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Liver Cancer

There are several different types of cancer that can form in the liver, due to the fact that the liver is composed of different types of cells. In most cases, liver cancer is the direct result of one of several types of liver diseases that a person may contract, such as cirrhosis and hepatitis.

In order to understand how liver cancer can affect the body, one must understand what role the liver plays in the essential functions of the body.

What is the Liver? The liver is the largest organ found inside the human body, located on the right side just underneath the bottom of the ribcage. It has two left and right lobes and is one of the only organs that receives a supply of blood from two different sources. This includes the hepatic artery, supplying oxygenated blood from the heart and the portal vein, which carries blood rich in nutrients from the intestines. The liver is multifunctional, performing such tasks as:
The storage and processing of nutrients received from the intestine, essential for the body to continue to function. The liver prepares these nutrients so that they can be used by the body for energy and maintenance. Creation of elements that allow blood to clot. If a person is cut, these blood clotting components are important so that bleeding stops properly. The liver creates bile. Without bile, many nutrients cannot be absorbed properly, especially important fats. The liver is also the primary organ that filters out harmful substances from the bloodstream. For instance, when a person drinks alcohol, the liver is most responsible for removing alcohol from the blood. The liver is comprised of many different types of cells. As a result, there are many different types of tumors that can form on the liver, both benign (non-cancerous) and malignant (cancerous).
Benign Liver Tumors: Benign liver tumors are usually not life threatening, especially if they are found early, though they are capable of growing quite large, hindering function of the liver. They will almost never spread to other parts of the body in other organs, though if left untreated, some benign tumors may turn cancerous. Types of benign tumors of the liver include:

| Hemangiomas | Hepatic Adenomas | Focal Nodular Hyperplasia |

Some of these tumors do not need immediate treatment and a person can live a normal life without any symptoms or surgery. Eventually, though as the tumor is closely monitored, a doctor may determine that it will need to be removed to prevent future complications.
Malignant Liver Tumors: Malignant liver tumors are highly dangerous, because they do not have symptoms until much later in their stages. Once symptoms do arise, the cancer is usually not easily treated. Though liver cancer rarely travels to other parts of the body, if it progresses enough, it may spread through the bloodstream or through the lymph node system. Types of malignant liver tumors include:

| Hepatocellular Carcinoma | Bile Duct Cancer (also known as Cholangiocarcinoma) | Angiosarcomas | Hemangiosarcomas | Hepatoblastoma |

Hepatocellular carcinoma is the most common type of liver cancer and is usually caused by liver disease. Other types, such as metastatic liver cancer is liver cancer that is found in the liver, but has originated in another organ. Lung cancer, breast cancer and colon cancer are three common types of metastatic cancer that can spread to the liver. It is relatively common for other forms of cancer to spread to the liver because the liver processes blood from two major vessels and cancer quite often can spread through the bloodstream and through these two blood vessels.
Causes of Liver Cancer: All cancers, including liver cancer, are formed when DNA inside normal healthy cells is altered. Usually, the altered cells will die or repair themselves, but sometimes, the cancer continues to divide to form more altered cells. The cells divide and grow more rapidly than normal cells and eventually form a tumor. Substances, such as aflatoxins, are known to damage DNA in liver cells. In addition, certain diseases of the liver can lead to liver cancer when the DNA is altered by conditions of the disease. Hepatitis, a liver condition often caused by a virus, may eventually form liver cancer. Cirrhosis, a liver condition caused by alcoholism can also lead to liver cancer. In fact, when a person is diagnosed with liver cancer, more often than not, he or she also will possess a certain type of liver disease.
Risk Factors of Liver Cancer: A risk factor is not necessarily a cause of liver cancer, though it will greatly increase the chances of a person developing it. Scientists have studied what risk factors may cause liver cancer:
Gender: Liver cancer, such as hepatocellular carcinoma is more common in men than in women. This is probably due to the fact that men perform behaviors more consistent with liver cancer risk factors than women. For instance, men, on average, drink more than women, a habit associated with liver cancer.
Cirrhosis: Cirrhosis is a type of disease that is caused by alcohol. Alcohol damages liver cells, which need to be constantly replaced with new ones. Eventually, these new cells formulate scar tissue, which can negatively affect the functions of the liver. People with cirrhosis have a greater risk of developing liver cancer. Cirrhosis may also form from hepatitis, another liver condition.
Hepatitis: Hepatitis B is a major risk factor for liver cancer. It is a liver condition caused by a viral infection which is spread through blood and sexual fluids. Hepatitis B causes yellowing of the skin (jaundice) and flu-like symptoms while creating long term damage to liver cells.
Aflatoxins: A substance known for causing cancer. They are created by a fungus which are capable of contaminating peanuts, wheat, nuts, corn and rice. The fungus thrives in these substances in a warm and moist climate. A long-term exposure to this substance is the greatest risk factor for liver cancer.
Other Risk Factors Include:

| Diabetes | Obesity | Vinyl Chloride | Anabolic Steroids | Arsenic | Birth Control Pills (unproven) | Tobacco Use |

Symptoms of Liver Cancer: The symptoms of liver cancer are commonly unnoticeable until later stages of the cancer. Since the liver has multiple and important functions, when the symptoms do become apparent, a doctor will usually recognize liver cancer based on the following conditions:

 | Weight loss | Nausea and vomiting | Abdomen pain | Jaundice (yellowing of skin and eyes) | Swollen liver noticeable by touch |
Abdominal fluid buildup |

Itching: Liver tumors may begin to release hormones as well that can have adverse effects on other organs, leading doctors to believe that a problem with the endocrine system is to blame.
Diagnosis of Liver Cancer: Currently, there are no formal screening tests that can accurately detect liver cancer in its earliest stages. Even so, there are some tests that can be performed if a patient is considered to have a high risk of developing liver cancer.
Medical Exam:
When a doctor attempts to diagnose a patient based on his or her symptoms or medical history, there are several tests that can be conducted. This includes a routine physical exam that focuses on a person's abdomen. The goal of the doctor is to discover abnormal characteristics in the area of the liver and its surroundings. Pain, swelling, and evidence of abdominal fluid may lead a doctor to suspect liver cancer.
Imaging: A doctor may ask a patient to undergo further tests, including imaging tests. Usually, a doctor can detect the presence of a tumor on the liver using advanced imaging tests using x rays, magnets and sound waves. Imaging tests also assist doctors in performing certain types of surgery and biopsies. An ultrasound is a common tool used in testing for liver cancer. It uses sound waves to formulate an image on a monitor. CT scans are also a common way to test for cancer, including liver cancer. The CT scan uses x rays to take many pictures of your body. These pictures are put together to formulate a full image of the inside of a person. Magnetic resonance imaging (MRI) is also a common cancer test. It uses radio waves and powerful magnets to form detailed images.
Laparoscopy: This is a diagnosing technique used by doctors that involves inserting a thin tube with a light into the abdomen in a patient to observe organs inside the body. A biopsy can also be performed easily during this process. It is a relatively simple procedure that involves creating a small incision on a person's abdomen.
Biopsy: This process involves taking a tissue sample from the liver to discover if cancer is present when the sample is placed under a microscope. New technology has made the process of taking tissue samples in a biopsy much easier through needle biopsies.
Prognosis of Liver Cancer: A prognosis is a prediction given by a physician that will explain the likely outcome and treatment options of a patient diagnosed with cancer. A physician will determine a prognosis based on the grade of the liver cancer, the stage of the cancer and the overall general health of the patient. Some people want to know their prognosis because they feel that it is helpful to them, while others choose not to know because they take comfort in not knowing. Unfortunately, due to the fact that most liver cancer patients do not find out they have liver cancer until later stages of the disease, the fact that liver cancer is caused by other chronic liver diseases such as cirrhosis, and the fact that liver cancer patients are generally over the age of 60, the prognosis of it is very poor. Only 31 percent of liver cancer cases are found in early stages that can be surgically treated. Most times, liver cancer is inoperable and alternate treatment options are very ineffective.
Survival Rate of Liver Cancer: If liver cancer is found in its early stages and the tumor found on the liver is determined to be resectable (capable of being removed through surgery), the chances of a patient's five year survival is about 50 percent, given that they do not have the cancer in conjunction with cirrhosis. While the outlook for liver cancer may seem pretty grim when looking at these numbers, every patient is different and his or her situation is always unique. Talking to a doctor is the best way to understand what the future holds for a person.
Liver Cancer Stages: Like all other cancers, liver cancer is staged when it is diagnosed in a patient. The stage usually depends on how far advanced the cancer is, such as how far it spread throughout the body and the size of the tumor. When a cancer is classified and staged, a treatment plan can then be identified for the patient. The most common staging system used to classify liver cancer is the TNM system, created by the American Joint Committee on Cancer (AJCC). In the TNM system, T describes the size of the tumor, N is whether or not the cancer spread to lymph nodes, and M is whether or not the cancer has spread to other parts of the body. After these three elements are identified in a liver tumor, the tumor is then placed in one of four stages, four being the most advanced stage of the cancer.
Liver Cancer Treatment:
Surgery: When liver cancer is diagnosed in a patient, surgery is often not possible because the cancer has already spread throughout the body. Surgery is the best option, however, for liver cancer treatment, and if found early enough, it can be removed along with a portion of the surrounding liver tissue. Still, the chance of survival even after successful surgery is pretty slim due to the fact that many liver cancer patients also have chronic liver disease and may need a liver transplant.
Cryoablation: This procedure uses extreme cold to destroy cancer cells. During this procedure, a cryoprobe containing liquid nitrogen is placed directly onto liver tumors, using ultrasound images as a guide. Cryoablation can be the sole liver cancer treatment, or it can be used in conjunction with surgery, chemotherapy and other standard treatments.
Radiofrequency Ablation: The opposite of cryoablation, radiofrequency ablation uses an electric current to heat and destroy cancer cells. A CT scan or ultrasound images are used as a guide and your surgeon will insert several thin needles into small incisions in your abdomen. Once these needles reach the tumor, they are heated with an electric current, destroying the tumor.
Other Treatment Options: Treatment options for liver cancer other than surgery are manly done to prevent the cancer from spreading and to alleviate symptoms, as opposed to curing it. If surgery is not an option, chemotherapy and radiation therapy may be used to extend a patent's life for about a year and make symptoms less noticeable.
Statistics of Liver Cancer: There were about 22,620 cases of liver cancer, including 16,410 being of men and 6,210 being of women. Also, 18,160 will die from the disease, including 12,090 men and 6,070 women. These liver cancer statistics show that liver cancer is more common in men than it is in women. A man's risk of getting cancer is 1 in 100 while a woman's is about 1 and 217. A person's habits may greatly increase these risks though, such as heavy alcohol consumption and unsafe sexual practices
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