What is Liver Cancer?
Cancer is when unhealthy cells begin to divide and grow uncontrollably to form a malignant growth or tumor. These cells can metastasize and spread to other parts of the body.
Liver Cancer, also known as Hepatic Cancer, is a cancer that occurs in the liver. Cancer in the liver destroys liver cells and interferes with its ability to function normally.
Liver cancer may be primary or secondary. Primary cancer originates in the liver cells, while secondary cancer spreads to the liver from another organ. Over 90% to 95% of primary liver cancers originate from liver cells and are known as hepatocellular cancer or carcinoma.
Types of Liver Cancer
- Hepatocellular Carcinoma (HCC): The most common type, making up nearly 75% of cases. Also called Hepatoma, common in people with severe liver damage, often from alcohol abuse.
- Bile Duct Cancer (Cholangiocarcinoma): Develops in the bile ducts within the liver, accounting for 10-20% of liver cancers.
- Angiosarcoma: A rare liver cancer originating in the liver’s blood vessels.
- Hepatoblastoma: Primarily affects children under 3 years old. Early detection leads to high survival chances. Extremely rare.
Signs and Symptoms of Liver Cancer
- Jaundice
- Fatigue
- Fever
- Nausea and vomiting
- Loss of appetite
- Abdominal swelling
- Weight loss
- Enlarged liver, spleen, or both
- Fluid buildup in the abdomen
- A lump below the right rib cage
- Discomfort in the back or near the right shoulder blade
For hepatocellular carcinoma (HCC), doctors recommend treatment options based on tumor characteristics, liver function, performance status, and cancer-related symptoms.
When Should I See a Doctor?
Schedule an appointment with your general practitioner if you have any bothersome, unexplained symptoms. The physician might suggest diagnostic tests to rule out liver cancer or other medical issues. If a tumor is confirmed, you will be referred to a hepatologist, gastroenterologist, or oncologist for liver cancer treatment.
See our hepatologists, gastroenterologists, and oncologists for more details and appropriate liver cancer treatment.
What Causes Liver Cancer?
Liver cancer occurs when the DNA of liver cells undergoes changes or mutations. It can sometimes result from chronic hepatitis infections. However, liver cancer can also develop without any underlying diseases, and its cause may remain unknown.
Methods for Diagnosing Liver Cancer
- Physical examination and medical history: A check for signs of disease, lumps, or anything unusual through patient history and physical exam.
- Blood tests: Tests that may reveal liver function abnormalities, such as liver function tests.
- Imaging tests:
- Ultrasound: Helps locate abnormal tissue in the liver and diagnose primary liver cancer.
- Computed tomography (CT): Recommended if ultrasound shows abnormalities. Detects tumors and checks if cancer has spread to other organs.
- Magnetic resonance imaging (MRI): Inspects liver tumors, looks for blood vessel obstructions, and detects cancer spread.
- PET-CT scan: Detects and monitors liver cancer, helping identify type and stage.
- Liver biopsy: Tissue or cell samples examined under a microscope for cancer signs. Not always necessary, as imaging can sometimes confirm diagnosis.
Liver Cancer Staging
- Very early stage: Tumor smaller than 2 cm. Bilirubin levels normal. Surgery is usually recommended.
- Early stage: Tumor smaller than 5 cm. Liver function varies. Normal bilirubin levels. Candidates for liver transplant, surgery, or radiofrequency ablation (RFA).
- Intermediate stage: Tumor may be large or multiple tumors present. Regional therapies like transarterial chemoembolization are usually recommended.
- Advanced stage: Tumor has invaded portal vein or spread to lymph nodes, lungs, bones. Targeted therapy is usually recommended.
Liver Cancer Treatments and Procedures
- Surgery: Procedure to remove a portion of the liver. Partial hepatectomy removes the liver cancer and a small portion of healthy tissue if tumor is small and liver function is good.
- Liver Transplant Surgery: Diseased liver is removed and replaced with a healthy donor liver. Suitable for early-stage liver cancer with cirrhosis.
- Freezing Cancer Cells (Cryoablation): Uses extreme cold to destroy cancer cells by placing a cryoprobe containing liquid nitrogen directly onto the liver tumor.
- Heating Cancer Cells (Radiofrequency Ablation): Electric current heats and kills cancer cells, also called hyperthermia cancer treatment.
- Injecting Alcohol: Pure alcohol injected directly into tumors via skin or during surgery to dry out and kill cancer cells.
- TACE (Transarterial Chemoembolization): Blocks blood supply to tumor after delivering anticancer drugs via blood vessels near the cancer; beads releasing drugs block blood flow, targeting tumor with fewer side effects.
- TARE (Transarterial Radioembolization): Similar to TACE but uses radioactive Yttrium-90 microspheres to treat primary and metastatic liver tumors.
- Radiation Therapy: Uses high-energy X-rays or particles to destroy cancer cells over a set period.
- Stereotactic Body Radiation Therapy (SBRT): Delivers high radiation doses to tumors about 5 cm or smaller, minimizing damage to nearby healthy tissue; side effects may affect stomach and lungs but often preventable.
- Systemic Therapy for Advanced HCC: Medications administered through bloodstream to destroy cancer cells throughout the body for later-stage hepatocellular carcinoma.
Faqs
Liver cancer starts in the liver, an organ that filters blood and helps digest food. The most common type is hepatocellular carcinoma (HCC). Liver cancer can also be metastatic (spread from other organs).
Key risk factors include:
- Chronic hepatitis B or C infection
- Cirrhosis (scarring of the liver from alcohol, hepatitis, or fatty liver disease)
- Heavy alcohol use
- Obesity and nonalcoholic fatty liver disease (NAFLD)
- Aflatoxin exposure (from moldy grains/nuts)
Liver cancer often shows no early signs. As it progresses, symptoms may include:
- Upper right abdominal pain
- Unexplained weight loss
- Fatigue
- Swelling in the abdomen
- Jaundice (yellowing of skin/eyes)
- Loss of appetite or nausea
🔔 These can overlap with other liver issues, so testing is crucial.
Doctors use:
- Blood tests (especially alpha-fetoprotein or AFP)
- Imaging (ultrasound, CT scan, MRI)
- Liver biopsy (in some cases)
If caught early, liver cancer may be cured with:
- Surgical resection (removing the tumor)
- Liver transplant
However, many cases are diagnosed late, making cure more difficult.
Treatment depends on the stage and overall liver health. Options include:
- Surgery
- Liver transplant
- Ablation therapy (destroying the tumor with heat or cold)
- Radiation therapy
- Targeted therapy
- Immunotherapy
- Chemotherapy (less commonly used for liver cancer)
You’re at higher risk if you:
- Have hepatitis B or C
- Have cirrhosis or liver disease
- Drink heavily
- Have a family history of liver cancer
- Are exposed to aflatoxins or industrial chemicals
Yes — partly. Preventive steps include:
- Getting vaccinated against hepatitis B
- Regular screening if you have liver disease or hepatitis
- Limiting alcohol intake
- Managing weight and blood sugar
- Avoiding contaminated food and water
Yes — people at high risk (especially those with cirrhosis or hepatitis) should get regular ultrasounds and AFP blood tests every 6 months.
Survival depends heavily on when it's detected:
- Localized (early stage): Around 30–35% 5-year survival
- Advanced stage: Drops to 3–10%
🩺 Early detection is critical for improving outcomes.
