Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach.
Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.
Cancer that spreads to the liver is more common than cancer that begins in the liver cells. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. This type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver.
Types
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.
Risk factors
The risk of hepatocellular carcinoma, the most common type of liver cancer, is higher in people with long-term liver diseases. It’s also higher if the liver is scarred by infection with hepatitis B or hepatitis C. Hepatocellular carcinoma is more common in people who drink large amounts of alcohol and who have an accumulation of fat in the liver.
Diagnosis
Tests and procedures used to diagnose hepatocellular carcinoma include:
- Blood tests to measure liver function
- Imaging tests, such as CT and MRI
- Liver biopsy, in some cases, to remove a sample of liver tissue for laboratory testing
Treatment
Which treatment is best for you will depend on the size and location of your hepatocellular carcinoma, how well your liver is functioning, and your overall health.
Hepatocellular carcinoma treatments include:
- Surgery. Surgery to remove the cancer and a margin of healthy tissue that surrounds it may be an option for people with early-stage liver cancers who have normal liver function.
- Liver transplant surgery. Surgery to remove the entire liver and replace it with a liver from a donor may be an option in otherwise healthy people whose liver cancer hasn’t spread beyond the liver.
- Destroying cancer cells with heat or cold. Ablation procedures to kill the cancer cells in the liver using extreme heat or cold may be recommended for people who can’t undergo surgery. These procedures include radiofrequency ablation, cryoablation, and ablation using alcohol or microwaves.
- Delivering chemotherapy or radiation directly to cancer cells. Using a catheter that’s passed through your blood vessels and into your liver, doctors can deliver chemotherapy drugs (chemoembolization) or tiny glass spheres containing radiation (radioembolization) directly to the cancer cells.
- Radiation therapy. Radiation therapy using energy from X-rays or protons may be recommended if surgery isn’t an option. A specialized type of radiation therapy, called stereotactic body radiotherapy (SBRT), involves focusing many beams of radiation simultaneously at one point in your body.
- Targeted drug therapy. Targeted drugs attack specific weaknesses in the cancer cells, and they may help slow the progression of the disease in people with advanced liver cancers.
- Immunotherapy. Immunotherapy drugs use your body’s germ-fighting immune system to attack the cancer cells. Immunotherapy may be an option for treating advanced liver cancer.
- Clinical trials. Clinical trials give you a chance to try new liver cancer treatments. Ask your doctor whether you’re eligible to participate in a clinical trial.
Symptoms
Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:
- Losing weight without trying
- Loss of appetite
- Upper abdominal pain
- Nausea and vomiting
- General weakness and fatigue
- Abdominal swelling
- Yellow discoloration of your skin and the whites of your eyes (jaundice)
- White, chalky stools
When to see a doctor
Make an appointment with your doctor if you experience any signs or symptoms that worry you.
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