Information on Liver Cancer:
Types of liver cancer
Cancer of the liver can develop in two different ways. This section is written about primary liver cancer, which is cancer that began in the liver itself. The alternative, known as secondary cancer, is cancer that began elsewhere in the body and travelled to the liver in the blood stream. The most common cancers that spread to the liver include bowel, breast, lung, pancreas, and stomach cancer.
Primary liver cancer is found in two different forms:
- Hepatoma (or hepatocellular carcinoma) – This is the most common kind of liver cancer and develops from the cells of the liver (the hepatocytes). This type of cancer is usually confined to the liver, although it can spread to other parts of the body.
- Cholangiocarcinoma (or bile duct cancer) – This type of cancer starts in the cells that line the bile ducts.
The causes of primary liver cancer
Primary liver cancer is quite rare in the UK, but it has been linked to cirrhosis of the liver. Cirrhosis is damage to the liver that is often due to heavy drinking of alcohol over a long period of time.
Chronic hepatitis B, C and D can also increase the risk of developing hepatoma by causing cirrhosis of the liver. Haemachromatosis is another condition (albeit a rare one) that has also been linked to an increased risk of hepatoma. It does this by causing excess deposits of iron in the body.
Scientists have not yet determined the exact cause of most bile duct cancers, but some bowel conditions such as ulcerative colitis have proven to increase the risk of developing cholangiocarcinoma.
In the UK, liver cancer is found more commonly in middle-aged and elderly people, although it has been known to develop in children and young adults. Liver cancer is found in men more frequently than in women.
The symptoms of primary liver cancer
Neither primary nor secondary liver cancers show symptoms in their early stages (which illustrates the need for early detection techniques), but when they do, the following may occur:
- A vague discomfort in the upper abdomen that can become painful.
- Pain in the right shoulder – If the liver becomes enlarged it can stimulate nerves that are connected to the right shoulder, causing referred pain.
- Reduced or loss of appetite.
- Unexplained weight loss.
- High temperature or feeling shivery.
- Jaundice – where the skin and whites of the eyes become yellowed and the skin becomes itchy. As liver cancer develops it can block the bile duct, preventing bile from leaving the liver and entering the small intestine – on its way out of the body. This also results in pale bowel motions and dark yellow urine.
- A build-up of fluid in the abdomen – which can be caused by the lining of the abdomen being irritated by cancer cells, increased blood pressure in the veins leading to the liver, cancer cells obstructing the flow of fluid in the lymphatic system or liver damage that affects the production of the blood proteins that help to maintain the body’s natural fluid balance.
Although some of these symptoms can be caused by other medical conditions, if you are experiencing any of the above you should consult your doctor immediately.
Methods of diagnosis
Having taken your full medical history, your doctor will conduct a physical examination. Further tests to help diagnose cancer of the liver are as follows:
- Blood tests – for checking liver function.
- Blood tests for alpha-feto protein – a substance found in the blood that increases in the presence of hepatoma.
- CT scan (CAT scan).
- Hepatic arteriography – This is an x-ray technique that is assisted by injecting a dye into your bloodstream that shows up on X-ray, in order to show any abnormalities in the liver’s blood supply.
- Liver biopsy.
- Liver ultrasound.
- Magnetic resonance imaging (MRI or NMR scan).