The liver is responsible for many essential functions in the body. Sometimes, liver cells can become cancerous cells, leading to liver cancer. It’s estimated that before the end of 2023, there will be 41,210 new cases of liver cancer diagnosed in the U.S.
Here, we’ll go over the most common liver cancer symptoms and types of liver cancer. We’ll then review common treatments and how early detection can improve outcomes.
The liver is a large organ in the upper right region of the abdomen. While it’s mostly made up of cells called hepatocytes, it has other types of cells that line surrounding blood vessels and small tubes called bile ducts.
The liver produces bile, which helps transport waste and break down fats in the small intestine. It also produces cholesterol and proteins that help transport fat throughout the body. It holds many other metabolic, digestive, and storage functions that are vital for remaining healthy.
Liver cancer occurs when cells inside the liver change and become cancerous over time. Most liver cancer cells come from hepatocytes. These liver cells can grow into liver tumors, which can then potentially spread to the rest of the body (metastasize).
Liver cancer can be separated into two main types: primary and secondary. Primary liver cancer begins in the liver. Secondary liver cancer begins elsewhere in the body and then spreads to the liver.
This is the most common type of primary liver cancer. Hepatocellular carcinoma (HCC) accounts for about 90% of all liver cancers. The main causes of liver cancer are the Hepatitis B virus, Hepatitis C virus, liver cirrhosis (scarring of the liver) from alcohol, and non-alcoholic fatty liver disease. Other contributing factors include smoking, obesity, and diabetes.
Another risk factor for HCC is exposure to a toxin called Aflatoxin, which is produced by Aspergillus, a mold that exists both indoors and outdoors. Most people with a healthy immune system don’t get sick from inhaling Aspergillus spores in the environment. Still, aflatoxin is estimated to account for anywhere from 4.6% to 28.2% of liver cancer cases worldwide.
A less common type of primary liver cancer is cholangiocarcinoma or bile duct cancer. Cholangiocarcinoma starts in the cells that line the bile ducts. Cholangiocarcinoma usually happens outside the liver, but when it starts in the liver, it’s called intrahepatic cholangiocarcinoma.
Rarely, liver cancer can start from the cells that line the blood vessels throughout the liver. These types are called angiosarcoma and hemangiosarcoma. These rare types of liver cancer can happen in people who have been exposed to certain chemicals, such as vinyl chloride. They can also be associated with a genetic condition called hereditary hemochromatosis, which is an iron storage disease.
Secondary liver cancer, or liver metastases, commonly comes from colorectal cancer but also stems from breast, pancreatic, lung, and melanoma cancers.
When liver cancer is in its early stages, it may not lead to any symptoms or signs. However, there are a few early symptoms and signs, including:
Other liver cancer symptoms can include:
Sometimes, people can have symptoms that seem unrelated to the liver, which can result from a condition called paraneoplastic syndrome. This is when liver cancer cells produce hormones that lead to other problems. This can lead to conditions including:
When it comes to diagnosing liver cancer, there are usually several tests used in combination. Blood tests, including liver function tests, can be very useful in assessing the liver’s function. They can show if there’s an accumulation, or build-up, of bilirubin in someone’s body, which leads to jaundice. A blood test called alpha-fetoprotein (AFP) can be elevated in people with hepatocellular carcinoma. This test can be helpful when used along with imaging tests.
While ultrasound, computed tomography (CT scan), and magnetic resonance imaging (MRI) can all help in diagnosing liver cancer, research shows that MRI is usually the most accurate. It’s also very safe when compared to CT scans, as it does not expose the person to any radiation. Sometimes, a liver biopsy may be necessary in cases where imaging is unclear.
Liver cancer treatment options generally depend on the type of liver cancer, its stage, and whether it’s localized or has spread elsewhere in the body. Some procedures focus on the liver tumors directly, which can include ablation (destroying liver cancer tissue) or chemoembolization (cutting off blood supply to the tumor).
Cancer care often includes having an oncologist who specializes in cancer treatment, and medical treatments may include chemotherapy or radiation. Other important care team members may include gastroenterologists or hepatologists (liver specialists), as well as palliative care specialists who can help patients manage pain and other liver cancer symptoms.
For some people whose liver cancer is detected in its early stages, a treatment option may include a liver transplant. Candidates for liver transplant can include those with hepatocellular carcinoma that is localized, meaning it has not yet spread to other parts of the body.
Guidelines for liver transplantation also depend on the size and number of tumors in the liver itself. Liver transplant is considered curable in these candidates and can increase their 5-year survival rate to upwards of 70%.
When it comes to cancer, outcomes are usually better when it is caught early. For liver cancer, it’s no different. According to the American Cancer Society, while 5-year survival rates for distant or metastasized liver cancer are only 3%, the rates for localized (limited to one area of the liver) are 36%. This shows that early detection is key to optimizing outcomes.
While liver cancer is serious, there are some lifestyle factors you can change to reduce your risk. Since a major risk factor for liver cancer is Hepatitis B, you can decrease your risk greatly by getting the Hepatitis B vaccine. Other ways to prevent Hepatitis B and Hepatitis C would be to avoid intravenous drug use and practice safe sex.
Since drinking alcohol in excess can lead to liver cirrhosis, drinking in moderation can reduce your risk. In general, practicing a healthy lifestyle with a nutritious diet and exercise routine can decrease your risk by preventing non-alcoholic fatty liver disease. Take Ezra’s quick quiz to assess your own cancer risk.
When it comes to your health, being proactive is key. One way to do that is by getting an Ezra Full Body Scan. Research has shown that detecting liver cancer in its early stages improves outcomes.
Ezra offers a full body MRI that takes only about one hour of your time while being able to potentially detect upwards of 500 medical conditions in up to 13 organs, including your liver. Moreover, you can discuss your results with an Ezra medical provider via a telehealth visit, usually within 5 business days. Take charge of your health and consider booking a scan today.