Liver cancer is cancer that begins in the liver. The main types of primary adult liver cancer are hepatocellular carcinoma and intrahepatic bile duct cancer.
Primary liver cancer most commonly occurs as hepatocellular carcinoma. Risk is strongly associated with chronic liver disease, especially hepatitis B, hepatitis C and cirrhosis. Treatment depends on tumor extent, liver function and overall health.
The liver is the largest internal organ and lies mainly in the upper right abdomen beneath the diaphragm. It has right and left lobes and performs major metabolic, detoxification, digestive and protein-production functions.
Primary liver cancer develops when liver or bile-duct cells acquire changes that disrupt normal growth. Chronic inflammation, fibrosis and cirrhosis can create an environment that increases the risk of malignant transformation.
Abnormal liver cells acquire genetic changes that allow uncontrolled growth and survival. A tumor may remain within the liver, invade blood vessels or spread to other parts of the body.
Primary adult liver cancers include hepatocellular carcinoma, which arises from hepatocytes, and intrahepatic cholangiocarcinoma, which arises from bile-duct cells. Other rare primary liver tumors also exist.
The main adult primary liver cancers are hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Less common tumors include hepatic angiosarcoma and other rare cancers.
Jaundice
Unexplained weight loss
Right-upper-abdominal discomfort
Abdominal swelling
Loss of appetite
Unusual fatigue or weakness
Nausea or vomiting
Easy bruising or bleeding
Dark urine
Pale or chalky stools
Fever
Feeling full after eating a small amount
Risk factors include chronic hepatitis B or C infection, cirrhosis, heavy alcohol exposure, metabolic liver disease, aflatoxin exposure, smoking and certain inherited disorders.
Chronic hepatitis B
Chronic hepatitis C
Cirrhosis
Heavy alcohol use
Obesity and metabolic disease
Type 2 diabetes
Aflatoxin exposure
Smoking
Family or inherited liver disorders
Evaluation may include physical examination, liver-function tests, AFP testing, ultrasound, multiphasic CT or MRI and additional imaging. Biopsy is used selectively when imaging does not establish the diagnosis or another tumor type is suspected.
Examination for jaundice
Abdominal examination for liver enlargement or mass
Assessment for abdominal fluid accumulation
Assessment for weight loss
Assessment for bruising or bleeding
Review of chronic liver disease history
Assessment of liver-function status
Review of hepatitis B and hepatitis C history
Liver function tests
Alpha-fetoprotein
Complete blood count
Serum bilirubin
Albumin
Prothrombin time or INR
Kidney function tests
Hepatitis B testing
Hepatitis C testing
Liver ultrasound
Multiphasic contrast-enhanced CT
Contrast-enhanced MRI of the liver
Chest imaging when staging requires it
Additional imaging for suspected metastatic disease
Image-guided liver biopsy when required
Assessment of portal-vein or hepatic-vein invasion
Assessment of liver reserve and cirrhosis severity
Genetic or molecular testing in selected tumor types
Multidisciplinary liver-cancer assessment
Liver cyst
Hemangioma
Focal nodular hyperplasia
Hepatic adenoma
Liver abscess
Metastatic cancer to the liver
Regenerative or dysplastic nodules in cirrhosis
Liver cancer staging considers tumor burden, vascular invasion, spread outside the liver, liver function and overall health. The Barcelona Clinic Liver Cancer system commonly describes very early, early, intermediate, advanced and end-stage disease.
Staging or grading systems differ between diseases. The information here is educational and should be interpreted by a qualified healthcare professional in the context of the individual case.
Treatment can include surveillance of selected very small lesions, surgical resection, liver transplantation, tumor ablation, radiation therapy, transarterial treatments such as TACE and systemic therapy for advanced disease. Treatment is individualized according to tumor stage and liver function.
Systemic immunotherapy for selected advanced hepatocellular carcinoma
Targeted therapy for selected advanced hepatocellular carcinoma
Antiviral treatment for chronic hepatitis B or C when indicated
Pain-control medicines
Medicines for symptoms or complications of chronic liver disease
Supportive and palliative medicines when appropriate
Medicines listed here are for educational information only. Do not start, stop, or change a medicine without professional medical advice.
Complications can include liver failure, jaundice, ascites, gastrointestinal bleeding, cancer-related pain, blood-vessel invasion, cancer spread and complications from treatment.
Vomiting blood or passing black, tarry stools
Severe abdominal swelling with breathing difficulty
Confusion or marked drowsiness
Severe jaundice with rapid deterioration
Fainting or severe weakness
Severe abdominal pain
Sudden neurological symptoms or severe breathing difficulty
If symptoms are severe, rapidly worsening, or life-threatening, seek emergency medical care immediately.
Earlier detection can provide potentially curative treatment options. Prognosis is influenced by cancer stage, liver function, cirrhosis, general health and treatment response.
Survival statistics describe outcomes in groups of people and cannot predict exactly what will happen to one individual. Prognosis depends on factors such as cancer stage, tumor biology, treatment response, overall health, and follow-up.
Primary liver cancer is an important global cancer. Hepatocellular carcinoma is the most common adult primary liver cancer, and chronic hepatitis B and C and cirrhosis are major risk factors.
Hepatitis B vaccination, prevention and treatment of viral hepatitis, reducing harmful alcohol exposure, maintaining a healthy weight, controlling metabolic disease and avoiding tobacco can reduce liver-cancer risk.
What type of liver cancer do I have?
What is the stage or BCLC category of my cancer?
How well is my liver functioning?
Do I need a biopsy?
What do my AFP and liver-function tests mean?
Could surgery remove the tumor?
Could ablation or TACE be appropriate?
Am I a candidate for liver transplantation?
Do I need systemic treatment?
How often should I have follow-up imaging?
BimariDur provides educational health information to help people understand diseases, symptoms, tests, and treatment concepts. It does not replace examination, diagnosis, or treatment by a qualified healthcare professional.
Do not delay professional medical care because of information read on BimariDur.