What is the liver?
The liver can repair itself quite easily and can usually function with only a small portion of it working.
There are 2 main types of primary liver cancer. The most common type is known as a hepatoma, it starts in the cells, which perform the major tasks of the liver, called hepatocytes. The second type of cancer is known as cholangiocarcinomas and it starts in the cells that line the bile ducts of the liver.
Although nobody is exactly sure what causes primary liver cancer, it does tend to arise in those people whose liver has been severely damaged by a condition called cirrhosis (scarring of the liver). Any disease that causes cirrhosis of the liver will increase the risk of you developing liver cancer. Cirrhosis of the liver can be caused by infection with the hepatitis B or C virus and drinking excess alcohol. Hepatitis A does not cause cirrhosis or primary liver cancer.
A primary cancer situated elsewhere in the body always causes secondary liver cancer. If cancer cells from the primary cancer escape into the bloodstream the liver is the most likely place for them to embed and grow, as all blood in the body passes through the liver.
The symptoms for both primary and secondary cancer are similar though in the early stages you may have no symptoms. Secondary liver cancer tends to be found when the primary cancer is diagnosed. When symptoms are present they may include any of the following:
These symptoms can be common to many other non-serious conditions, so always have any symptoms you are experiencing checked by your doctor.
To avoid liver cancer you should stop smoking, as this will greatly reduce your risk of developing lung and stomach cancer. Try to maintain a healthy balanced diet and reduce your consumption of alcohol – a major cause of cirrhosis of the liver. Protect yourself against the hepatitis virus by practicing safe sex and avoid sharing needles.
If you have cirrhosis of the liver your doctor should regularly test you for the presence of a hepatoma. The test may involve regular blood tests, which looks for the presence of alpha-feta protein (A.F.P.), a substance found in abnormal amounts in those with a hepatoma.
Your doctor may have a feel of your liver from a physical examination and may also carry out a urine test which among other things looks for bilirubinand urobilinogen, if these levels are raised this could indicate the liver is damaged. If these levels are raised and/or the liver feels larger or harder than it should then your doctor may recommend a LFT (Liver Function Test) for more detailed results and looks at the following:
A cancer of the liver might be suspected when an abnormality is seen in ‘liver blood tests’. This blood test detects there is something wrong in the liver but this may not necessarily be because of cancer.
If the liver cancer type is a hepatoma it normally produces abnormal amounts of a substance called alpha-feta protein, which can be detected in the blood.
To diagnose liver cancer you will have a scan of the liver with an ultrasound, CT scan or a M.R.I. (Magnetic Resonance Imaging). These tests build up a picture of the liver and show the exact location of the tumour, though they cannot usually tell, if it is a primary or secondary cancer. For a final diagnosis you will usually have a biopsy, which involves the doctor taking a small sample of liver cells, for examination under a microscope. A biopsy will tell the doctor what type of cell is causing the cancer to develop.
If you have a hepatoma there are a number of treatments available. If the cancer is small it may be removed by an operation. Even if you need to have the majority of the liver removed, it will start to regrow very quickly and could be back to normal size within a month.
If cirrhosis has seriously affected the liver, a liver transplant may be considered. Chemotherapy may be used in the treatment of primary and secondary cancer but it is unlikely that radiotherapy will be used.
If the cause of primary liver cancer is cholangiocarcinomas then it can be very difficult to treat. The first stage of treating this type of cancer is to relieve the jaundice, caused by blocked bile ducts (where this type of cancer forms). Once this has been carried out, the doctor can assess the size and position of the tumour and will hopefully be able to perform surgery. Radiotherapy may also be used to treat this type of cancer.