Liver Cancer

Definition of Liver Cancer 

Liver is a vital organ of our body that is located on the right side of the upper abdomen (belly). Liver cancer is the uncontrolled growth of liver cells that results in a tumor formation and thus increased size. This tumor can be either benign (non fatal) or malignant (fatal).

The liver cancer can be primary (the one that originates in liver and then can spread to other organs) or secondary (metastasized) cancer (the one that originates in other body part and then comes to liver). The majority liver cancers are of secondary type. The primary liver cancer is less common and is mostly due to chronic (long term) hepatitis.


Cause of Liver Cancer 


Following are the most common causes of liver cancer:

  • Hepatitis C and B infection (long term infection and is most important cause of primary cancer)

  • Cirrhosis (scarring)  of liver

  • Exposure to carcinogens (cancer causing toxins like aflatoxin, vinyl chloride and arsenic etc)

  • Smoking

  • Excessive alcohol consumption (resulting in long term liver disease)

  • Diabetes mellitus

  • Any disease that results in long term inflammation of gut (like ulcerative colitis)

  • Hemochromatosis (inborn disease in which there is abnormally excessive iron deposition in liver)

  • Non alcoholic fatty liver disease

  • Any disease that results in low immunity (like AIDS)

  • Having family history of cancer

  • Excessive radiation exposure

Signs and Symptoms of Liver Cancer :

Majority cases of liver cancer do not show any signs and symptoms (like other cancers) in its early stage and show signs and symptoms at its advanced stage, most of the time. The signs and symptoms of liver cancer are non specific and they may be confused with any non fatal disease of liver or digestive tract. The key point is, the signs and symptoms mentioned below will show themselves continuously and they will get worse with the passage of time. In that case, a doctor must suspect the presence of liver cancer:

  • Weight loss

  • Changed eating behavior (Decreased appetite)

  • Nausea and vomiting

  • Weakness

  • Fatigue

  • Fever

  • Pain (on right side of upper abdomen or right shoulder)

  • Increased liver size (which is felt on palpation as a mass just under the ribs on right side of upper abdomen)

  • Increased spleen size ( which is felt as a mass just under the ribs on left side of upper abdomen)

  • Swelling of abdomen (protruding abdomen)

  • Jaundice (which can be seen as yellowing of the white portion of eyes and skin)

  • White stools (chalk like)

  • Urine having dark color

  • Itching

In some liver cancers, the tumor cells may form different hormones that act on their target organs, thus causing additional signs and symptoms mentioned below:

  • Hypercalcemia (increased blood calcium level): It may cause confusion, constipation or abnormality of muscles

  • Hypoglycemia (low blood sugar level): It may cause fatigue and fainting

  • High cholesterol levels: It may cause disease of blood vessels or heart thus causing heart problems

  • High red blood cells level: It may cause flushing and red face


Risk Factors for Liver Cancer 


Certain factors can cause the increased risk of liver cancer like:

  • Gender: Males are at higher risk as compared to females

  • Age: People of older age are at high risk

  • Race: It is more common in Asians and Africans

  • Obesity: People with increased body weight have higher risk

  • Excessive use of alcohol: Alcohol consumption can damage liver that may result in liver cancer

  • Smoking

  • History of diabetes: People with diabetes are at an increased risk of developing liver cancer

  • Parasitic infection: People having infection of liver fluke are at higher risk

  • Removed gall bladder

  • Autoimmune hepatitis: People having this rare genetic disease are at higher risk

  • Some rare diseases:  Like Wilson’s disease and alpha-1-antitrypsin deficiency

  • Water wells with arsenic: Long term consumption of well water that is contaminated with arsenic might cause liver cancer


Diagnosis of Liver Cancer 


A doctor uses following approaches to diagnose liver cancer:

  • Medical history: Signs and symptoms are noticed by doctor

  • Physical examination: A mass may be noticed on right upper side of abdomen

  • Imaging scans: CT scan, ultrasound and MRI is done

  • Biopsy: A small part of liver tissue is obtained, dyed with stain and observed under microscope for confirming the presence of cancer

  • Blood tests: Liver enzymes and serum marker tests are performed


Prevention from Liver Cancer 


Following preventive measures may help in reducing the risk of developing liver cancer:

  • Proper treatment of any liver disease or infection

  • Limited use of alcohol and smoking

  • Maintaining body weight to normal

  • Avoiding exposure to radiations and cancer causing chemicals


Treatment of Liver Cancer 


The treatment of liver cancer, like other cancers depends on following factors:

  • Stage of cancer

  • Preferences of patient

  • Overall health status of patient


Following are the treatment options available for liver cancer:


  • Surgery: Removal of part of liver with cancer in early stage is helpful.  But in case of advance stage cancer the whole lobes of liver is removed


  • Radiation therapy: High energy radiations are used to kill cancer cells. Used mostly in early stage of cancer solely or can be used with surgery for fast recovery from cancer


  • Chemotherapy: Drugs are used to target the cancer cells.  These drugs are used mostly in early stage of cancer solely or can be used with surgery for fast recovery from cancer


  • Liver transplant: In case of advance stage cancer, liver transplant is also an option