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Liver Cancer

(Malignant Hepatoma; Hepatocellular Carcinoma; Primary Liver Cancer)

Definition

Liver cancer is growth of cancer cells in the liver. The liver is an organ in the right side of the abdomen. It helps with digestion. It also filters and stores blood.

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Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

Liver cancer is more common in men, and older adults. Other things that raise the risk are:

Symptoms

There may be no symptoms in the early stages of liver cancer.

When symptoms happen, they may be:

  • Yellowing of the skin or whites of the eye—jaundice
  • Loss of hunger and weight
  • Tiredness and weakness
  • Belly pain, swelling, or nausea
  • Dark urine
  • Itching

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Tests may include:

  • Blood tests
  • Biopsy—a sample of tissue is taken and tested
  • Laparoscopy—to look inside the liver

Imaging tests will check for tumors and the spread of cancer. They may include:

The exam and test results are used to diagnose the cancer. They are also used for staging. Staging outlines how far and fast cancer has spread.

Treatment

The goal is to remove the cancer, if possible. Treatment depends on the stage of the cancer. It also depends on the person's health.

Options may be:

  • Surgery to try to cure the cancer, such as:
    • Removing the tumor, nearby tissue, and possibly nearby lymph nodes
    • A liver transplant
  • Other procedures, such as:
    • Cryosurgery—freezes and destroys tumors
    • Ethanol ablation—kills cancer cells by injecting alcohol into the tumor
    • Embolization—injected substances decrease the liver's blood supply to cancer cells
    • Radiofrequency ablation— uses heat to destroy the tumor
  • Chemotherapy by mouth, injection, or IV— to kill cancer cells
  • Biological therapies—to help the body fight cancer
  • External or internal radiation—to kill cancer cells and shrink tumors

Prevention

The risk of liver cancer may be reduced by:

  • Having children get the hepatitis B vaccine
  • Drinking alcohol moderately
  • Eating a healthy diet
  • Practicing safe sex
  • Using clean needles—if injecting medicines or drugs
RESOURCES:

American Cancer Society
https://www.cancer.org

American Liver Foundation
https://liverfoundation.org

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca

Canadian Cancer Society
http://www.cancer.ca

REFERENCES:

Embolization therapy for liver cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/liver-cancer/treating/embolization-therapy.html. Accessed March 19, 2021.

General information about adult primary liver cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/liver/patient/adult-liver-treatment-pdq. Accessed March 19, 2021.

Hepatocellular carcinoma in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hepatocellular-carcinoma-in-adults. Accessed March 19, 2021.

Hepatocellular carcinoma in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hepatocellular-carcinoma-in-children. Accessed March 19, 2021.

Jiang Y, Han QJ, et al. Hepatocellular carcinoma: mechanisms of progression and immunotherapy. World J Gastroenterol. 2019;25(25):3151-3167.

Liver cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/liver-cancer.html. Accessed March 19, 2021.

Last reviewed January 2021 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 3/19/2021