Liver cancer: Symptoms, diagnosis, treatment and prevention

What is liver cancer?

The liver continuously filters blood that circulates through the body, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. The liver performs many other important functions, such as removing toxins and other chemical waste products from the blood and readying them for excretion. Because all the blood in the body must pass through it, the liver is unusually accessible to cancer cells travelling in the bloodstream.

Digestive system

The liver can be affected by primary hepatitis, which arises in the liver, or by cancer which forms in other sites and then spreads to the liver. Most liver cancer is secondary or metastatic, meaning the malignancy originated elsewhere in the body -- usually the colon, lung or breast. Primary liver cancer, which starts in the liver, is relatively rare in the UK, with about 3,600 people diagnosed with this each cancer each year. However it accounts for up to half of all cancers in some undeveloped countries. This is mainly because of the prevalence of hepatitis, caused by contagious viruses, that predisposes a person to liver cancer. Worldwide, primary liver cancer affects twice as many men as women and is most likely to affect people over 50.

Because the liver is made up of several different types of cells, several types of tumours can form in the liver. Some of these are benign (non-cancerous), and some are cancerous and can spread to other parts of the body (metastasise). These tumours have different causes and are treated differently. The outlook for your health or recovery depends on what type of tumour you have.

The benign (non-cancerous) tumours of the liver include:

• Haemangioma
• Hepatic adenoma
• Focal nodular hyperplasia

None of these tumours are treated like liver cancer. They may need to be removed surgically if they cause pain or bleeding.

Liver cancers include:

• Hepatocellular carcinoma (HCC)
• Cholangiocarcinoma (These are really cancers of the bile duct. They will not be discussed in this article.)

This article discusses hepatocellular carcinoma. It's important to know what type of liver tumour you have. Ask your doctor which type you have.

What causes liver cancer?

Primary liver cancer (hepatocellular carcinoma) tends to occur in livers damaged by genetic defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, haemochromatosis (too much iron in the liver), Primary biliary cirrhosis (chronic damage to the liver ducts) and cirrhosis. More than half of all people diagnosed with primary liver cancer have cirrhosis (a scarring condition of the liver often caused by alcohol abuse, hepatitis B and C, and haemochromatosis that results in permanent liver damage and often liver failure). Haemochromatosis, or iron overload, is a genetic condition, and those who suffer from it are at greater risk.