Your liver is the largest organ inside your body. It filters harmful substances from the blood, digests fats from food and stores the sugar that your body uses for energy. Primary liver cancer starts in the liver. Metastatic liver cancer starts somewhere else and spreads to your liver.
What are the symptoms of liver cancer?
The initial symptoms (the clinical presentations) of liver cancer are variable. In countries where liver cancer is very common, the cancer generally is discovered at a very advanced stage of disease for several reasons. For one thing, areas where there is a high frequency of liver cancer are generally developing countries where access to healthcare is limited. For another, screening examinations for patients at risk for developing liver cancer are not available in these areas. In addition, patients from these regions actually have more aggressive liver cancer disease.
Jaundice If the bile duct becomes blocked, bile produced by the liver will flow back into the bloodstream, causing jaundice. This will cause the skin and whites of the eyes to go yellow and may make the skin very itchy. The itching may sometimes be relieved by antihistamine tablets or other drugs, which your doctor can prescribe. Sometimes the jaundice itself can be relieved.
Causes of Liver Cancer
Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach. Your liver processes most of the nutrients absorbed from your small intestine and determines how much sugar (glucose), protein and fat enter your bloodstream. It also manufactures blood-clotting substances and certain proteins. Your liver performs a vital detoxifying function by removing drugs, alcohol and other harmful substances from your bloodstream.
Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can lodge in the liver and start to grow. Cancers that begin in the gut often spread to the liver. The ability of the liver to regenerate may also be linked to the development of liver cancers.
How is liver cancer diagnosed?
Liver cancer may be discovered in a routine checkup if the doctor feels hard lumps in the abdomen, or incidentally by imaging studies. To confirm a diagnosis of liver cancer, doctors would use blood tests; ultrasound; computer tomography (CT) scans; and magnetic resonance imaging, or MRI. Doctors may find it necessary to do a biopsy, where a small sample of liver tissue is removed with a needle and then examined for cancer cells.
Liver Cancer Treatment
Systemic chemotherapy for hepatocellular carcinoma has not been very successful. Doxorubicin, cisplatin and 5-FU have been the most successful drugs, however response rates have been very low (less than 10%) and treatment has had no impact on overall survival. The use of combination chemotherapy has not shown to have any advantage over single-agent chemotherapy. Intraarterail chemotherapy (mitomycin, doxorubicin, cisplatin) can be given into the hepatic artery that is providing blood supply to the tumor.
In situations in which spread is limited to the liver, systemic chemotherapy may be used, although other treatment methods may be effective. When the tumor is localized to only a few areas of the liver, the cancer may be removed surgically.
Use of radiofrequency waves or injection of toxic substances may also be used to kill tumors. When larger areas of the liver are involved, liver-directed chemotherapy (infusing chemotherapy directly into the liver), or embolization (blockage of blood flow to parts of the liver) may be used.
Patients with such limited cancer may benefit from chemotherapy infused directly into the liver. Delivered by an implanted pump connected to the hepatic artery, this therapy takes advantage of the liver’s ability to metabolize some drugs, meaning that the tumor may be exposed to high concentrations of chemotherapy while the rest of the body is spared the side effects.