis. Your treatment choices can include:

• Radiotherapy - This procedure uses high-energy rays to kill all your cancer cells. Radiotherapy can either be internal or external.

• Chemotherapy - In a chemotherapy treatment, a combination of chemotherapy drugs is injected into your body to kill the abnormal and cancerous cells.

• Alcohol Injection - This procedure is also known as percutaneous ethanol injection, which uses ultrasound to directly guide the doctor in the process of injecting the needle into the liver tumor. Ethanol is injected and is aimed at destroying the tumor cells. Anesthesia is also administered to block pain during the procedure.

Bottom Line

Liver cancer can be primary, which means that it can originate from the body's liver cells, or secondary, which develops from other body organs and then spreads to the liver.

Liver cancer can be a very deadly condition resulting in a quick death since the liver is one of the most important organs in the body. However, liver cancer can be treated during the early stages and can be prevented as well. To prevent or control liver cancer, you need to avoid all the risk factors that will increase your chances of developing liver cancer. As they say, prevention is better than cure.