What is Liver Cancer?
Liver cancer is a significant health issue and is among the fastest-growing types of cancer in the United States. It is categorized into two types: primary and secondary. Primary liver cancer originates within the liver, while secondary liver cancer metastasizes to the liver from other parts of the body. This article will primarily focus on primary liver cancer.
Early detection is crucial in the treatment of many cancers, including liver cancer. Healthcare providers are particularly vigilant about the factors that increase the risk of liver cancer. This vigilance helps them identify and monitor individuals at a higher risk. The objective is to diagnose and treat primary liver cancer at the earliest possible stage.
Type of Liver Cancer
Liver cancer includes various forms, each with unique characteristics and treatment methods:
1. Hepatocellular Carcinoma (HCC): This is the most common type of primary liver cancer, originating from hepatocytes, the cells responsible for processing nutrients. It typically starts as a single tumor and spreads over time. Risk factors include chronic hepatitis B or C, metabolic disorders like nonalcoholic fatty liver disease, and excessive alcohol consumption.
2. Intrahepatic Cholangiocarcinoma: This is the second most common type of primary liver cancer, starting in the bile duct cells. Risk factors include hepatitis B or C infection, primary sclerosing cholangitis, and nonalcoholic fatty liver disease.
3. Fibrolamellar-Hepatocellular Carcinoma (FLL-HCC): This is a less aggressive and less common variant of HCC, often affecting individuals in their 20s and 30s. It can be misdiagnosed as focal nodular hyperplasia, a benign liver condition.
4. Angiosarcomas, Hemangiosarcoma, and Hemangioendotheliomas: These rare tumors develop along the inner linings of blood vessels and are primarily found in very young children. They are generally treatable.
5. Hepatoblastomas: These tumors consist of cells that resemble fetal liver cells, bile duct cells, or mature liver cells. Hepatoblastomas are generally treatable.
6. Benign Liver Tumors: These noncancerous tumors often don’t cause symptoms and are usually discovered during scans for other health conditions. Common types include adenomas, liver cysts, hemangiomas, and focal nodular hyperplasia.
Stages of liver cancer
Liver cancer is categorized into various stages, each indicating the patient’s survival rate and helping determine the appropriate treatment. Here are the stages of liver cancer:
1. Stage I: This early stage of liver cancer involves a single tumor that has not spread to nearby blood vessels.
2. Stage II: At this stage, the cancer may have spread to nearby blood vessels, or there may be more than one tumor, none larger than about 5 centimeters.
3. Stage III: This stage is further divided into three sub-stages:
o IIIA: There is one tumor larger than 5 centimeters, and it may have spread to a major blood vessel around the liver.
o IIIB: The tumors can be of any size and may have spread to the gallbladder or broken through the lining of the peritoneal cavity.
o IIIC: The cancer has spread to nearby lymph nodes.
4. Stage IV: At this stage, the cancer has spread to different organs of the body, such as the lungs or bones. The size of the tumor can vary, and it may have also spread to the blood vessels and/or lymph nodes near the liver.
The survival rate for stage 4 liver cancer indicates the number of people alive for a certain period after diagnosis. These statistics consider people who have few or no symptoms of cancer and are undergoing treatment. Stage 4 liver cancer survival rates are very low, with statistics showing only a 7% survival rate for a 5-year period. However, those whose cancer is surgically removed show a survival rate of about 75% after 1 year, 50% after 3 years, and 30% after 5 years. Unfortunately, the life expectancy for metastatic liver cancer is 0%, even with liver transplantation.
Worldwide Incidence and Consequences of Liver Cancer
Liver cancer ranks as the 6th most common cancer globally. It holds the 5th position in prevalence among men and the 9th among women. Over 900,000 individuals were diagnosed with this disease in 2020.
Mongolia reported the highest overall rate of liver cancer in 2020, closely followed by Egypt.
In the United States, liver cancer is projected to cause approximately 29,380 deaths (19,000 men and 10,380 women) in 2023. Among men, it is the fifth leading cause of cancer-related deaths, while it ranks seventh among women.
On a global scale, liver cancer is diagnosed in more than 800,000 people each year and accounts for over 700,000 deaths annually.
Symtoms
Liver cancer occurs when the DNA of healthy liver cells is affected. DNA carries instructions for our cells’ functions, including when to grow, multiply, and die. Mutations in DNA can activate oncogenes or deactivate tumor suppressor genes, leading to uncontrolled cell growth and the development of cancer.
Hepatocellular carcinoma (HCC), the most common type of liver cancer, often results from cirrhosis related to hepatitis B virus (HBV) and hepatitis C virus (HCV). These viruses infect liver cells and alter their DNA, transforming healthy liver cells into cancerous ones.
Intrahepatic cholangiocarcinoma (IHC), another type of liver cancer, is believed to be caused by long-term inflammation in the bile ducts, which may lead to DNA changes that transform healthy cells into abnormal ones.
Liver cancer may not present symptoms in its early stages. However, as it progresses, symptoms for both HCC and IHC may include:
· A lump below the rib cage or pain on the right side of the abdomen, or pain near the right shoulder.
· Jaundice, a condition that causes skin and eyes to yellow.
· Unexplained weight loss, nausea, or loss of appetite.
· Fatigue.
· Dark-colored urine.
These symptoms should prompt a visit to a healthcare provider for proper diagnosis and treatment.
Cause
Liver cancer develops when the DNA in healthy liver cells undergoes detrimental changes. These cells carry our body’s genetic instructions, including those that regulate cell growth, division, and death. DNA mutations can activate oncogenes that promote growth or deactivate tumor suppressor genes, leading to uncontrolled cell growth and the onset of cancer.
Hepatocellular carcinoma (HCC), the most common type of liver cancer, often results from liver cirrhosis associated with the hepatitis B (HBV) and hepatitis C (HCV) viruses. These viruses infect liver cells and alter their DNA, transforming healthy cells into cancerous ones.
Intrahepatic cholangiocarcinoma (IHC), another form of liver cancer, is believed to be linked to long-term inflammation in the bile ducts, which may lead to DNA changes and the transformation of healthy cells into abnormal ones.
Certain chemicals, such as aflatoxins, are known to damage liver cell DNA, including crucial genes like TP53, which normally regulates cell growth.
Risk factor
Several factors can increase the risk of developing liver cancer:
1. Chronic Liver Diseases: Conditions such as cirrhosis, which cause scarring of the liver, significantly increase the risk of liver cancer.
2. Tobacco Use: Smoking is linked to a heightened risk of various types of cancer, including liver cancer.
3. Obesity: Being overweight or obese can increase the risk of liver cancer.
4. Excessive Alcohol Consumption: Heavy drinking can lead to liver damage and cirrhosis, both of which increase the risk of liver cancer.
5. Diabetes: People with diabetes, especially type 2 diabetes, may have an increased risk of liver cancer, usually in patients who also have other risk factors such as heavy alcohol use and chronic viral hepatitis.
6. Chronic Hepatitis B or C: Long-term infection with the hepatitis B or C virus significantly increases the risk of liver cancer. These viruses can spread from person to person through sharing contaminated needles (such as in drug use), unprotected sex, or childbirth.
7. Aflatoxins: Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with aflatoxins, which can end up in foods made from these products.
8. Certain Inherited Liver Diseases: Diseases such as hemochromatosis and Wilson’s disease, which lead to permanent liver damage, can increase the risk of liver cancer.
aving one or more risk factors does not guarantee that you will get liver cancer. Many people with risk factors never develop the disease, while others with no known risk factors do.
Diagnosis
Liver cancer is diagnosed and treated through a combination of methods:
Diagnosis:
1. Physical Examination: Doctors may perform a physical examination to check for signs of liver cancer, such as lumps or swelling in the abdomen and changes in nearby organs.
2. Blood Tests: These can detect abnormalities in liver function and may include a test for alpha-fetoprotein (AFP), a substance that can indicate liver cancer if levels are elevated.
3. Imaging Tests: Doctors may recommend imaging tests, such as an ultrasound, CT scan, or MRI, to visualize the liver.
4. Biopsy: In some cases, a piece of liver tissue may be removed and examined in a laboratory to confirm a diagnosis of liver cancer.
Tests:
1. AFP Tumor Marker Test: An elevated level of AFP in the blood can indicate liver cancer.
2. Liver Function Tests: These tests measure the levels of certain substances in the blood to assess liver health.
3. CT Scan: This imaging technique uses X-rays and computer technology to create detailed images of the body’s internal structures.
4. MRI: This imaging technique uses magnetic fields and radio waves to create detailed images of the body’s internal structures.
5. Ultrasound Exam: This test uses high-energy sound waves to create echoes off the liver and produce images of the organ.
Treatment:
1. Surgery: The surgical removal of the cancerous part of the liver offers the best chance for a positive outcome.
2. Liver Transplantation: This procedure involves replacing the diseased liver with a healthy one from a donor.
3. Ablation Therapy: This treatment uses heat to destroy cancer cells.
4. Chemotherapy: This treatment uses drugs to kill cancer cells.
5. Radiation Therapy: This treatment uses targeted radiation to kill cancer cells.
6. Targeted Drug Therapy: This treatment uses drugs designed to specifically attack cancer cells.
7. Immunotherapy: This treatment uses the body’s immune system to fight cancer.
Prognosis
The choice of treatment depends on the stage of the cancer, the health of the liver, and the overall health of the patient.
The prognosis for liver cancer varies, with an overall 5-year survival rate around 17%. This rate is influenced by the stage of the cancer. For instance, individuals with early-stage, localized liver cancer have a 5-year survival rate of approximately 31%. However, this rate decreases to about 11% when the cancer has spread to nearby organs or lymph nodes.
Patients diagnosed with early-stage liver cancer, especially those without cirrhosis or other serious health conditions, have a good chance of successful treatment if the cancer can be surgically removed. For those undergoing liver transplants, the 5-year survival rate increases to between 60% and 70%.
Caring
Managing liver cancer also involves supportive care services, which can help patients cope with the physical and emotional challenges of the disease. These services include:
· Pain management
· Nutritional support
· Emotional support
· Palliative care
It’s crucial for patients and their families to have thorough discussions with their healthcare team about all available treatment options, understanding their goals and potential side effects.
Liver cancer is a significant health issue and is among the fastest-growing types of cancer in the United States. It is categorized into two types: primary and secondary. Primary liver cancer originates within the liver, while secondary liver cancer metastasizes to the liver from other parts of the body. This article will primarily focus on primary liver cancer.
Early detection is crucial in the treatment of many cancers, including liver cancer. Healthcare providers are particularly vigilant about the factors that increase the risk of liver cancer. This vigilance helps them identify and monitor individuals at a higher risk. The objective is to diagnose and treat primary liver cancer at the earliest possible stage.
Type of Liver Cancer
Liver cancer includes various forms, each with unique characteristics and treatment methods:
1. Hepatocellular Carcinoma (HCC): This is the most common type of primary liver cancer, originating from hepatocytes, the cells responsible for processing nutrients. It typically starts as a single tumor and spreads over time. Risk factors include chronic hepatitis B or C, metabolic disorders like nonalcoholic fatty liver disease, and excessive alcohol consumption.
2. Intrahepatic Cholangiocarcinoma: This is the second most common type of primary liver cancer, starting in the bile duct cells. Risk factors include hepatitis B or C infection, primary sclerosing cholangitis, and nonalcoholic fatty liver disease.
3. Fibrolamellar-Hepatocellular Carcinoma (FLL-HCC): This is a less aggressive and less common variant of HCC, often affecting individuals in their 20s and 30s. It can be misdiagnosed as focal nodular hyperplasia, a benign liver condition.
4. Angiosarcomas, Hemangiosarcoma, and Hemangioendotheliomas: These rare tumors develop along the inner linings of blood vessels and are primarily found in very young children. They are generally treatable.
5. Hepatoblastomas: These tumors consist of cells that resemble fetal liver cells, bile duct cells, or mature liver cells. Hepatoblastomas are generally treatable.
6. Benign Liver Tumors: These noncancerous tumors often don’t cause symptoms and are usually discovered during scans for other health conditions. Common types include adenomas, liver cysts, hemangiomas, and focal nodular hyperplasia.
Stages of liver cancer
Liver cancer is categorized into various stages, each indicating the patient’s survival rate and helping determine the appropriate treatment. Here are the stages of liver cancer:
1. Stage I: This early stage of liver cancer involves a single tumor that has not spread to nearby blood vessels.
2. Stage II: At this stage, the cancer may have spread to nearby blood vessels, or there may be more than one tumor, none larger than about 5 centimeters.
3. Stage III: This stage is further divided into three sub-stages:
o IIIA: There is one tumor larger than 5 centimeters, and it may have spread to a major blood vessel around the liver.
o IIIB: The tumors can be of any size and may have spread to the gallbladder or broken through the lining of the peritoneal cavity.
o IIIC: The cancer has spread to nearby lymph nodes.
4. Stage IV: At this stage, the cancer has spread to different organs of the body, such as the lungs or bones. The size of the tumor can vary, and it may have also spread to the blood vessels and/or lymph nodes near the liver.
The survival rate for stage 4 liver cancer indicates the number of people alive for a certain period after diagnosis. These statistics consider people who have few or no symptoms of cancer and are undergoing treatment. Stage 4 liver cancer survival rates are very low, with statistics showing only a 7% survival rate for a 5-year period. However, those whose cancer is surgically removed show a survival rate of about 75% after 1 year, 50% after 3 years, and 30% after 5 years. Unfortunately, the life expectancy for metastatic liver cancer is 0%, even with liver transplantation.
Worldwide Incidence and Consequences of Liver Cancer
Liver cancer ranks as the 6th most common cancer globally. It holds the 5th position in prevalence among men and the 9th among women. Over 900,000 individuals were diagnosed with this disease in 2020.
Mongolia reported the highest overall rate of liver cancer in 2020, closely followed by Egypt.
In the United States, liver cancer is projected to cause approximately 29,380 deaths (19,000 men and 10,380 women) in 2023. Among men, it is the fifth leading cause of cancer-related deaths, while it ranks seventh among women.
On a global scale, liver cancer is diagnosed in more than 800,000 people each year and accounts for over 700,000 deaths annually.
Symtoms
Liver cancer occurs when the DNA of healthy liver cells is affected. DNA carries instructions for our cells’ functions, including when to grow, multiply, and die. Mutations in DNA can activate oncogenes or deactivate tumor suppressor genes, leading to uncontrolled cell growth and the development of cancer.
Hepatocellular carcinoma (HCC), the most common type of liver cancer, often results from cirrhosis related to hepatitis B virus (HBV) and hepatitis C virus (HCV). These viruses infect liver cells and alter their DNA, transforming healthy liver cells into cancerous ones.
Intrahepatic cholangiocarcinoma (IHC), another type of liver cancer, is believed to be caused by long-term inflammation in the bile ducts, which may lead to DNA changes that transform healthy cells into abnormal ones.
Liver cancer may not present symptoms in its early stages. However, as it progresses, symptoms for both HCC and IHC may include:
· A lump below the rib cage or pain on the right side of the abdomen, or pain near the right shoulder.
· Jaundice, a condition that causes skin and eyes to yellow.
· Unexplained weight loss, nausea, or loss of appetite.
· Fatigue.
· Dark-colored urine.
These symptoms should prompt a visit to a healthcare provider for proper diagnosis and treatment.
Cause
Liver cancer develops when the DNA in healthy liver cells undergoes detrimental changes. These cells carry our body’s genetic instructions, including those that regulate cell growth, division, and death. DNA mutations can activate oncogenes that promote growth or deactivate tumor suppressor genes, leading to uncontrolled cell growth and the onset of cancer.
Hepatocellular carcinoma (HCC), the most common type of liver cancer, often results from liver cirrhosis associated with the hepatitis B (HBV) and hepatitis C (HCV) viruses. These viruses infect liver cells and alter their DNA, transforming healthy cells into cancerous ones.
Intrahepatic cholangiocarcinoma (IHC), another form of liver cancer, is believed to be linked to long-term inflammation in the bile ducts, which may lead to DNA changes and the transformation of healthy cells into abnormal ones.
Certain chemicals, such as aflatoxins, are known to damage liver cell DNA, including crucial genes like TP53, which normally regulates cell growth.
Risk factor
Several factors can increase the risk of developing liver cancer:
1. Chronic Liver Diseases: Conditions such as cirrhosis, which cause scarring of the liver, significantly increase the risk of liver cancer.
2. Tobacco Use: Smoking is linked to a heightened risk of various types of cancer, including liver cancer.
3. Obesity: Being overweight or obese can increase the risk of liver cancer.
4. Excessive Alcohol Consumption: Heavy drinking can lead to liver damage and cirrhosis, both of which increase the risk of liver cancer.
5. Diabetes: People with diabetes, especially type 2 diabetes, may have an increased risk of liver cancer, usually in patients who also have other risk factors such as heavy alcohol use and chronic viral hepatitis.
6. Chronic Hepatitis B or C: Long-term infection with the hepatitis B or C virus significantly increases the risk of liver cancer. These viruses can spread from person to person through sharing contaminated needles (such as in drug use), unprotected sex, or childbirth.
7. Aflatoxins: Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with aflatoxins, which can end up in foods made from these products.
8. Certain Inherited Liver Diseases: Diseases such as hemochromatosis and Wilson’s disease, which lead to permanent liver damage, can increase the risk of liver cancer.
aving one or more risk factors does not guarantee that you will get liver cancer. Many people with risk factors never develop the disease, while others with no known risk factors do.
Diagnosis
Liver cancer is diagnosed and treated through a combination of methods:
Diagnosis:
1. Physical Examination: Doctors may perform a physical examination to check for signs of liver cancer, such as lumps or swelling in the abdomen and changes in nearby organs.
2. Blood Tests: These can detect abnormalities in liver function and may include a test for alpha-fetoprotein (AFP), a substance that can indicate liver cancer if levels are elevated.
3. Imaging Tests: Doctors may recommend imaging tests, such as an ultrasound, CT scan, or MRI, to visualize the liver.
4. Biopsy: In some cases, a piece of liver tissue may be removed and examined in a laboratory to confirm a diagnosis of liver cancer.
Tests:
1. AFP Tumor Marker Test: An elevated level of AFP in the blood can indicate liver cancer.
2. Liver Function Tests: These tests measure the levels of certain substances in the blood to assess liver health.
3. CT Scan: This imaging technique uses X-rays and computer technology to create detailed images of the body’s internal structures.
4. MRI: This imaging technique uses magnetic fields and radio waves to create detailed images of the body’s internal structures.
5. Ultrasound Exam: This test uses high-energy sound waves to create echoes off the liver and produce images of the organ.
Treatment:
1. Surgery: The surgical removal of the cancerous part of the liver offers the best chance for a positive outcome.
2. Liver Transplantation: This procedure involves replacing the diseased liver with a healthy one from a donor.
3. Ablation Therapy: This treatment uses heat to destroy cancer cells.
4. Chemotherapy: This treatment uses drugs to kill cancer cells.
5. Radiation Therapy: This treatment uses targeted radiation to kill cancer cells.
6. Targeted Drug Therapy: This treatment uses drugs designed to specifically attack cancer cells.
7. Immunotherapy: This treatment uses the body’s immune system to fight cancer.
Prognosis
The choice of treatment depends on the stage of the cancer, the health of the liver, and the overall health of the patient.
The prognosis for liver cancer varies, with an overall 5-year survival rate around 17%. This rate is influenced by the stage of the cancer. For instance, individuals with early-stage, localized liver cancer have a 5-year survival rate of approximately 31%. However, this rate decreases to about 11% when the cancer has spread to nearby organs or lymph nodes.
Patients diagnosed with early-stage liver cancer, especially those without cirrhosis or other serious health conditions, have a good chance of successful treatment if the cancer can be surgically removed. For those undergoing liver transplants, the 5-year survival rate increases to between 60% and 70%.
Caring
Managing liver cancer also involves supportive care services, which can help patients cope with the physical and emotional challenges of the disease. These services include:
· Pain management
· Nutritional support
· Emotional support
· Palliative care
It’s crucial for patients and their families to have thorough discussions with their healthcare team about all available treatment options, understanding their goals and potential side effects.
