What is liver cancer?

Primary liver cancer is cancer that begins inside the liver. This article focuses on primary liver cancer.

Secondary liver cancer is cancer that starts in another part of the body, such as the bowel, before spreading to the liver.

Liver cancer is the fifth most common type of cancer and the third most common cause of cancer-related death in the world.  The areas of the world that have the highest rates of liver cancer are western and central Africa, southeast Asia, Mongolia and China.  Just over half of all cases of liver cancer occur in China

There are two risk factors for liver cancer that explain this unusual geographical concentration of cases:

  • hepatitis B – a viral infection that is particularly common in certain parts of Africa and Asia
  • aflatoxin – a poisonous substance that can contaminate food and is found in Africa and east Asia

 

Primary liver cancer is a rare but serious type of cancer that mostly affects older people. The initial symptoms of liver cancer are often vague and non-specific. They include:

  • unexplained weight loss
  • nausea (feeling sick)
  • vomiting
  • tiredness
  • jaundice – yellowing of the skin and the whites of the eyes

In many cases, cancer of the liver does not cause noticeable symptoms until it has reached an advanced stage.

 

The liver

The liver is one of the most complex organs in the human body and it performs more than 500 functions. Some of the liver’s most important functions include:

  • digesting proteins and fats
  • removing toxins (poisons) from the body
  • helping to control blood clotting (thickening)
  • releasing bile, a liquid that breaks down fats and aids digestion

Liver cancer is a serious condition because it can disrupt these functions or cause them to fail completely, which could prove fatal.

 

Risk factors for liver cancer include:

 

Non-alcoholic fatty liver disease

The reason obesity is a risk factor for liver cancer is that over time, high levels of fat in the body can damage the liver, similar to the way in which alcohol damages the liver. The medical term for this type of liver damage is non-alcoholic fatty liver disease.

People with type 2 diabetes also have a higher risk of developing non-alcoholic fatty liver disease and liver cancer.

 

Screening

As liver cancer is a relatively rare condition, there is currently no national routine NHS screening programme for it because it would not be an effective use of resources.   However, regular check-ups for liver cancer (known as ‘surveillance’) are recommended for people known to have a high risk of developing the condition, such as those with a confirmed hepatitis C infection or those who have had cirrhosis (scarring of the liver) as a result of alcohol misuse, diabetes or obesity.  If you are in a high-risk group for developing liver cancer, having regular check-ups will help to ensure that the condition is diagnosed early. The earlier that liver cancer is diagnosed, the more effective the treatment is likely to be.

 

Outlook

Generally, the outlook for people with liver cancer is poor. This is because the majority of cases are detected at quite a late stage. However, if a cancer is diagnosed at an early stage, treatment options include:

  • surgical resection – surgery is used to remove a section of liver
  • liver transplant – the liver is replaced with a donor liver
  • radiofrequency ablation – a small electrical current is used to destroy the cancerous cells

However, these curative treatment options may not always be possible even if the cancer is diagnosed early. This is either because the liver is too damaged by scarring (cirrhosis) to survive ablation or resection of the tumor, or the person is not well enough to withstand the effects of a liver transplant.

Currently, only 1 in 10 people is diagnosed for liver cancer at an early stage. In most people who are diagnosed with liver cancer, the cancer has advanced too far to be cured. As a result, only 1 in 5 people live for a least a year after being diagnosed with liver cancer. Just 1 in 20 people live for at least five years.


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