Hepatology

Liver Cancer

The liver is one of the main organs of the digestive system, responsible for processing materials absorbed by the intestine and producing the chemicals needed for the body to function. The liver also detoxifies harmful chemicals and metabolizes prescription drugs and medicines.

Cancer that forms in the liver is called primary liver cancer; cancer that spreads from other organs to the liver is referred to as secondary liver cancer.

Types of Liver Cancer

There are three types of primary liver cancer:

• Hepatocellular carcinoma: The liver is made up mainly of cells called hepatocytes. Hepatocellular carcinoma occurs when hepatocytes begin to grow out of control. It can start as a single tumor that grows larger, or as small cancer nodules throughout the liver. Hepatocellular carcinoma is the most common type of liver cancer.
• Intrahepatic cholangiocarcinoma: This form of liver cancer starts in cells that line the bile ducts in the liver. Intrahepatic cholangiocarcinomas make up about 10-20% of cancers.
• Angiosarcoma/Hemangiosarcoma: These are rare cancers that begin in cells lining the blood vessels of the liver. These tumors grow quickly and can be widespread.

Symptoms of Liver Cancer

Liver cancer typically does not present symptoms in its early stages, but eventual signs and symptoms include:

• Weight loss
• Loss of appetite
• Upper abdominal pain or abdominal swelling
• Nausea and vomiting
• Weakness and fatigue
• Jaundice/yellowing of skin or eyes

Risk factors for liver cancer include:

• Chronic hepatitis: Viral infections of the liver, including Hepatitis C and Hepatitis B
• Cirrhosis: Progressive condition that causes scar tissue to form in the liver, destroying liver function.
• Nonalcoholic Fatty Liver Disease (NAFLD): The accumulation of excess fat in the liver
• Alcoholic Liver Disease: Excessive alcohol consumption can damage the liver and lead to cancer
• Diabetes: People with the blood sugar disease are at a higher risk of liver cancer

Liver Cancer Screening

Screening for liver cancer may be recommended for individuals who are at a high risk for liver cancer. Testing for liver cancer involves a physical exam and additional imaging tests. Signs of liver cancer include abdominal swelling and yellowing of the eyes and skin (jaundice). Individuals who present signs of liver cancer may undergo additional test to diagnose liver cancer, including:

• Lab tests: Blood tests may reveal liver function abnormalities
• Imaging tests: MRI, PET/CT, and ultrasound tests can help doctors find and diagnose liver cancer, and see how far it may have spread.
• Biopsy: Doctors may need to remove a sample of liver tissue to see if cancer if present.

UI Health also uses noninvasive transient elastography (Fibroscan) to assess different stages of liver disease.

Liver Cancer Treatment

Treating liver cancer depends on the extent of the cancer and the patient's health history. Treatment options include:

• Surgery: Surgery can be employed to treat liver cancers, including removing cancer tumorous and resection of the liver.
• Chemotherapy/Interventional Oncology: Liver-directed therapies, including chemoembolization, radioembolization, and microwave ablation can be used to deliver treatment to cancer cells in the liver.
• Liver Transplant: Depending on the stage of cancer, liver transplant may be a treatment option for certain patients.