Liver cancer: Symptoms, diagnosis, treatment and prevention
Liver cancer is relatively rare, making up around 1% of all new cancers in the UK.
Liver cancer affects more men than it does women, and is more common in over 65s.
Primary liver cancer starts in the liver itself, secondary liver cancer begins elsewhere in the body and spreads to the liver.
Liver cancer symptoms
Liver cancer symptoms can be vague and may not appear until the cancer is advanced. Symptoms include:
Causes of liver cancer
The exact cause of primary liver cancer is still not known, but it is linked to liver damage from cirrhosis, alcohol abuse, non-alcoholic fatty liver disease and hepatitis.
Another risk factor is the genetic condition haemochromatosis where the body stores too much iron from food.
Seek medical advice if:
Seek medical advice if you develop symptoms that suggest liver cancer. Although the symptoms may be related to another liver disorder or some other ailment, it's best not to let them go undiagnosed for more than a few weeks. Early detection of cancer offers the chance of a better response to treatment.
How do I know if I have liver cancer?
Screening for early detection of primary liver cancer is not performed routinely, but it may be considered for people at high risk of the disease. To diagnose liver cancer, a doctor must rule out other causes of the symptoms.
Patients at high risk include alcoholics and patients with chronic hepatitis or cirrhosis.
Additional tests include:
- Blood tests that measure tumour markers - substances elevated in the presence of a particular cancer - can aid diagnosis. Liver cancers secrete a substance called alpha fetoprotein (AFP) that is normally present during pregnancy but goes away after birth. An elevated AFP in adults may indicate liver cancer.
- Imaging with ultrasound and CT scans may reveal existing tumours, but only a biopsy will distinguish a benign tumour from a malignant one.
What are the treatments for liver cancer?
Any liver cancer is difficult to cure. Primary liver cancer is rarely detectable early, when it is most treatable. Secondary or metastatic liver cancer is hard to treat because it has already spread. Also, the liver's complex network of blood vessels and bile ducts makes surgery difficult. Most treatment concentrates on making patients feel better and perhaps live longer.
Patients with early-stage tumours that can be removed surgically have the best chance of being cured. Unfortunately, most liver cancers are inoperable at diagnosis, either because the cancer is too advanced or the liver is too diseased to permit surgery. In some patients, chemotherapy reduces their tumours to operable size. After surgery, chemotherapy may help kill remaining cancer cells. Patients in remission must be monitored closely for potential recurrence. A few patients may be eligible for a liver transplant - although the procedure has increased risks, it offers some chance of a cure.
Advanced liver cancer has no standard curative treatment. Chemotherapy and low-dose radiotherapy may control the cancer's spread and ease pain. However, these are of modest benefit in this type of cancer. Most patients receive strong painkilling medication along with medication to relieve nausea and swelling or to improve appetite.
People with advanced liver cancer may choose to join clinical trials testing new approaches to treatment. Such studies include freezing tumour cells to kill them; using biological agents such as interferon or interleukin-2 to stimulate immune cells into attacking cancer more vigorously; and delivering lethal agents directly to cancer cells through synthetic proteins designed to target specific tumours.