Liver Cancer Symptoms: Signs You Shouldn’t Ignore

Liver cancer is a serious condition that affects thousands of people every year. In this blog post, we will discuss what it is, what are liver cancer symptoms, and how it is diagnosed and treated.

What is liver cancer?

Liver cancer is a life-threatening disease that occurs when cancer forms in the liver. It is a vital organ that performs many functions in the body. The liver filters blood, produces bile, stores nutrients, breaks down drugs and toxins, and helps with blood clotting and immune response.

When it takes hold, it destroys liver cells and interferes with the liver’s normal operating ability.

According to the National Cancer Institute, primary liver cancer is the sixth leading cause of cancer deaths in the United States.

Types of liver cancer

There are two main types of liver cancer:

Primary and secondary

Primary liver cancer starts in the liver cells or the bile ducts.

The main types of primary liver cancer are:

1. Hepatocellular carcinoma (HCC): HCC is the most common type of liver cancer, accounting for about 90% of all primary types. HCC usually occurs in people who have chronic liver problems, such as cirrhosis, hepatitis B or C, alcoholism, or fatty liver disease.

The 5-year survival rate for HCC is about 18%.

2. Fibrolamellar carcinoma (FL-HCC): FL-HCC is a rare type of HCC that affects mostly young people between 5 and 35 years of age. It accounts for only 1% of all primary types.

The outlook for FL-HCC is better than for HCC, with a 5-year survival rate ranging from 44% to 68% for surgical treatment and from 2% to 17% for nonsurgical treatment.

3. Cholangiocarcinoma: It is the second most common type of primary liver cancer, accounting for 10% to 20% of all cases. It starts in the bile ducts.

The 5-year survival rate for cholangiocarcinoma is between 5% and 10%.

4. Angiosarcoma: It is a very rare type of cancer that starts in the blood vessels or lymph vessels inside or near the liver. Angiosarcoma accounts for less than 1% of all primary types.

The outlook for angiosarcoma is very poor, with a 5-year survival rate of less than 10%.

Secondary liver cancer starts in another part of the body and spreads to the liver.

Symptoms of Liver Cancer

Usually, symptoms do not appear until the disease is advanced.

The most common signs are:

  • Jaundice: It is a condition that causes the skin and eyes to turn yellow.
  • Stomach pain.
  • A localized pain in the right shoulder blade.
  • Unaccounted weight loss.
  • Swollen liver, enlarged spleen, or both.
  • Ascites (fluid buildup in the abdomen).
  • Tiredness.
  • Nausea.
  • Vomit.
  • Back pain.
  • Itching.
  • Fever.
  • Loss of appetite.

Additionally, it can result in high calcium and cholesterol levels, as well as low blood sugar.

However, these symptoms may not appear until the later stages of the disease, when the tumor is large or has spread to other organs. Therefore, it is important to have regular check-ups and screening tests if you have a high risk of developing liver cancer.

Causes of liver cancer

The causes are not fully understood, but some factors have been associated with an increased risk of developing the disease. These include:

1. Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).

These viruses can cause inflammation and scarring of the liver, which can lead to cancer.

2. Cirrhosis.

This is a condition in which healthy liver tissue is replaced by scar tissue, which impairs the function of the liver and increases the risk of HCC.

3. Heavy alcohol use.

Drinking too much alcohol can damage the liver cells and cause cirrhosis, which is a risk factor for HCC.

4. Diabetes.

People with diabetes have high levels of blood sugar, which can damage various organs, including the liver. Diabetes can also cause fatty liver disease, which can lead to cirrhosis and HCC.

5. Obesity.

Being overweight or obese can increase the risk of diabetes and fatty liver disease, which are risk factors for liver cancer.

6. Exposure to aflatoxins.

These are toxins produced by a type of fungus that can contaminate some foods, such as peanuts, corn, and grains. Aflatoxins can damage the DNA of liver cells and cause mutations that lead to cancer.

7. Family history.

Having a close relative who has primary liver cancer may increase the risk of developing the disease.

Stages of liver cancer

liver cancer symptoms

The AJCC TNM system assigns a number from 1 to 4 to describe the stage of liver cancer. In general, a lower number means the cancer is less advanced and has not spread much, while a higher number means the cancer is more advanced and has spread more.

Here are the main features of each stage:

Stage 1

Stage 1 liver cancer is also called very early or early-stage.

It means that there is only one tumor in the liver, and it has not grown into any blood vessels or spread to any lymph nodes or distant organs.

It can be further divided into two sub-stages:

Stage 1A: The tumor is 2 centimeters (cm) or smaller in size.

Stage 1B: The tumor is larger than 2 cm in size.

It has a good prognosis, and can often be cured with surgery or other local treatments that destroy the tumor without removing it.

Stage 2

Stage 2 liver cancer means that there is either:

  • A single tumor larger than 2 cm that has grown into blood vessels in the liver, or
  • More than one tumor in the liver, but none of them are larger than 5 cm.

It has not spread to any lymph nodes or distant organs.

It has a moderate prognosis, and can sometimes be cured with surgery or other local treatments.

Stage 3

Stage 3 liver cancer is also called intermediate or advanced stage. It means that there are multiple tumors in the liver, or that at least one tumor has grown into a major branch of the hepatic or portal veins. These are large veins that carry blood to and from the liver.

It has not spread to any lymph nodes or distant organs.

It can be further divided into two sub-stages:

  • Stage 3A: There are multiple tumors in the liver, and at least one of them is larger than 5 cm.
  • Stage 3B: At least one tumor has grown into a major branch of the hepatic or portal veins.

It has a poor prognosis, and cannot be cured with surgery or other local treatments.

Stage 4

Stage 4 liver cancer is also called end-stage or terminal-stage. It means that the cancer has spread to nearby lymph nodes or distant organs, such as the lungs, bones, or brain.

It can be further divided into two sub-stages:

  • Stage 4A: The cancer has spread to nearby lymph nodes, but not to distant organs.
  • Stage 4B: The cancer has spread to distant organs.

It has a very poor prognosis, and cannot be cured with any treatment.

According to the ACS, based on data from 2009 to 2015, the 5-year relative survival rates for liver cancer by stage are:

  • Stage 1: 40%
  • Stage 2: 28%
  • Stage 3: 16%
  • Stage 4: 6%

How is liver cancer diagnosed?

To diagnose liver cancer, your doctor may perform some of the following tests:

  1. Blood tests: These can check your liver function and look for markers that indicate liver damage or cancer.
  2. Imaging tests: These can show the size, shape, and location of any tumors in your liver or nearby organs. They may include ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, positron emission tomography (PET) scan, or angiography.
  3. Biopsy: This is a procedure where a small sample of tissue is taken from your liver or tumor and examined under a microscope to confirm the diagnosis and type of cancer.
  4. Laparoscopy: This is a minimally invasive surgery where a thin tube with a camera and light is inserted through a small incision in your abdomen to look at your liver and other organs.

Liver Cancer Treatment

The treatment options depend on the stage, size, location, and type of the tumor, as well as the overall health and preferences of the patient.

Some of the common treatments include:

1. Surgery.

This involves removing part or all of the liver that contains cancer. Surgery can be curative for some early-stage liver cancers that have not spread beyond the liver. However, surgery is not an option for many patients with advanced or widespread disease or poor liver function.

2. Liver transplant.

This involves replacing the diseased liver with a healthy one from a donor. Liver transplants can be curative for some patients with early-stage liver cancer who meet certain criteria and have no other treatment options. However, liver transplants are not widely available and have many risks and complications.

3. Ablation.

This involves destroying tumors in the liver using heat (radiofrequency ablation), cold (cryoablation), electric current (microwave ablation), or alcohol injections (percutaneous ethanol injection). Ablation can be effective for some small tumors that cannot be removed by surgery or are not suitable for transplant.

4. Embolization.

This involves blocking the blood supply to tumors in the liver using tiny particles (transarterial chemoembolization) or radioactive beads (transarterial radioembolization).

5. Radiation therapy.

Use of high-energy rays or particles to kill cancer cells or shrink tumors.

6. Chemotherapy.

This involves using drugs that kill cancer cells or stop them from dividing. Chemotherapy is not very effective and is usually used only for patients who cannot have other treatments or as part of a clinical trial.

7. Targeted therapy.

This involves using drugs that target specific molecules involved in the growth and spread of cancer cells. Targeted therapy can slow down tumor growth and improve survival for some patients with advanced-stage liver cancer who have a certain gene mutation (sorafenib, lenvatinib, regorafenib, cabozantinib) or a high level of a protein called alpha-fetoprotein (AFP) (ramucirumab).

8. Immunotherapy.

This involves using drugs that stimulate the immune system to fight cancer cells. Immunotherapy can improve survival for some patients with advanced-stage liver cancer who have not responded to or cannot tolerate targeted therapy (nivolumab, pembrolizumab, atezolizumab, and bevacizumab).

9. Supportive Care.

Palliative Care: Palliative care is used in final cases where curative treatments are ineffective in treating the underlying condition. It aims to raise the standard of living of the patient.

Also Read: Prescription Drugs vs. Over-the-counter Drugs: Which Is Right for Your Health?

Conclusion

Liver cancer is a serious disease that affects thousands of people every year. There are different types, each with its causes, symptoms, and treatments.

It can be diagnosed and staged by various tests and systems. It can be treated by various methods, depending on several factors. It has a poor outlook, especially if it is diagnosed at a late stage or if it has spread to other parts of the body.

If you have any questions or concerns about it, please consult your doctor or a specialist

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