Hepatology
Areas of Expertise
- Alcoholic Liver Disease
- Autoimmune Liver Disease
- Chronic Hepatitis
- Liver Cirrhosis
- Liver Cancer
- Liver Lesions
- Nonalcoholic Fatty Liver Disease
- Primary Biliary Cirrhosis
- Primary Sclerosing Cholangitis
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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 main 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 liver's blood vessels. These tumors grow quickly and can be widespread.
Symptoms of Liver Cancer
Liver cancer typically does not present with symptoms in its early stages, but eventual signs and symptoms can 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
Our Team
Liver Cancer Screening
Screening for liver cancer may be recommended for individuals who are at high risk for liver cancer. Testing for liver cancer involves a physical exam and additional blood and imaging tests. Individuals who present with concerning signs or symptoms of liver cancer may undergo further tests to diagnose liver cancer, including:
- Lab tests: Blood tests may reveal liver function abnormalities. AFP and CA19-9 are proteins found in the blood that also may be elevated with certain types of liver cancer.
- Imaging tests: CT, MRI, PET/CT, and ultrasound tests can help doctors find and diagnose liver cancer, and see if it has spread outside of the liver.
- Biopsy: Doctors may need to remove a sample of liver tissue to see if cancer is present, as well as check for signs of damage within the liver. This is often done through a needle into the liver (percutaneous).
UI Health also uses noninvasive transient elastography (Fibroscan) to assess different liver fibrosis/disease stages.
Liver Cancer Treatment
Treating liver cancer depends on the extent of the tumor and the patient's health history. Treatment options include:
- Surgery: Surgery can be employed to remove many types of liver cancers, including removing cancer tumors and resection of the liver. Surgeons may remove liver cancers with minimally invasive, robotic surgical techniques depending on various factors.
- Chemotherapy
- Interventional Radiology: Liver-directed therapies, including chemoembolization (cutting off the blood supply to liver tumors with chemotherapy), radioembolization (cutting off the blood supply to tumors), and microwave ablation (heat therapy using microwaves to destroy cancer cells), can be used to deliver treatment to cancer cells in the liver.
- Liver Transplant: Depending on the stage of cancer, a liver transplant may be a treatment option for certain patients.