Liver Cancers
Liver cancer is a type of cancer that originates from cells in the liver. The liver is located in the upper right part of the abdomen, below the diaphragm and above the stomach. Many different types of cancer can develop in the liver. The most common type of liver cancer is hepatocellular carcinoma. There are 18,000 new cases of primary liver cancer per year in the United States. Other types (such as intrahepatic cholangiocarcinoma, hepatoblastoma) are much rarer.
Cancers that have spread to the liver are more common than cancers originating from liver cells. If the cancer starts in another part of the body, such as the colon, lung or breast, and spreads to the liver, it is called metastatic cancer rather than liver cancer. Such cancers are referred to by the name of the organ from which they originated (such as cancer originating in the large intestine that has spread to the liver is called "metastatic colon cancer"). Colon cancers are the most common tumors that metastasize to the liver, and while surgery is the primary treatment option, there are other treatment options for patients who are not suitable for surgery.
In most people, liver cancer does not show any signs and symptoms in the early stages of primary cancers (cancers that originate in the liver). When signs and symptoms of liver cancer do appear, they may include:
- Unexplained weight loss
- Loss of appetite
- Upper abdominal pain
- Nausea and vomiting
- General weakness and fatigue
- Abdominal bloating
- Yellow discoloration of the skin and the white part of the eyes (jaundice)
- White, lime-like stools
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Liver cancer risk factors include
- Chronic Hepatitis-B (HBV) and Hepatitis-C (HCV) infections.
- Cirrhosis.
- Some inherited liver diseases. Inherited liver diseases such as Hemochromatosis (a genetic disease characterized by iron accumulation in the liver) and Wilson's Disease (a genetic disease characterized by copper accumulation in the liver) can increase the risk of developing liver cancer.
- Diabetes. People with blood sugar disorders and irregularities have a higher risk of liver cancer compared to other people.
- Non-alcoholic fatty liver disease. Fat accumulation in the liver increases the risk of liver cancer.
- Aflatoxin exposure. Aflatoxins are poisons produced by molds that grow on poorly stored crops. They can be found in crops such as grains and nuts.
- Excessive alcohol consumption.
For the diagnosis of liver cancer, the patient's history and physical examination are first evaluated. Then laboratory tests are ordered (complete blood count, biochemical parameters, and tumor markers). And radiologic imaging tests are used. These may include ultrasonography (USG), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET). If these tests suggest that the mass in the liver originates from another organ (metastasis), endoscopy or colonoscopy may be requested. If there is no additional focus, it is thought to originate mainly from the liver.
The treatment plan for liver cancer is tailored to the individual patient. Removal of the mass in the liver, if the mass is large or there are many masses, removal of part / half of the liver can also be performed. These surgical procedures can be performed with laparoscopic (closed) or open technique. After the operation, systemic treatments (chemotherapy) can be applied to the patient. For patients with advanced cancer, regional tumor shrinking procedures (chemoembolization, embolization) can be applied. The treatment plan should be individualized and modified according to the patient's response.
