Liver Cancer

The various types of liver cancer break down into two main categories: primary and secondary liver cancer.
 

Primary Liver Cancer

When cancer starts in your liver, it’s called primary liver cancer. Those with liver damage (cirrhosis) are at increased risk of developing primary liver cancers. There are various types of primary liver cancer which include:
 

• Hepatocellular carcinoma (HCC) - HCC is the most common kind of primary liver cancer. This can be one single tumor or multiple tumors in the liver. HCC may occur in patients with liver damage (cirrhosis).
• Cholangiocarcinoma (bile duct cancer) - bile ducts are tubes that carry bile to the gallbladder. Cholangiocarcinoma is a rare form of cancer that starts in the bile ducts of the liver.
• Angiosarcoma & hemangiosarcoma - angiosarcoma and hemangiosarcoma are rare, yet fast-growing forms of liver cancer that begin to develop in the cells lining the blood vessels of the liver. People who have been exposed to vinyl chloride, arsenic or radium are more likely to develop these forms of liver cancer.
   

Secondary Liver Cancer

Secondary liver cancer, also known as metastatic liver cancer, occurs when cancer starts somewhere else in the body and spreads to the liver. Primary breast cancer, lung cancer and renal cancers are common cancer types that can end up in the liver

According to the American Cancer Society, the most common causes of liver cancer are chronic infections with hepatitis B virus (HBV) or hepatitis C virus (HCV). However, there are a handful of other genetic and lifestyle risk factors that can determine someone’s likelihood of getting liver cancer. 
 

Common Risk Factors

• Gender - men are more likely to develop liver cancer than women
• Ethnicity - if you’re Asian American or Pacific Islander in the United States, you may be at greater risk of developing liver cancer at some point in your lifetime.
• Type 2 diabetes - type 2 diabetes has been linked to an increased risk of developing liver cancer. This risk may be more severe, since people with type 2 diabetes may have other co-occurring risk factors, such as obesity, heavy alcohol use or chronic viral hepatitis.
   

Genetic Risk Factors

• Inherited diseases - some inherited metabolic diseases can cause cirrhosis. People with inherited hemochromatosis, for example, absorb too much iron from their food. And if enough iron builds up in the liver, it can lead to cirrhosis and even liver cancer.
• Chronic viral hepatitis - globally, the most common risk factor for liver cancer is chronic infection with HBV or HCV. People infected with both have an even greater risk of developing liver cancer.
• Cirrhosis - cirrhosis is a disease where the cells in your liver become damaged and are replaced by scar tissue. In the United States, cases of cirrhosis have been commonly linked to alcohol abuse and chronic HBV or HCV infections. The majority of people who are diagnosed with liver cancer already have evidence of cirrhosis.

If you have cirrhosis or active HBV or HCV infection talk to your Mercy provider about ultrasound screening for liver cancer.  
 

Lifestyle Risk Factors

• Alcohol - heavy use of alcohol is a leading cause of cirrhosis, which can lead to liver cancer in some instances.
• Obesity - overweight people are at greater risk of developing liver cancer. This is due to obesity being linked to fatty liver disease and cirrhosis.
• Anabolic steroids - men who take anabolic steroids to increase their muscle mass can expect an increased risk of developing liver cancer.

Signs and symptoms of liver cancer aren't prevalent in the early stages and usually don't appear until cancer has advanced or grown in size. If you experience one or more of these symptoms over a period of time, it’s best to talk to your Mercy doctor to see if a liver cancer screening is right for you.

As the cancerous tumor develops, signs of liver cancer may include: 
 

• Unintended weight loss
• Sudden loss of appetite
• Feeling of fullness, even after a small meal
• Vomiting
• Pain in the abdomen or near the right shoulder blade
• Swelling or fluid in the abdomen
• Yellowing of the skin and eyes (jaundice)

If you’ve been diagnosed with liver cancer, it’s natural to feel afraid. But you can take comfort in knowing that Mercy’s cancer team offers more than just the latest medical treatments for all types and stages of liver cancer. Together, we can help you understand your condition and your treatment options. That way, you can make informed and thorough decisions about your care. 

Mercy gastroenterologists, oncologists, surgeons, pathologists and radiologists use advanced diagnostic testing methods to detect liver cancer, evaluate the extent of the disease and develop your treatment plan.

Lab Tests 

Laboratory tests may be used by your doctor to determine whether you have liver cancer, the possible cause of your cancer or how well your treatment is working.

Imaging Tests

Diagnostic imaging tests, which include ultrasounds, MRIs and CT scans, may be used to help your Mercy doctor pinpoint suspicious areas in the body that may be cancerous, learn how far a tumor has spread or guide specific treatments in the liver.

Biopsy

A biopsy is the routine removal of a small piece of tissue to determine whether liver cancer is present. A biopsy is usually performed using a needle or conducted during a laparoscopy or surgery.

Early detection of liver cancer can increase the likelihood of successful treatment. People with high or multiple risk factors should consider liver cancer screening.

Liver Cancer Screening

Liver cancer screening uses ultrasound imaging and an alpha-fetoprotein (AFP) blood test to detect the presence of cancer in the body. This type of screening is recommended for patients who may be at higher risk, such as those patients with HBV +, HCV + or cirrhosis). Since there currently isn't a routine test available for liver cancer, it’s important to talk to your Mercy primary care provider to decide if a screening is right for you.

Prevention

Minimizing your risk factors may help with liver cancer prevention. Some behavior and lifestyle modifications may include:

• Treating chronic viral infections, including HBV and HCV
• Limiting your intake of alcoholic beverages
• Maintaining a healthy weight
• Having regular check-ups with your Mercy primary care provider

In most cases, surgery is the best treatment option for liver cancer that hasn’t spread beyond the liver. There are a couple of common types of liver cancer surgeries available to patients. Mercy gastrointestinal surgeons are skilled in using the latest surgical procedures and techniques, such as minimally invasive laparoscopic surgery, robotic surgery and endoscopic surgery, to treat your cancer. Your Mercy surgeon will help you understand what to expect during your treatment, operation and recovery. 

Liver Resection

Liver resection is usually performed to remove the cancerous portion of the liver, leaving the healthy surrounding tissue intact and in place.

Liver Transplant

Common among patients with cirrhosis, a liver transplant completely removes the diseased liver and replaces it with a healthy one. While Mercy doesn’t perform liver transplants, we’ll help coordinate care for all patients as needed.

Interventional radiology is a field within radiology that relies on imaging technology and minimally invasive techniques to treat diseases such as liver cancer. 

Radiofrequency Ablation (RFA)

RFA is a common interventional radiology procedure which destroys a cancerous tumor using extreme heat or cold, and embolization, which kills a tumor by cutting off its blood supply.

Most liver cancers are resistant to chemotherapy. In order to prevent liver cancer from coming back, your Mercy doctor may recommend chemotherapy. Chemo uses drugs administered orally or by infusion therapy to reach and fight cancer cells throughout the body. This may be an option for some liver cancer patients after their surgery to shrink and target cancer cells that may have been missed.

Immunotherapy treatment for liver cancer uses your immune system to fight cancer. This can be used to treat some types of liver cancers.

Targeted drug therapy for liver cancer uses drugs and other substances to precisely target cancerous cells, sparing surrounding healthy cells. It can also be used alongside other treatment types, such as chemotherapy or radiation therapy.