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What is Liver Cancer?

Liver cancer is when cancer cells form in the liver, one of the largest organs in the body. The liver filters the blood to remove harmful things from it. It also makes bile, which helps the body digest fat. Its other important job is to store glycogen, which is sugar that’s ready to be used by the body for energy.

Liver cancer is not common in the United States. Most liver cancers are hepatocellular (hep-uh-toh-sel-yuh-ler) carcinoma (kar-suh-noh-muh). These are cancers of the liver cells. More rarely, liver cancer can start in the cells that line the bile ducts, which carry bile from the liver to the gallbladder to help digest fats. This article covers both types of cancer because the signs, symptoms, and treatment are similar for both.

Liver cancer is rare in children. When they do get liver cancer, it is usually hepatoblastoma (hep-uh-blas-toh-ma). This is a tumor that develops from fetal liver cells.

Cancer can spread to the liver after starting somewhere else in the body. This article will focus on cancer that starts in the liver.

Symptoms

Many liver cancers have no symptoms until the cancer spreads. People with liver cancer may have these symptoms, usually once the cancer is more advanced:

  • Pain or pressure on the upper right side of the abdomen or in the right shoulder blade
  • Nausea and vomiting
  • Feeling full after a small meal or having no appetite
  • Unintended weight loss
  • Fatigue (tiredness)
  • Swelling in the liver, which feels like a lump on the right side just under the rib cage
  • Swelling in the spleen, which feels like a lump on the left side just under the rib cage
  • Jaundice. Jaundice is when the eyes and skin turn more yellow because bilirubin (bil-uh-roo-bin) builds up in the body. Usually, the liver turns bilirubin into bile and sends it to the intestines so the body can get rid of it. The person may also notice dark urine and pale, greasy stool that floats.
  • Easy bruising or bleeding
  • Fever

When to See a Doctor

See a doctor if you become jaundice (yellowish skin and eyes), or if you are having pain, problems digesting your food, or any of the symptoms of liver cancer. Most of the time, these symptoms will not be from liver cancer. But it helps to have them checked and find out what is causing them, especially if you have a history of liver disease, like cirrhosis of the liver or hepatitis.

Causes

Researchers only partially understand what causes liver cancer. Cancer is caused by damage to the genetic material in the cells. We know of some toxins and infections that can damage the cells. But sometimes the cause of liver cancer isn’t known.

Diseases and injuries that damage the liver increase your risk for liver cancer. It doesn’t mean you will get cancer if you have these conditions, but it increases your chances of having liver cancer. These conditions are risk factors for liver cancer in adults:

  • Hepatitis B or hepatitis C, with an even greater risk if you have both.
  • Cirrhosis of the liver, which happens when liver cells are damaged. The damaged part becomes scar tissue. In most cases, cirrhosis is caused by alcohol abuse or hepatitis. Sometimes cirrhosis is caused by other problems like fatty liver disease.
  • Obesity, which can lead to fatty liver disease and cirrhosis.
  • Metabolic syndrome and/or Type 2 diabetes, especially if you also have another risk factor such as alcohol abuse or hepatitis.
  • Metabolic syndrome, which is when you have risk factors like extra fat around the waistline, high blood sugar, high blood pressure, and high levels of bad cholesterol.
  • Hemochromatosis (hee-muh-kroh-muh-toh-sis), which is when the body stores too much iron and it damages the liver.
  • Eating food that has aflatoxins, which is made by a fungus that can grow in nuts or grains stored in warm, moist environments. The U.S. tests food for these toxins to make sure it is safe.
  • Workplace exposure to vinyl chloride, a chemical used in making plastics.

Diagnosis and Tests

The doctor will talk to you to find out more about your symptoms and what you are feeling and noticing. The doctor will also ask about your family’s health history. The doctor will examine you to check for jaundice and unusual bumps or swelling in your belly.

Once your doctor suspects that liver cancer is possible, the doctor will have you get one or more these tests to diagnose it.

  • Blood test to check for a tumor. An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of a liver cancer tumor, but sometimes a person can have liver cancer without a high AFP level. Cirrhosis and hepatitis can also increase AFP levels. Sometimes the AFP level is normal even when there is liver cancer.
  • Computed tomography (CT) scan. This scan uses x-rays to make pictures of the inside of the body. The doctor may do a special type of CT scan in which the patient receives an injection of dye before getting the scan.
  • Positron emission tomography (PET) scan. This test helps the doctor find out if the cancer has spread. You are given glucose mixed with a small amount of radioactive material. The scanner can then find cancer cells because they use glucose faster than other cells.
  • MRI. This test makes pictures of the inside of the body by using a magnet and radio waves. The doctor may first inject a dye to get pictures of blood vessels in and near the liver.
  • Ultrasound. This test uses sound waves that bounce off the liver and make echoes, which can be used to make a picture of what is there. It can be used to find a tumor.
  • Biopsy. If any scan or image shows a tumor, the doctor will remove some or all of the tumor cells to see if they are cancerous. They may use a needle to take some tissue and fluid, or they may do laparoscopic surgery to look inside and remove tissue. With laparoscopic surgery, the surgeon makes small cuts in your abdomen. The surgeon puts a small tube inside with a camera into one cut, and instruments to remove some of the tissue into another cut.

Treatments

Your doctor may recommend any of the treatments below for liver cancer.

  • Watching. If the tumor is less than 1 centimeter, the doctor may recommend just watching it every three months to make sure it doesn’t get bigger or change.
  • Surgery. A surgeon may remove part of the liver where the cancer is. The rest of the liver is able to take over, and some of the liver may grow back.
  • Liver transplant. The whole liver is removed and replaced with a healthy donated liver.
  • Ablation. The part of the liver that has cancer is destroyed by exposing it to extreme heat or cold or giving an injection of ethanol to kill the tissue.
  • Embolization. This blocks the blood flow to the cancer cells so they will die. A catheter (tube) is put into an artery through the leg, and a medicine that stops blood flow to the tumor is put into it. Sometimes medicine that kills the cancer is also put in.
  • Targeted therapy. This therapy attacks cancer cells and uses drugs that block signals that tumors need in order to grow.
  • Radiation. This therapy uses high energy X-rays (radiation) aimed at cancer cells to kill cancer cells or keep them from growing. It may be done from outside the body, or the radiation may be put inside the body near the tumor.

Prevention

You can help prevent liver cancer by preventing some of the risk factors.

  • Get a vaccine for hepatitis B to prevent getting this disease.
  • Maintain a healthy weight.
  • Prevent metabolic syndrome (extra weight at the waistline, high blood sugar, high blood pressure, high cholesterol) by eating healthy foods and adding physical activity to your day.
  • Get treatment for alcohol addiction, which can cause cirrhosis of the liver.