Definition: what is liver cancer?
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The liver is a vital organ and one with the most volume in the human body. Located to the right side of the abdomen between the diaphragm and stomach, the liver has multiple functions: it filters toxins and stores and converts the nutrients absorbed by the intestines. It also makes the proteins that contribute to blood clotting, produces bile which allows fats to be absorbed and also helps to regulate the glucose levels of some hormones.
There are two types of liver cancer. Primary liver cancer begins in the liver cells, the hepatocytes. The most common is Hepatocellular Carcinoma.
Secondary liver cancer, or liver metastasis, is cancer which originated in another part of the body and has spread to the liver. Since the liver is a blood filter, cancerous cells from another organ can easily reach the liver through the bloodstream.
Causes of liver cancer
Causes of liver cancer, when it is primary, are difficult to identify, but some risk factors have been identified:
- chronic hepatitis B and chronic hepatitis C (and not A) are the reason for hepatocellular carcinoma.
- liver cirrhosis, often, but not only, due to alcohol
- exposure to some toxins, such as some types of mushrooms due to poorly stored agricultural products (aflatoxins), vinyl chloride used in some plastics, anabolic steroids and arsenic.
- tobacco
Symptoms: what does liver cancer cause?
At the beginning of liver cancer, the disease rarely triggers specific symptoms and it is for this reason that this cancer is often diagnosed later. At this time, symptoms include:
- unexplained weight loss
- loss of appetite
- pains in the abdomen
- nausea and/or vomiting
- general weakness
- mass appearing in the liver region
- jaundice (yellowing of the skin and eyes, pale stools and dark urine)
These symptoms are not however only linked to liver cancer and can appear in other more common diseases. As soon as symptoms start to appear, consult your doctor.
Treatment: how to treat liver cancer
There are numerous therapeutic options to treat liver cancer: surgery, ablation by radiofrequency, cryosurgery, percutaneous injection, chemotherapy or radiotherapy. The choice of treatments and their combinations are chosen by the doctor according to the state of health of the patient as well as the extent of the tumour.
- Surgery:
Surgery, or partial hepatectomy, when possible is the first choice of treatment. To be performed, many conditions are considered: the tumour must be limited to the liver, be severable, and the remaining healthy liver volume must be sufficient to ensure normal function. Being able to only partially regenerate itself, after a partial hepatectomy, the volume of the liver increases, but never to its original size.
In cases where the liver is too affected without the cancer spreading to another organ, the doctor may consider a total hepatectomy, meaning a complete ablation of the liver. This will be followed by a transplant of the whole liver or liver lobe from a compatible donor. It is rare however, that a liver transplant is possible to treat primary liver cancer.
- Ablation
Whilst the tumour can’t be removed by surgery, ablation by radio-frequency is often used. This involves burning up the abnormal cells by inserting small electrodes into the liver and issuing electric shocks.
- Chemotherapy
Chemotherapy is considered when surgery and techniques to remove it locally aren’t possible, or when the tumour regresses. It involves medication treatment administered intravenously or orally. These medications attack the cancerous cells and in order to limit secondary effects and when possible, chemotherapeutic medication can be directly injected into the tumour or into the artery which supplies blood to the liver.
Other options exist such as cryosurgery, which is increasingly abandoned to make way for radio-frequency ablation, as well as percutaneous injections which are also used less and less. Ultimately, radiotherapy is rarely used in primary liver cancer, as this type of cancer is not very sensitive to it.
Prognosis of liver cancer
The liver cancer prognosis depends on many factors: the position of the tumour, its characteristics and the stage of the cancer. It is important to diagnose the cancer as soon as possible. This is because the vital prognosis depends on the state of the liver function. The higher it is, the higher the chances of survival.
However, liver cancer remains to be an illness that is very often fatal. It is estimated that 13% of people affected by liver cancer survive more than five years after the initial diagnosis.
