Liver Cancer

Definition

The liver is one of the most important organs in the body. It is divided into sections, called lobes, and acts as a filter for blood. The liver does the following:

• Takes harmful substances out of the blood that are later passed out of the body as waste. Makes bile, a fluid that helps digest fat.
• Digests and stores other nutrients from food like sugar, which is used for energy.
• Makes substances used for many body functions, including ones that make your blood clot.

Liver cancer can be classified in two ways. Primary liver cancer is one that starts in the tissue of the liver. The most common type of primary liver cancer is called hepatocellular carcinoma. The number of cases of primary liver cancer in the United States has been increasing over the years.

Secondary liver cancer is cancer that started in some other place in the body and moved to the liver. This type is also called metastatic liver cancer.

In 2019, chronic liver disease was the eighth leading cause of death for non-Hispanic Blacks, ages 45-64 years old, according to The Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS).

Black men are 60 percent more likely to have liver and IBD cancer and to die from this disease as compared to non-Hispanic white men. In 2022, 7 percent of deaths in Black men were a result of liver cancer.

Additionally, Black women are 30 percent more likely to die from liver and IBD cancer than non-Hispanic white women. In 2022, an estimated 3 percent of Black women died from liver cancer.

Blacks are also often diagnosed with liver cancer at a later stage than other races.

Risk factors

A risk factor does not mean that you will develop liver cancer, however, it can increase your chances of getting it. Liver cancer, risk factors include:

• Having other liver diseases, including hepatitis B or C (viral diseases that attack the liver) or cirrhosis (a disease that causes scarring). Having a family history of liver diseases that can cause cirrhosis (liver diseases that run in families) is also a risk factor.
• Having diabetes.
• Being obese.
• Being a man. Men are more likely to get liver cancer than women.
• Drinking too much alcohol over a long period of time.
• Being exposed to a type of poison made by moldy crops.

Symptoms

If your liver cancer is in the early stages, you may have no symptoms at all. If your liver is swollen, you might notice the following symptoms:

• A lump below the rib cage or pain on the right side of the abdomen, or pain near the right shoulder.
• Jaundice (a disease that causes skin and eyes to yellow).
• Unexplained weight loss, nausea, or loss of appetite.
• Fatigue.
• Dark-colored urine.
• Bloating.

However, it is important to note that liver cancer is only one of the reasons that a liver can be swollen.

Causes

You might get liver cancer from liver diseases like hepatitis. Having cirrhosis can also increase your risk. However, some people who get liver cancer don’t have any other liver diseases. In many cases, the actual cause isn’t known.

Diagnosis

Your doctor may think about liver cancer if they find lumps or other symptoms during your physical exam. The doctor might order other tests, like:

• Blood tests
• Ultrasound (sonography)
• Computed Tomography (CT Scan)
• Magnetic Resonance Imaging (MRI)
• Angiogram
• Laparoscopy
• Biopsy

The doctor uses a process called staging to give the cancer diagnosis a number from I to IV. The higher the number, the more cancer has a chance to spread. Cancers are also defined by how they can be treated, mostly by deciding if cancer can be removed by surgery.

Liver cancer stages include the following:

• Stage I: One tumor is found in the liver only.
• Stage II: One tumor is found, but it has spread to the blood vessels, OR more than one tumor is present, but they are all smaller than 3 cm.
• Stage III: In Stage III liver cancer, there is more than one tumor and one of them at least is larger than 5 cm, OR the cancer has moved beyond the liver to large blood vessels, another organ, or to the lymph nodes.
• Stage IV: The cancer has spread to other places in the body, such as the lungs or bones, as well as lymph nodes.

Liver cancer that has returned may also be called recurrent. Recurrent liver cancer could come back in the liver or anywhere else in the body.

Treatments

If you have liver cancer, your treatment and chance of recovery (also called prognosis) may depend on certain things. These include your general health, how well your liver is working, the stage of the cancer that you have and your levels of alpha-fetoprotein.

Liver cancer may be treated using one or more methods: surgery, loco-regional therapy, different types of drug therapy, and even liver transplantation.

Prognosis

Your outlook, also called your prognosis, depends on things like your overall health, the type and stage of your cancer, and how well you respond to treatment.

Liver cancer can be cured for the small number of people who are able to have a successful organ transplant. Liver cancer is also resolved for about one in three people who have surgery to remove tumors or parts of the liver. Liver cancer that is not treated successfully is fatal, but researchers are working daily to find more effective treatments.

Prevention

• Avoid behaviors that lead to cirrhosis. Do not drink alcohol.
• Maintain a healthy weight to prevent nonalcoholic fatty liver disease.
• Get a hepatitis B vaccine. This vaccine is safe for nearly everyone. You can ask your doctor about the hepatitis A vaccine as well.
• Avoid getting hepatitis C by practicing safe sex, not using IV drugs, and refusing to get a tattoo or piercing from any tattoo shop that can’t prove to you that they use clean needles. If you do use IV drugs, do not share needles or use needles that aren’t clean.
• Ask your doctor about how often you should have liver cancer screenings if you have any type of liver disease. Also, ask about screenings if you are a heavy drinker, have diabetes or weigh more than is recommended.