Definition

Liver cancer [2] is a disease in which cancer [2] cells grow in the liver. The liver is located in the right side of the abdomen and has many functions, including: storing and metabolizing nutrients, and filtering and storing blood.

Cancer occurs when cells in the body (in this case liver cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer [2] refers to malignant tumors , which can invade nearby tissue and can spread to other parts of the body. A benign tumor does not invade or spread.

Causes

The cause of liver cancer [2] is not known, but research shows that certain risk factors are associated with the disease.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for liver cancer [2] include:

• Sex: male
• Age: 40 and older
• Infection with the hepatitis B [3] virus or the hepatitis C [4] virus
• Formation of scar tissue in the liver (called cirrhosis [5] )
• Excessive alcohol consumption [6]
• Malnutrition
• Exposure to an infectious agent, such as a liver fluke (found in southern Pacific countries)
• Hemochromatosis (abnormal collection of iron in body tissues)
• Hereditary metabolic disorders such as AAT deficiency and tyrosinemia
• Exposure to certain chemicals:
  
  • Aflatoxin: a substance made by a fungus that often infects wheat, peanuts, soybeans, corn, and rice in tropical and subtropical regions
  • Vinyl chloride and thorium dioxide: chemicals that are strictly controlled
  • Anabolic steroids: male hormones sometimes given for medical [7] reasons, but also taken by athletes to increase strength
  • Arsenic: a toxic chemical

Symptoms

Symptoms of liver cancer [2] in the early stages are vague and often go unnoticed.

Liver cancer [2] can cause the following symptoms:

• Loss of appetite
• Unexplained weight loss
• Fever
• Fatigue
• Weakness
• Pain in abdomen
• Swollen abdomen
• Nausea
• Dark urine
• Excessive itchiness of the skin
• Confusion and increased sleepiness
• Yellowing of the skin and/or the whites of the eye [8]

Note: These symptoms may also be caused by other, less serious health [9] conditions. A person experiencing these symptoms should see a doctor.

Diagnosis

Your doctor will ask about your symptoms and medical [7] history, and perform a physical examination.

Tests may include:

• Blood tests—to see how well the liver is functioning or to find substances in the blood that indicate liver cancer [2] may be present
• X-ray [10] —of the chest and abdomen
• Angiogram [11] —x-rays of blood vessels
• CT scan [12] —a type of x-ray that uses a computer to make pictures of the inside of the liver
• MRI scan [13] —a test that uses magnetic waves to make pictures of the inside of the liver
• Laparoscopy [14] —a thin, lighted tube inserted through a small incision in the abdomen to look at the liver
• Biopsy [15] —removal of a sample of liver tissue to test for cancer [2] cells. Usually performed using a special hollow needle or during a laparoscopy procedure.

Treatment

Once liver cancer [2] is found, staging tests are performed to find out if the cancer [2] has spread and, if so, to what extent. Surgery is the only curative procedure in the management of a primary liver cancer [2]. Chemotherapy and radiation therapy can reduce symptoms associated with the cancer [2], but are not considered curative by themselves, and without surgery.

Surgery—removal of the cancerous tumor and nearby tissue, and possibly nearby lymph nodes

Cryosurgery—destroys tumors by freezing them with a metal probe

Ethanol ablation—kills cancer [2] cells by injecting alcohol directly into the tumor

Radiation therapy [16] —the use of radiation to kill cancer [2] cells and shrink tumors. Radiation may be:

External radiation therapy—Radiation directed at the liver from a source outside the body

Internal radiation therapy—Radioactive materials placed into the liver in or near the cancer [2] cells

Chemotherapy [17] —the use of drugs to kill cancer [2] cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter directly into the liver. The drugs enter the bloodstream and travel [18] through the body killing mostly cancer [2] cells, but also some healthy cells.

As of 2007, there is now a new class of therapies targeting vascular endothelial growth factor receptor (VEGF) with some effects in advanced liver cancer [2]. Sorafenib (Nexavar, Bayer/Onyx) has been FDA approved based on its ability to prolong life of patients in a large international trial. In this study overall survival was improved from median 7.9 months to 10.7 month (by 44% in relative terms).

Biological therapy—the use of medications or substances made by the body to increase or restore the body's natural defenses against cancer; also called biological response modifier (BRM) therapy .

Prevention

To reduce your risk of getting liver cancer:

• If you use needles to inject medication or drugs, always use a clean needle and do not share needles with anyone else.
• Use condoms when having sexual intercourse if you or your partner is not in a monogamous relationship, or if you don't know if your partner has hepatitis.
• Have children vaccinated against hepatitis B.
• Drink alcohol in moderation. Moderate alcohol intake is no more than two drinks per day for men and one drink per day for women.