Liver Cancer (The James)

Liver Cancer (The James)

 

Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:

  • To filter harmful substances from the blood so they can be passed from the body in stools and urine.
  • To make bile to help digest fat that comes from food.
  • To store glycogen (sugar), which the body uses for energy.

 

There are two types of adult primary liver cancer:

  • Hepatocellular carcinoma
  • Cholangiocarcinoma (bile duct cancer)

 

Risk factors for liver cancer:

  • Having hepatitis B and/or hepatitis C infection
  • Having cirrhosis
  • Heavy alcohol use. Heavy alcohol use and having hepatitis B infection increases the risk even more.
  • Having nonalcoholic steatohepatitis (NASH), a condition in which fat builds up in the liver and may progress to inflammation of the liver and liver cell damage.
  • Using tobacco, such as cigarette smoking.
  • Having certain inherited or rare disorders that damage the liver, including the following:
    • Hereditary hemochromatosis, Alpha-1 antitrypsin deficiency, Glycogen storage disease, Porphyria cutanea tarda, and Wilson disease.
    • Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

 

Signs and symptoms of liver cancer:

  • A hard lump on the right side just below the rib cage
  • Discomfort in the upper abdomen on the right side
  • A swollen abdomen
  • Pain near the right shoulder blade or in the back
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Easy bruising or bleeding
  • Unusual tiredness or weakness
  • Nausea and vomiting
  • Loss of appetite or feelings of fullness after eating a small meal
  • Weight loss for no known reason
  • Pale, chalky bowel movements and dark urine
  • Fever

 

Diagnosing liver cancer:

The following tests and procedures may be used:

  • Physical exam and history
  • Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of liver cancer. Other cancers and certain noncancerous conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even when there is liver cancer.
  • Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver cancer.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the liver.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. Procedures used to collect the sample of cells or tissues include the following:
    • Fine-needle aspiration biopsy: The removal of cells, tissue or fluid using a thin needle.
    • Core needle biopsy: The removal of cells or tissue using a slightly wider needle.
    • Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Another instrument is inserted through the same or another incision to remove the tissue samples.

A biopsy is not always needed to diagnose adult primary liver cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (the size of the tumor, whether it affects part or all of the liver, or has spread to other places in the body).
  • How well the liver is working.
  • The patient’s general health, including whether there is cirrhosis of the liver.

 

Adapted from: Adult Primary Liver Cancer Treatment, National Cancer Institute

 

 

© March 2, 2023. The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.