What Is It?
Liver cancer is the uncontrolled growth of abnormal cells in the liver. The liver:
Cancer in the liver either starts in the liver (primary liver cancer) or spreads to the liver from other places in the body (secondary liver cancer). Primary liver cancer is the most common solid tumor worldwide, with more than one million cases diagnosed each year. However, it is relatively rare in the United States and Europe. The American Cancer Society estimates that more than 17,000 people are diagnosed with primary liver cancer each year. Most of them are over age 40, and more than 15,000 will die of the disease. In the United States, liver cancer is about twice as common in men as in women.
Most liver tumors in the United States have spread (metastasized) to the liver from other organs, most commonly from the colon, rectum, lung, breast, pancreas and stomach. When a cancer spreads to the liver from somewhere else, the cancer cells are the same in both places. For example, if lung cancer spreads to the liver, the cancerous cells in the liver are the same as the cancerous cells in the lung. For that reason, the person is treated for lung cancer, not liver cancer. Doctors would call the cancer in the liver "metastatic lung cancer." The liver is the most common place for cancer to spread.
Only primary liver cancer is treated as liver cancer. There are four main types of primary liver cancer:
Risk Factors
Factors that increase your risk of developing primary liver cancer include:
Symptoms
Symptoms usually do not appear until the disease is advanced. Symptoms can include:
Diagnosis
Liver cancer most often is diagnosed in later stages of the disease because symptoms do not appear until then. Once your doctor suspects you might have liver cancer, he or she will use one or more of the following methods to diagnose the disease:
Expected Duration
Without treatment, liver cancer will continue to grow.
Prevention
Most primary liver cancer can be prevented. Here are some things you can do:
Treatment
The type of treatment depends on a number of factors, including the stage of the cancer, your age and your general health. Surgery, radiation therapy and chemotherapy are potential treatment options. Often, a combination of all three is used.
Usually, a single-tumor cancer that has not spread to lymph nodes or other organs can be removed through surgery. However, only a small percentage of liver cancers are found in this early stage.
For a few cases, a liver transplant may be considered. There also are several experimental treatment methods. In many cases, a cure is not possible, so treatment focuses on relieving the symptoms of the cancer or keeping the cancer from growing, spreading or returning.
People with liver cancer may not be able to have surgery or the type of surgery is limited because their liver isn't working right or they have other health problems. Surgery usually doesn't work for people with cirrhosis, hepatitis or multiple liver tumors in different locations. For these people, other techniques may stop the growth of the cancer temporarily and relieve symptoms:
Chemotherapy: The introduction of newer chemotherapy agents has improved the outlook for patients with hepatocellular cancer. A drug known as sorafanib has recently been approved by the Food and Drug Administration for the treatment of patients with advanced or metastatic hepatoma and represents the first agent of its kind to show some modest effectiveness in liver cancer. In addition, additional agents that decrease the blood supply of the tumors have been shown to be helpful. On occasion, infusion of chemotherapy directly into the blood vessel (the hepatic artery) can be considered.
Note that these techniques have not been proven to help someone survive longer.
For most cases of liver cancer, it is not possible to remove the entire tumor, or the cancer has spread throughout much of the liver or to distant sites. There are no standard treatments for liver cancer in these stages. You may be able to participate in a clinical trial -- an experimental treatment being tested. These trials involve risk because the treatment might not work and you can have unanticipated side effects.
When To Call a Professional
Call your doctor if you have any of the symptoms of liver cancer. Call if you have any symptoms of diseases related to liver cancer, including:
Prognosis
The outlook for people with liver cancer depends on whether the tumor is confined to the liver and whether it can be entirely removed with surgery. Even with surgery, the 5-year survival rate for people with hepatocellular carcinoma and cholangiocarcinoma is less than 20%. The outlook following a successful liver transplant may be better.
In children with hepatoblastoma, the 5-year survival rate is about 70% when the cancer is confined to the liver and can be removed completely. Most people with angiosarcoma of the liver have disease that has already spread at the time of diagnosis and the outlook usually is poor.
Additional Info
American Cancer Society (ACS)
1599 Clifton Road, NE
Atlanta, GA 30329-4251
Toll-Free: 1-800-227-2345
TTY: 1-866-228-4327
http://www.cancer.org/
American Liver Foundation
75 Maiden Lane
Suite 603
New York, NY 10038
Phone: 212-668-1000
Fax: 212-483-8179
Email: info@liverfoundation.org
http://www.liverfoundation.org/
Cancer Research Institute
National Headquarters
One Exchange Plaza
55 Broadway, Suite 1802
New York, NY 10006
Toll-Free: 1-800-992-2623
Email: info@cancerresearch.org
http://www.cancerresearch.org/
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, GA 30333
Toll-Free: 1-800-232-4636
TTY: 1-888-232-6348
http://www.cdc.gov/
National Cancer Institute (NCI)
NCI Public Inquiries Office
6116 Executive Blvd.
Room 3036A
Bethesda, MD 20892-8322
Toll-Free: 1-800-422-6237
TTY: 1-800-332-8615
Email: cancergovstaff@mail.nih.gov
http://www.nci.nih.gov/
National Comprehensive Cancer Network (NCCN)
275 Commerce Drive, Suite 300
Fort Washington, PA 19034Phone: 215-690-0300
Fax: 215-690-0280
http://www.nccn.org/
