Hepatocellular Carcinoma
(Liver Cancer)

Liver Cancer Summary
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
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Liver cancer facts

  • Primary liver cancer, or hepatocellular carcinoma (HCC) is the sixth most common cancer diagnosed worldwide, but is the second-leading cause of cancer death worldwide behind only lung cancer. The majority of patients with liver cancer will die within one year of diagnosis as a result of the cancer.
  • A patient whose cancer starts elsewhere in the body and spreads to the liver should not be said to have liver cancer. It is then cancer metastatic to the liver - suchas colon cancer metastatic to the liver. This may also be referred to as secondary liver cancer.
  • In the U.S., patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, obesity or diabetes, and hemochromatosis are at the greatest risk of developing HCC.
  • Patients with chronic liver disease (for example, hepatitis C virus, hepatitis B virus, or hemochromatosis) should avoid drinking alcohol, which can further increase their risk of developing cirrhosis and HCC.
  • Many patients with liver cancer do not develop symptoms until the advanced stages of the disease. When the patient does develop symptoms, the prognosis is usually poor.
  • The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein most effectively diagnoses primary liver cancer.
  • A liver biopsy can make a definitive diagnosis of primary liver cancer, but the procedure requires an expert liver pathologist and is not necessary for all patients.
  • The natural history of liver cancer is quite variable and depends on the stage of the tumor and the severity of the associated cirrhosis.
  • Medical treatments for hepatocellular carcinoma such as chemotherapy are slowly becoming more effective, although still disappointing. The new drug sorafenib has shown that survival of patients with HCC can be prolonged.
  • Ablative and local techniques such as chemoembolization, radioembolization, radiofrequency or cryoablation, and stereotactic radiosurgery can by very useful in controlling individual cancers for an extended time.
  • Surgical resection (removal) of the tumor may be curative for a select group of individuals with primary liver cancer, specifically for those with small tumors and healthy liver function.
  • For patients with small primary liver cancers and significant associated liver disease, liver transplantation offers the only chance for cure.
  • This is a disease that should be almost entirely preventable by societal and lifestyle changes.
Medically Reviewed by a Doctor on 4/17/2014

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Liver Cancer - Treatment Question: What kinds of treatment, including surgery, have been used for liver cancer in you or a relative?
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Liver Cancer - Symptoms Question: What were the signs and symptoms of liver cancer in you or someone you know?

Liver Cancer Symptoms

Early liver cancer often doesn't cause symptoms. When the cancer grows larger, people may notice one or more of these common symptoms:

  • Pain in the upper abdomen on the right side
  • A lump or a feeling of heaviness in the upper abdomen
  • Swollen abdomen (bloating)
  • Loss of appetite and feelings of fullness
  • Weight loss
  • Weakness or feeling very tired
  • Nausea and vomiting
  • Yellow skin and eyes, pale stools, and dark urine from jaundice
  • Fever

These symptoms may be caused by liver cancer or other health problems. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated as early as possible.

SOURCE:
National Cancer Institute

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