What is liver cancer? — Liver cancer happens when normal cells in the liver change into abnormal cells and grow out of control. The liver is a big organ in the upper right side of the belly (figure 1).
Most people who get liver cancer have long-term liver disease (also called chronic liver disease). Having long-term liver disease increases a person's chances of getting liver cancer. The most common and most serious form of long-term liver disease is a condition called "cirrhosis," which scars the liver.
What are the symptoms of liver cancer? — Liver cancer does not usually cause any symptoms of its own. A few patients might have a lump or mild pain in the upper belly, feel full early on when they try to eat, or lose weight.
Others might have symptoms that are caused by the liver disease they had before they got cancer. Those symptoms can get worse or come back because of the cancer. They include:
Swelling of the belly or legs
The skin or white part of the eyes turning yellow
If you have these symptoms, tell your doctor or nurse.
Is there a test for liver cancer? — Yes. If your doctor suspects you have liver cancer, they will do 1 or more of the following tests:
An MRI scan, CT scan, ultrasound, or other imaging test – Imaging tests create pictures of the inside of the body and can show abnormal growths.
Biopsy – For this test, a doctor will remove a small sample of tissue from the liver. Another doctor will look at the sample under a microscope to see if it has cancer.
What is liver cancer staging? — Cancer staging is a way in which doctors find out if a cancer has spread past the layer of tissue where it began and, if so, how far.
How is liver cancer treated? — Liver cancer can be treated in different ways. Treatment depends on the stage of your cancer. It also depends on how healthy your liver is (in other words, how serious your liver disease was before you got cancer). The different treatments include:
Surgery – Liver cancer can sometimes be treated with surgery to remove the part of the liver with the cancer.
Liver transplant – A liver transplant is a type of surgery in which a doctor replaces a diseased liver with a healthy liver from another person.
Ablation therapy – Ablation therapy is a procedure that can kill cancer cells in the liver. It does not involve surgery. Doctors can do ablation therapy in different ways. They can kill the cancer cells using heat, microwaves, a laser, or radiation therapy.
Blocking the cancer's blood supply – Doctors can do a procedure called "embolization" to block off the blood vessel that sends blood to the cancer. This keeps the cancer from growing by "starving" it of its blood supply. Sometimes, the embolization procedure is combined with chemotherapy ("chemoembolization") or radiation ("radioembolization").
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
Immunotherapy – This is the term doctors use for medicines that work with the body's infection-fighting system (the "immune system") to stop cancer growth.
What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Regular follow up tests usually include exams, blood tests, and imaging tests.
You should also watch for the symptoms listed above. Having those symptoms could mean the cancer has come back. Tell your doctor or nurse if you have any symptoms.
If you had a liver transplant, you will need to take medicines called "anti-rejection medicines" for the rest of your life. These medicines help keep your body from reacting badly to your new liver.
What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, your doctor will talk with you about possible treatment choices. These might include the treatments listed above.
What else should I do? — It is important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment. People who have liver cancer, especially if they have long-term liver disease, should avoid alcohol and any drugs that could be harmful to the liver.
Getting treated for liver cancer involves making many choices, such as what treatment to have.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16838 Version 10.0
Release: 28.2.2 - C28.105
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