An overview of Liver Cancer

Cancer that starts in your liver's cells is called liver cancer. Your liver, an organabout the size of a football, is located in the upper right part of your abdomen,above your stomach and below your diaphragm.

The liver is prone to developing a number of cancers. Hepatocellular carcinoma, themost prevalent form of liver cancer, develops in the primary liver cell type(hepatocyte). Hepatoblastoma and intrahepatic cholangiocarcinoma are twosignificantly less frequent kinds of liver cancer.

Cancer that spreads to the liver is more common than cancer that begins in the livercells. Cancer that begins in another area of the body — such as the colon, lung orbreast — and then spreads to the liver is called metastatic cancer rather than livercancer. This type of cancer is named after the organ in which it began — such asmetastatic colon cancer to describe cancer that begins in the colon and spreads tothe liver.

Healthcare providers stage HCC using standards set by the Barcelona Clinic LiverCancer system (BCLC). This system evaluates HCC liver on characteristics, includingwhether your liver is working well, tumor size and your symptoms. Healthcareproviders may use different terms for each BCLC stage; sometimes, presented as beingstages I to IV or 0-C or by terms such as early and advanced stage HCC.Hepatocellular carcinoma stages include the following:

Stage I/very early stage/stage 0 : You have a single tumor in your liver thatmeasures less than 2 centimeters (cm). Blood tests show your bilirubin level isnormal.

Stage II/early stage/stage A : You have a single tumor that measures 5 cm orless or you have more than one tumor that measures less than 3 cm. The tumor mayhave spread to your blood vessels.

Stage III/intermediate stage/stage B : In this stage, you may have more thanone tumor and/or a tumor that measures more than 5 cm. The tumor may have spread toyour lymph nodes, large blood vessels or another organ.

Stage IV/advanced stage/stage C : The cancer has spread to other places inyour body, such as your lungs or bones, as well as lymph nodes.

When something alters the DNA of healthy liver cells, liver cancer results. The genesthat instruct our cells how to function are carried by DNA. Everyone has genes thatcontrol when cells divide, proliferate, and die. Oncogenes, for instance, promotecell division and growth. Other genes, known as tumor suppressor genes, keep an eyeon cell activity, preventing uncontrollable cell growth and ensuring that cells passaway when they should.

Our cells receive new instructions whenever our DNA is altered or mutated. DNAalterations in HCC activate oncogenes and/or silence tumor suppressor genes. Forinstance, research indicates that more than half of all instances of HCC are causedby cirrhosis brought on by the hepatitis B and C viruses. These viruses modify theDNA of the liver cells they infect, transforming normal liver cells into malignantones.

Most people don't have signs and symptoms in the early stages of primary livercancer. When signs and symptoms do appear, they may include:

1. Losing weight without trying

2. Loss of appetite

3. Upper abdominal pain

4. Nausea and vomiting

5. General weakness and fatigue

6. Abdominal swelling

7. Yellow discoloration of your skin and the whites of your eyes (jaundice)

8. White, chalky stools

While you can’t completely prevent liver cancer, you can do the following to loweryour chances of getting liver cancer:

1. Avoid behaviors that lead to cirrhosis.

2. Reach or maintain a healthy weight.

3. Get a hepatitis B vaccine. This vaccine is safe for nearly everyone. Ask yourdoctor about the hepatitis A vaccine.

4. Avoid hepatitis C.

5. If you have any liver disease, have diabetes, obesity or are a heavy drinker, askyour healthcare provider about liver cancer screenings.

Your healthcare provider may suspect you have liver cancer if they find liver cancersigns and symptoms during your physical examination. They may order the followingtests to learn more:

Ultrasound (sonography) : This test provides pictures of your soft tissuestructures. Healthcare providers use ultrasound to look for liver tumors.

Blood tests : Healthcare providers may do blood tests for cancer, such as aliver function test, to check on liver enzymes, proteins and other substances thatshow whether your liver is healthy or damaged. They may test for alfa-fetoprotein(AFP). High AFP levels may indicate liver cancer.

Computed tomography (CT) scan : This special type of X-ray takes detailedimages of your liver, providing information about liver tumor size and location.

Magnetic resonance imaging (MRI) : This test produces very clear images ofyour body using a large magnet, radio waves and a computer.

Angiogram : This test helps healthcare providers examine your liver’s bloodvessels. During this test, your healthcare provider injects dye into an artery sothey can track blood vessel activity and look for blockages.

Biopsy : Healthcare providers remove liver tissue to look for signs of cancer.Biopsies are the most reliable way to confirm a liver cancer diagnosis.

Surgically removing a portion of your liver, liver transplantation, andliver-directed therapies including hepatic arterial embolization and ablation are afew of the primary treatments offered by healthcare providers for HCC and IHC.Moreover, they might use different kinds of chemotherapy, chemoembolization,radiation therapy, radioembolization, immunotherapy, and targeted therapy.