Liver Cancer

What is Liver Cancer ?

There are two ways in which cancer can involve the liver. The cancer can arise from the liver itself (primary liver cancer) or it can spread to the liver from a primary tumour at another site (secondary, or metastatic, cancer).

• Primary liver cancer (most commonly hepatocellular carcinoma) originates in the liver.
• Metastatic liver cancer results from the spread (metastasis) of cancer from other areas of the body. In about 50 per cent of patients with metastatic liver cancer, the primary tumour is in the bowel (colon, rectum) or stomach.

No particular staging system exists for liver cancer. Although most hepatoblastomas are resectable curable, the prognosis is almost always poor. The disease progresses rapidly, with death usually occuring within 6 months of diagnosis from GI hemorrhage, progressive cachexia, liver failure. or metastasis spread. When cirrhosis is present, the prognosis is especially grim, with death from liver failure usually occurring within 2 months of diagnosis.

Causes of Liver Cancer

Once cause of liver cancer is exposure to vinyl chloride. Other causes of liver cancer are unknown. However certain risk factors have been identified. The risk factors are: Chronic Hepatitis, Cirrhosis of the liver and liver flukes (parasites).

Signs & Symptoms of Liver Cancer

A very early cancer will have little or no symptoms. It will have little or no symptoms because it is too small to cause any. As the cancer enlarges, it will have symptoms. The common symptoms are:

• Pain in the right upper abdominal area. Pain is caused by stretching of the liver's capsule.
• Weight Loss and loss of appetite.
• Nausea and vomiting.
• Breast swelling in males.
• Easy bruising or bleeding.
• Blood clotting problems leading to intestinal bleeding and bruises on the skin.
• General weakness and fatigue.
• Jaundice

Diagnostic Tests

Liver cancer is usually diagnosed with a number of different tests, which may include:

• Blood tests - to check your general health and to check for a chemical usually found in increased levels in people with primary liver cancer.
• Ultrasound - a picture of the liver is taken using sound waves.
• CT scan - a specialised x-ray taken from many different angles to build a three-dimensional (3-D) picture of the body.
• Magnetic resonance imaging (MRI) - similar to a CT scan, but uses magnetism instead of x-rays to build a picture of the body.
• Liver biopsy - a small piece of liver tissue is removed with a needle and examined for cancer cells.
• Laparoscopy - a small cut in the lower abdomen allows a thin mini-telescope (laparoscope) to be inserted to look at the liver and take a sample of the liver tissue.

Treatment

Because liver cancer may reach an advanced stage before diagnosis, few hepatic tumors are resectable. A resectable tumor must be solitary and not accompanied by cirrhosis, jaundice, or ascites. Resection is performed by lobectomy or partial hepatectomy.

Radiation therapy may be used alone or with chemotherapy. Chemotherapeutic drugs include fluorouracil, doxorubicin, methotrexate,streptozocin, and lomustine 1.V. or regular infusion of fluorouracil or flexuradine. Both therapies combined produce a better response rate than either therapy used alone. Liver transplantation is an alternative for some patients.

Surgery - to remove the cancer and damaged tissue. This is the main treatment for primary liver cancer. Surgery is only useful for secondary liver cancer if the cancer cells only affect one part of the liver.

Prevention Tips

Preventing and treating viral hepatitis may help reduce risk. Avoid excessive alcohol consumption. Certain patients may benefit from hemochromatosis screening.