About Liver Cancer

In brief

What Is Liver Cancer?

Cancer is a condition where normal cells undergo changes and begin to grow uncontrollably, often forming a lump known as a tumor or mass. Tumors can be either benign (non-cancerous) or malignant (cancerous). The type of cancer is typically named after the area of the body where it originates.

When cancer begins in the liver, it is referred to as primary liver cancer. If cancer spreads to the liver from another part of the body—a process called metastasis—it is not classified as liver cancer.

In most cases, when we talk about "liver cancer," we are referring to hepatocellular carcinoma (HCC), the most common form of primary liver cancer. HCC originates in the main type of liver cells. There are also other, less common types of liver cancer, sometimes called hepatobiliary cancers, which include:

  • Cholangiocarcinoma, which starts in the bile ducts
  • Angiosarcoma, which originates in the liver's blood vessels
  • Gallbladder cancer, which begins in the gallbladder cells

Below is a comparison of a normal liver vs cancerous liver.

Types of Liver Cancer

Where Does the Cancer Start?

Liver cells called hepatocytes

How Common Is the Cancer?

The most common type of liver cancer
Accounts for about 90% of liver cancers

Where Does the Cancer Start?

The bile duct, which begins inside the liver and extends to the small intestine

How Common Is the Cancer?

Accounts for about 9% of liver cancers

Where Does the Cancer Start?

Blood vessels in the liver

How Common Is the Cancer?

Accounts for less than 1% of liver cancers

Where Does the Cancer Start?

Gallbladder lining

How Common Is the Cancer?

Accounts for less than 1% of liver cancers

Where Does the Cancer Start?

Embryonic (or early stage) liver cells

How Common Is the Cancer?

Very rare kind of liver cancer usually found in children younger than 4 years

Where Does the Cancer Start?

Found in hepatocytes but often involves growth into the bile ducts

How Common Is the Cancer?

Rare and unique form of liver cancer occurring most commonly in children and young adults without hepatitis or cirrhosis. Accounts for less than 1% to 8% of all hepatocellular carcinomas

Where Does the Cancer Start?

Tumor often spreads all through the liver and/or to the lungs.

How Common Is the Cancer?

The third most common liver cancer in children and adolescents; usually occurs in children aged between 5 and 10 years

Where Does the Cancer Start?

Starts in the placenta and spreads to the fetus

How Common Is the Cancer?

Very rare type of cancer usually found during the first few months of life

Where Does the Cancer Start?

Cancer of the blood vessels in the liver and other organs

How Common Is the Cancer?

Rare type of cancer occurring in infants; tumors are often benign (not cancer), but a small number of children may develop cancerous tumors over time

What Is a Risk Factor?

Risk Factors

A risk factor is anything that increases the likelihood of developing a disease, such as cancer. Each type of cancer has its own set of risk factors. However, having one or more risk factors does not mean a person will definitely develop cancer, and some individuals with no known risk factors may still be diagnosed with it. Generally, the more risk factors a person has, the higher their chances of developing the disease.

Understanding your risk factors and discussing them with your healthcare provider can help you make informed decisions about your lifestyle and medical care to potentially reduce your risk.

Major & Other

What Are The Risk Factors For Liver Cancer?

The leading global risk factor for liver cancer is chronic infection with the hepatitis B virus (HBV). Around 15%–25% of people with chronic HBV infection develop serious liver conditions such as cirrhosis, liver failure, or liver cancer. In fact, the risk of liver cancer in individuals with chronic hepatitis B can exceed the risk of lung cancer in heavy smokers. Fortunately, long-term antiviral treatment can lower the risk of liver cancer by up to 60%.

Being aware of these factors can aid in early detection and prevention efforts.

Major Risk Factors
Chronic viral hepatitis
Cirrhosis
Aflatoxins and environmental toxins
Family history of liver cancer
Heavy alcohol use
Diabetes, obesity, and nonalcoholic fatty liver disease
Other Risk Factors
Race/ethnicity
Gender & age
Smoking
Inherited metabolic diseases
All is not lost

Liver Cancer: Prevention, Detection & Treatment

Prevention & Detection

Liver cancer is largely preventable by addressing its primary risk factors especially chronic infections with hepatitis B and C. Without widespread prevention efforts, the number of liver cancer cases is projected to increase significantly over the next two decades.

The Hepatitis B Vaccine: The First Anti-Cancer Vaccine

The hepatitis B vaccine, recognized by the U.S. Food and Drug Administration as the first "anti-cancer" vaccine, helps prevent chronic hepatitis B infection—a major cause of liver cancer. By preventing the infection, the vaccine significantly reduces the risk of developing liver cancer.

Cirrhosis and Liver Cancer

Approximately 80% of people diagnosed with liver cancer also have cirrhosis. While hepatitis B can lead directly to liver cancer without cirrhosis, in most cases, preventing cirrhosis helps lower the risk. Cirrhosis prevention includes:

  • Avoiding chronic hepatitis B and C infections
  • Reducing alcohol consumption
  • Quitting smoking
  • Avoiding exposure to industrial toxins and aflatoxins (toxins from mold in improperly stored food or grain)

Routine Medical Checkups

If you are at high risk for liver cancer—such as those living with hepatitis B or C, cirrhosis, or other known risk factors—it is recommended that you see a doctor at least once a year. These regular checkups help monitor liver function and viral load, allowing for early detection of liver damage or cancer and improving treatment success.

Screening and Early Detection

Early detection through regular liver cancer screening is one of the most effective ways to improve survival rates. When liver cancer is found at an early stage—before symptoms appear and while the tumor is still small—treatment is more likely to be successful. The 5-year survival rate for early-stage liver cancer that can be surgically removed may exceed 50%.

People with cirrhosis or other high-risk conditions should undergo liver cancer screening during routine medical visits, even if they are not experiencing symptoms. A hepatologist (a liver disease specialist) may be involved in your care to ensure appropriate monitoring and treatment.

Because liver cancer often develops silently, people with chronic hepatitis B or C should be screened regularly to detect tumors early—before they grow too large or disqualify a patient from curative treatments like liver transplantation.

Symptoms of Liver Cancer

Liver cancer in its early stages often has no symptoms, which is why regular screening is essential. As the disease progresses, symptoms may include:

Pain or discomfort in the upper right abdomen
A lump or feeling of heaviness in the upper abdomen
Swelling in the abdomen (due to fluid buildup)
Loss of appetite or early satiety
Unexplained weight loss
Fatigue or weakness
Nausea and vomiting
Jaundice (yellowing of the skin and eyes)
Pale stools and dark urine
Fever

These symptoms can also be caused by other conditions, so it's important to consult a qualified healthcare provider promptly if they occur.

Diagnosing Liver Cancer

To confirm a diagnosis of liver cancer, a range of tests may be conducted, including:

  • • Physical examination
  • • Liver function tests to assess how well your liver is working
  • Blood tests, such as:
  • • Alpha-fetoprotein (AFP), which can be elevated in liver cancer
  • • Calcium and cholesterol levels
  • • Complete blood count (CBC)
  • • Blood clotting tests
  • • Hepatitis B and C testing
  • Imaging studies, including:
  • • CT scans
  • • MRI
  • • Ultrasound
  • • Angiography
  • • Laparoscopy
  • • Liver biopsy, where a small sample of liver tissue is taken for examination under a microscope to confirm the presence of cancer cells

Treatment of Liver Cancer

Over the past two decades, liver cancer treatment and prevention have made significant strides. Today, the disease can often be prevented, detected earlier, and managed effectively with a range of treatment options depending on the stage and health of the liver.

Treatment decisions are highly individual and must balance the potential benefits with the risks, including the possibility of liver failure and impact on quality of life. Treatment approaches may include surgery, liver transplantation, targeted therapy, immunotherapy, and localized treatments such as radiofrequency ablation or embolization techniques.

Early detection and informed, timely treatment can lead to significantly better outcomes and improved survival.

Treatment Options

Surgery

The surgical procedure is where part of the liver tissue is removed. The goal is to remove the entire tumor, along with a margin of healthy tissue. Removing the part of the liver that has cancer is only possible if the cancer is detected early enough and has not spread to the blood vessels or outside the liver.

Chemotherapy

Chemotherapy involves using drugs to kill the cancer cells. It is a systemic treatment where the drugs are usually injected into a vein and they enter the bloodstream and are carried throughout the body. This can affect both cancer and healthy cells.

Immunotherapy

A treatment that utilizes the body's own immune system to fight cancer cells. It works by boosting or modifying the immune system to recognize and attack the cancer cells.

Targeted Oral Therapy

If chemotherapy is not effective and the patient also cannot undergo surgery, health care providers may treat the patient with targeted oral therapies (pills taken by mouth). The drugs used precisely identify and attack certain cancer cells, often by targeting specific molecules that cancer cells need to survive.

Radiation therapy

Also known as radiotherapy, may be an option for some people who cannot have surgery. It uses high energy radiation to kill cancer cells and shrink tumors, often as part of a larger cancer treatment plan.

Based on medical needs & lifestyle

Choosing The Right Treatment

Liver cancer is treated by a team of specialists, which may include surgeons, hepatologists (liver disease experts), medical oncologists, and radiation oncologists. Your care team may also involve an oncology nurse and a registered dietitian to support you throughout the process.

Before starting treatment, it's important to have a detailed discussion with your healthcare team about your options. The best treatment plan for you will depend on several key factors, including:

  • The number, size, and location of tumors in your liver
  • The overall function of your liver and the presence or severity of cirrhosis
  • Whether the cancer has spread beyond the liver
  • Your age, overall health, and how treatment might impact your daily life and well-being

A personalized approach ensures the treatment is tailored to your unique medical needs and lifestyle.

Hope and Healing
Need some clarification?

Frequent Questions

If you experience symptoms of liver cancer, it is crucial to seek medical advice immediately. Contact your healthcare provider for an evaluation and appropriate diagnostic tests. Early detection and treatment can improve outcomes.

Supporting someone with liver cancer involves providing emotional support, helping with daily activities, accompanying them to medical appointments, and encouraging them to follow their treatment plan.

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