Liver Cancer

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Some countries in sub-Saharan countries have cancer as the most common reason for cancer related deaths. In the mix of cancers, is the five year survival rate for liver cancer, which is the number of individuals that survive for five years or more from the day of diagnosis expressed in percentages clocking in at eighteen […] Read More

Top Doctors For Liver Cancer Treatments

Top Hospitals For Liver Cancer Treatments

Liver Cancer

What is liver cancer?

The liver is one of our body’s largest and major organs, which is situated on the upper right side of the body, behind the lower ribs. The major function of the liver is to form bile, which helps digest fatty food and eliminate waste products in the intestine, store nutrients, and remove waste products, harmful chemicals, and worn-out cells from the body.

Liver cancer is one of the life-threatening illnesses and one of the fastest-growing cancer types in the world. It is caused due to abnormal growth of cells in the liver.

liver cancer
Picture Courtesy: news medical net

 ​What are the types of liver cancer?

Types of Liver Cancer
Picture Courtesy: gastroclinix

Liver cancer is a condition where the normal cells that usually comprise the liver become abnormal in behavior and appearance. These abnormal cells, which could be cancerous (malignant), do not die and affect the surrounding normal cells. Thus leading to the formation of tumors. However, these tumors can range from relatively harmless (benign) to cancerous (malignant).

Benign Tumors: These are harmless tumors that do not spread to other body parts. However, if they grow large enough, they can cause problems. In such cases, the doctor would recommend surgery to remove the tumor. A few examples of benign liver tumors are as follows:

Hemangioma: The most common variety, hemangiomas start in the liver’s blood vessels and do not cause symptoms or require any treatment. However, they may need to be removed surgically if they begin to bleed.

Hepatic Adenoma: It starts in the hepatocytes, a major liver cell, and does not cause symptoms. However, when it does, it usually includes pain in the abdomen (stomach area) and loss of blood. Also, there is the risk of the tumor rupturing and eventually leading to cancer. Thus, doctors recommend surgery to remove it.

Focal Nodular Hyperplasia (FNH): A tumor made up of various types of liver cells. These are usually removed surgically as they are hard to differentiate against actual cancer cells.

Malignant Tumors: The locations of these tumors determine the type of cancer the individual is affected by. They are divided into two broad categories: Primary liver cancer and secondary liver cancer. Where primary liver cancer originates due to tumors in the liver, secondary liver cancer is due to cancer in an organ or tissue other than the liver, which moves to the liver. Since the liver is exposed to the blood from organs and tissues like the bladder, kidney, or breasts, it is extremely prone to cancer.

Primary Liver Cancer:

Hepatocellular carcinoma (HCC): The most common cancer in adults, Hepatocellular carcinoma (HCC) has different growth patterns. It may either originate from a single tumor on the liver and spread throughout the liver, or it may have small cancers all over the liver, a case commonly seen concerning cirrhosis and is the most common type of HCC in the US.

Intrahepatic Cholangiocarcinoma (Bile duct cancer): Originating from the bile ducts, which are the tubes that carry bile from the liver to the gall bladder, about ten to twenty percent of the cases of primary liver cancer fall under this category.

Angiosarcoma and hemangiosarcoma: Rare cancers that affect the liver’s blood vessels and are prone to individuals exposed to vinyl chloride or thorium dioxide.

Hepatoblastoma: Extremely rare and usually seen in children four years or younger. It is similar to fetal liver cells, and two out of three children are successfully treated by surgery and chemotherapy.

Secondary Liver Cancer (Also known as Metastatic liver Cancer):

Most of the time, cancer does not originate from the liver but from other tissues or organs in the body, namely the pancreas, lung, colon, stomach, or breast. This can be associated with the function of the liver to filter blood coming from the digestive tract. The blood coming in might have cancer cells suspended in them and thereby attach themselves to the liver and grow.


staging liver cancer
Picture Courtesy: liver cancer

One of the goals of the diagnosis mentioned above is to stage the liver cancer in the body: defining the extent of the cancer with the help of alpha-numeric parameters or generally accepted terminology. This helps the doctor determine the best treatment for the patient.

​​TNM Staging System:

The most common system for staging cancers, including liver cancer, is the TNM system.
Tumor (T): How big is the tumor and its extent?
Node (N): Has the tumor spread to the lymph nodes, and what is its extent?
Metastasis (M): Has the tumor spread and affected any other body part and its extent?

The extents of these three parameters are measured on a scale of 1 to 4, with 1 being the least and 4 being the highest. If, however, there is no presence of a tumor and it has not affected the lymph nodes or any other part of the body, then it is represented by the letter X. For example, TX, T1, T2, T3, and T4. Similarly, the nomenclature holds true for N and M.

How is liver cancer treated?

liver cancer treatment
Picture Courtesy: liver cancer treatment

The type of treatment recommended by the doctor will be based on the specific case: the cancer’s cause, location and extent, and whether it has spread to any of the neighboring organs. The choice of treatment is generally between the following:

Surgery: Usually preferred in the case of a small tumor limited to the liver, it involves removing the tumor via surgery and allowing the liver to grow back. Complications that may arise are bleeding, infection, pneumonia, or side effects of anesthesia. The different types of surgeries done for liver cancer are listed below:

  • Partial hepatectomy- A portion of the liver is removed during this procedure. This surgery is used only for early-stage of cancer. Over some time, the remaining healthy tissue will regrow and replace the missing part.
Partial hepatectomy
Picture Courtesy: gastro clinix
  • Liver Transplant: A liver transplant involves the patient replacing a part of the complete liver received from a donor. Complications include, along with those mentioned under surgery, rejection of the new liver by the immune system.

Ablation Therapy: Used under palliative care (relieving pain or symptoms with cancer), it involves using a heat laser or injecting special alcohol or acid in the area of cancer. Recommended when the cancer is unresectable (a tumor that cannot be completely removed via surgery).

Ablation Therapy liver cancer
Picture Courtesy: gastro clinix

Embolization: Involves cutting out the blood supply to the cancerous region. Preferred in cases where the tumor is large. Complications may include fever, abdominal pain, nausea, and vomiting.

Radiation Therapy: Involves using high-energy rays to kill cancer cells while avoiding the normal cells, which are also susceptible to damage from radiation. Complications include skin irritation near the treatment site, fatigue, nausea, and vomiting.

Chemotherapy: Another method used for killing cancer cells involves taking medicine, either via the mouth or by injecting it into an artery/vein feeding the liver. Complications, though temporary, may include fatigue, hair loss, easy bruising, nausea, and vomiting.

chemotherapy liver cancer
Picture Courtesy: gastro clinix

Targeted Agent: Involves taking Sorafenib (Nexavar) which can prolong the lifespan of patients with advanced liver cancer to about three months. Side effects include fatigue, rash, high blood pressure, sores on hands and feet, and loss of appetite.

Immunotherapy: Treats cancer using the body’s immune system. 


symptoms of liver cancer
Picture Courtesy: cancer symptoms

Most patients diagnosed with liver cancer are asymptomatic at an early stage. The below-mentioned symptoms are seen in patients at the late stage of cancer. They are:

  • Abdominal discomfort, pain, and swelling in the upper abdomen. 
  • Jaundice
  • Nausea, vomiting
  • Unexplained weight loss
  • Loss of appetite
  • Fever
  • Fatigue, extreme tiredness
  • Bruising or bleeding easily
  • Dark urine, pale and chalky stools.

How is liver cancer diagnosed?

liver cancer diagnosis
Picture Courtesy: verywellhealth

Physical examination:

Blood Tests: are performed to find the levels of Alfa-fetoprotein (AFP) in the blood as it is an important tumor marker. Usually, patients with the presence of tumors would have a larger than normal percentage of AFP in their bloodstream.

Liver function testsThis test is performed to check the function of the liver.

Other blood tests: They include complete blood count, renal function tests, blood glucose levels, calcium levels, etc.

Imaging Studies: The preferred means to determine the location and extent of cancer in the liver is through ultrasonography, multiphasic helical CT scan, and MRI. If the imaging studies fail to provide conclusive results, then follow-up studies will be performed.

AngiographyThis test is done to evaluate the arterial supply of blood to the liver.

Liver Biopsy: This involves extracting a sample from the cancerous part of the liver with the help of a needle and analyzed by a pathologist to determine the extent and the type of cancer. However, a biopsy comes with an added risk of seeding: it is when the cancer cells get attached to the needle used for a biopsy and spread to areas touched by the needle. The risk of seeding varies from one to three percent of the total cases.

Causes and Risk Factors

liver cancer risk factors
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Liver cancer is most commonly seen after the setting of chronic liver disease which is caused due to long-term damage to the liver called cirrhosis. Besides this, the following conditions and lifestyle options are known to increase the risk of liver cancer in individuals:


Can liver cancer be prevented? 

Liver cancer can be prevented by following the below-mentioned rules:
liver cancer prevention
Picture Courtesy: candrol

What is the survival rate of liver cancer?

The survival rate of liver cancer depends upon several factors, such as the patient’s grade or stage of cancer and overall condition. Early diagnosis and treatment result in a good prognosis for the patient. The five-year survival rate of liver cancer that has not spread beyond the liver is 34%. While the survival rate of regional metastasis (spread) of liver cancer to adjacent organs or lymph nodes is 12%. For distant metastasis of cancer that has spread to other body organs such as bones and lungs, it is 3%.