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Primary Liver Cancer

Primary liver cancer is generally not discovered early, likely because there are few signs and symptoms in the early stages. The prognosis is often poor, and liver cancer does not respond well to treatment.

However, by protecting yourself from cirrhosis and hepatitis – the two leading causes of the disease – you can greatly reduce your risk of developing liver cancer.

Note that primary liver cancer – which originates in the liver – is different from metastatic liver cancer in that metastic only occurs when tumors from other parts of the body spread to the liver. Metastic, therefore, is not considered liver cancer.

Signs and Symptoms

Because most people do not exhibit symptoms early on, liver cancer usually remains undetected until it has reached the advanced stages. For those who do experience symptoms, they may include:

• A yellow discoloration of the skin and whites of the eyes (jaundice)
• Abdominal pain, especially in the upper right part of the abdomen
• Abdominal swelling
• An enlarged liver
• General weakness and fatigue
• Loss of appetite
• Nausea and vomiting
• Weight loss

What Causes Liver Cancer?

Liver cancer begins in the liver cells when they start to grow abnormally. Why this happens is not entirely understood, however, researchers suggest that liver cancer begins with damage to DNA.

Risk Factors

While primary liver cancer affects both sexes, and all ages and races, certain factors increase the risk:

• Aflatoxin exposure (foods contaminated with fungi that produce aflatoxins such as corn, peanuts, and soybeans)
• Average age in Europe and the United States for a liver cancer diagnosis is sixty
• Bile duct disease (i.e. primary sclerosing cholangitis)
• Chronic hepatitis B infection (HBV)
• Chronic hepatitis C infection (HCV) (this is the most important risk factor for liver cancer)
• Cirrhosis
• Diabetes
• Excessive alcohol consumption
• More men than women develop liver cancer
• Smoking

Screening for Liver Cancer

The American Association for the Study of Liver Diseases recommends liver cancer screening for high risk people including those who have¹

• An inherited form of hemochromatosis
• Liver cirrhosis from alcohol use
• Primary sclerosing cholangitis
• Hepatitis B and one or more of the following: Are an Asian male older than forty, an Asian female older than fifty, or an African and older than twenty, have liver cirrhosis, or have a family history of liver cancer
• Hepatitis C

Diagnosing Liver Cancer

A variety of tests and procedures are used to diagnose liver cancer including blood tests, computerized tomography (CT) scanning, liver biopsy, magnetic resonance imaging (MRI), and ultrasound (ultrasonography).

Treatments for Primary Liver Cancer

While the goal of treatment is to completely eradicate liver cancer, the focus may turn to preventing the tumor from growing and/or spreading when complete eradication isn't possible. Depending on the stage of liver cancer, palliative care – relieving symptoms and making patients as comfortable as possible – may be the only option.

Various treatment options include,

• Chemotherapy treatment
• Cryoablation (cryosurgery or cryotherapy) uses extreme cold to destroy malignant cells
• Liver transplantation
• Pure alcohol injection directly into tumors
• Radiation therapy – high-powered energy beams to destroy cancer cells and shrink tumors
• Radiofrequency ablation – an electric current is used to destroy cancerous cells
• Surgery to remove malignant liver tissue

Prevention

By taking steps to protect yourself from developing cirrhosis and other liver diseases or from contracting hepatitis B and C, you can significantly reduce your risk of developing liver cancer.

Vaccination – which provides over ninety percent protection for both adults and children – is an effective way to prevent hepatitis B.

Since there is no vaccine for hepatitis C, the only way to prevent the disease is to reduce the risk of exposure to the virus. Avoiding behaviors such as sharing drug needles or personal items like toothbrushes, razors, and nail clippers with infected person(s) is recommended. Also,

• Avoid body piercing and tattooing. Improperly sterilized needles can spread hepatitis C.
• Avoid exposure to environmental toxins.
• Avoid injecting drugs. Use clean needles if you are unable to cease drug use.
• Avoid medications that may cause liver damage.
• Be cautious about accepting blood products in countries outside the United States.
• Consider the health status of your sexual partners, and always engage in safe sex.
• Limit alcohol consumption as it speeds the progression of all liver diseases, and is the leading cause of cirrhosis – a key factor in primary liver cancer.

For more information on the liver, please review the liver cleansing overview article, or search for related articles by using the search box.

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Notes:
1. Mayo Clinic.com, Tools for healthier lives, "Liver cancer: Prevention" http://www.mayoclinic.com/health/liver-cancer/DS00399/DSECTION=8 (accessed November 14, 2007).