Liver Cancer: Causes, Symptoms, Diagnosis, and Treatment

Liver cancer is cancer that starts in the cells of the liver. The organ under the right lung under the rib cage is one of the largest organs of the human body and has many important functions, including removing toxins from the body. Check out a full explanation of the causes, symptoms, and medications for cancer!

What is liver cancer?

Liver cancer is generally classified as primary or secondary. Primary liver cancer starts in liver cells. Secondary liver cancer develops when cancer cells from other organs spread to the liver.

Unlike other cells in the body, cancer cells can break away from the main source or where the cancer begins. Cells spread to other areas of the body through the bloodstream or lymphatic system. Cancer cells eventually gather in other organs and start growing there.

The most common type of liver cancer is hepatocellular carcinoma. This cancer arises from liver cells (hepatocytes) and is more common in men and those suffering from cirrhosis. Meanwhile, other types but rarely occur are intrahepatic cholangiocarcinoma and hepatoblastoma.

Causes of Liver Cancer

Primary liver cancer (hepatocellular carcinoma) tends to occur in hearts that are damaged due to birth defects, alcohol abuse, or chronic infections with diseases such as hepatitis B and C, hemochromatosis (hereditary diseases associated with too much iron in the liver), and cirrhosis.

Most people who are diagnosed with primary liver cancer have cirrhosis, a condition of liver damage due to scar tissue. This condition is caused by alcohol abuse.

Please note, hepatitis B, C, and hemochromatosis can cause permanent damage and liver failure.

Various cancer-causing substances are associated with primary liver cancer, including herbicides and certain chemicals such as vinyl chloride and arsenic. Aflatoxins, cancer-causing substances made by a type of plant fungus are also involved.

Other causes include androgen hormones, estrogen, and the use of thorotrast.

Thorotrast is a chemical that is injected when someone wants to do X-rays. These chemicals risk increasing angiosarcoma from the liver when used for a long time. In fact, these chemicals are also at risk of developing cholangiocarcinoma and hepatocellular cancer, but to a much lesser degree.

The following are some of the factors that increase the risk of liver cancer, including:

  • Gender. A man is more likely to get primary liver cancer than a woman.
  • Weight. Obesity can increase the risk of primary liver cancer.
  • Use of anabolic steroids. Male hormones used by athletes to increase muscle can increase the risk of liver cancer if used long term.
  • Diabetes history. Research shows a link between diabetes and liver cancer. This is probably due to the relationship between diabetes and fatty liver disease.
  • Congenital metabolic disease. Diseases that interfere with the body’s normal metabolism have been shown to increase the risk of liver cancer.
  • Rare disease. Research has found an association between liver cancer and some rare diseases such as alpha -1-antitrypsin deficiency, tyrosinemia, and Wilson’s disease.
  • Excessive alcohol consumption. Consuming more excessive alcohol every day for years can cause irreversible liver damage and increase risk.

Types of Liver Cancer

Because the liver consists of several different cell types, several types of tumors can form there. Some of them are benign (non-cancerous) and some are cancerous and can spread to other parts of the body (metastasize). These tumors or cancers have different causes and are treated differently. Prospects for health or recovery depend on the type you are experiencing.

The following are some common benign tumors, including:

  • Hemangioma.
  • Liver adenoma.
  • Focal nodular hyperplasia.
  • Cyst.
  • Lipoma
  • Fibroma.
  • Leiomyoma.

Meanwhile, here are some types of primary liver cancer, including:

1. Hepatocellular Carcinoma

Hepatocellular carcinoma or hepatocellular carcinoma (HCC), also known as hepatoma, is the most common. This condition develops in hepatocytes, which are the dominant liver cells.

This condition can spread from the liver to other parts of the body, such as the pancreas, intestines, and stomach. HCC is far more likely to occur in people who have severe liver damage due to alcohol abuse.

2. Cholangiocarcinoma

Cholangiocarcinoma is better known as bile duct cancer. This channel carries bile into the gallbladder to aid digestion. Bile duct cancer accounts for about 10 to 20 percent of all liver cancers.

When cancer starts in the channel in the liver, the condition is called intrahepatic bile duct cancer. Whereas when cancer starts in the ducts outside the liver, the condition is called extrahepatic bile duct cancer.

3. Angiosarcoma

Liver Angiosarcoma is a rare form that starts in the veins of the liver. This type of cancer tends to develop very quickly, so that it can only be diagnosed at a later stage.

4. Hepatoblastoma

Hepatoblastoma is a very rare type of liver cancer. This condition is almost always found in children, especially those under the age of 3 years. With surgery and chemotherapy, the prospect of people with this type of cancer can be very good. When hepatoblastoma is detected at an early stage, the survival rate is higher than 90 percent.

Symptoms of Liver Cancer

Symptoms usually do not appear clearly until the disease reaches an advanced stage. Some symptoms that can occur include:

  • Stomach ache.
  • Jaundice, where the skin and eyes turn yellow.
  • Pain close to the right shoulder.
  • Unexplained weight loss.
  • Enlarged liver, spleen, or both.
  • Swelling in the abdomen or a buildup of fluid.
  • Fatigue.
  • Nausea.
  • Back pain.
  • Itchy.
  • Fever.
  • Feeling full after consuming a snack.

Other symptoms can also cause swollen blood vessels that are visible under the skin of the stomach, as well as bruising and bleeding. This condition can also cause high levels of calcium, cholesterol and blood sugar levels. If some symptoms make you worry, immediately see a doctor to get the analysis and the right treatment.

Diagnosis of Liver Cancer

Diagnosis begins with a medical history and physical examination. Tell your doctor if you have a history of long-term alcohol abuse, chronic hepatitis B or C infection.

Some diagnostic tests and procedures for liver cancer include:

  • Liver function tests help doctors determine liver health by measuring levels of protein, liver enzymes, and bilirubin in the blood.
  • An alpha-fetoprotein (AFP) test in the blood can be a sign of liver cancer. This protein is only produced in the liver while still in the womb. AFP production usually stops after birth.
  • A CT scan of the abdomen or MRI produces detailed images of the liver and other organs in the abdomen. This procedure can enable the doctor to determine where the tumor has developed, determine its size, and assess whether it has spread to other organs.

Liver Biopsy

In addition to several diagnostic tests as above, another test that can be done is a liver biopsy. Liver biopsy involves taking a small piece of liver tissue. This procedure is done using anesthesia to prevent pain during this procedure.

During this procedure the doctor will insert a thin needle through the stomach into the liver to get tissue samples. The sample is then examined under a microscope to see signs of cancer.

Liver biopsy can also be performed using laparoscopy, a thin and flexible tube with a camera. The camera allows the doctor to see what the shape of the heart looks like and do a more precise biopsy. The laparoscope is inserted through a small incision in the abdomen. If tissue samples from other organs are needed, the doctor will make a larger incision, this procedure is called a laparotomy.

If a cancer is found, the doctor will determine the stage of the cancer. Cancer stage describes the severity of the cancer. This method is needed to help doctors determine treatment options.

Staging of Liver Cancer

To help undergo treatment, the condition of liver cancer is divided into four stages, including:

  • Stage I

The tumor remains in the liver and has not spread to other organs or locations.

  • Stage II

There are several small tumors in the liver or one tumor that has reached the blood vessels.

  • Stage III

There are several large tumors or one tumor that has reached the main blood vessels.

  • Stage IV

This condition describes the cancer has spread to other parts of the body.

After a doctor diagnoses and identifies the stage of the cancer, the patient will start receiving treatment according to the condition.

Treatment for Liver Cancer

The treatment carried out certainly depends on the stage, age, and overall body health condition. Here are some treatments that can be done, including:

1. Operation

Operations used to treat liver cancer include:

  • Surgery to remove the tumor

In certain situations, doctors can recommend surgery to remove the cancer and a small portion of healthy liver tissue that surrounds it – if the tumor is small and liver function is good. This procedure is done depending on the location of the cancer, how well the liver functions and overall health.

  • Liver transplant surgery

During a liver transplant operation, diseased organs are removed and replaced with a healthy liver from a donor. Liver transplant surgery is only an option for a small number of people with early-stage liver cancer.

Candidates for a liver transplant must have a tumor smaller than 5 cm or several tumors smaller than 3 cm each. If the size does not match, the risk of having cancer again can occur.

A transplant is said to be successful if it can reduce the risk of liver cancer and restore normal liver function. However, the immune system can also ‘reject’ new organs and attack them because they are considered as foreign objects.

2. Local Care

Local treatments for liver cancer are treatments that are given directly to cancer cells or the area around cancer cells. Local treatment options for liver cancer include:

  • Warming up the cancer cells

Radio frequency ablation uses electric current to heat and destroy cancer cells. Using imaging tests as a guide such as ultrasound, the doctor can insert one or more thin needles into small incisions in the abdomen. Other procedures for heating cancer cells may use microwaves or lasers.

  • Freezing cancer cells

During the procedure of freezing cancer cells, the doctor will place a device (cryoprobe) containing liquid nitrogen directly into the liver tumor. Ultrasound images are used to guide the cryoprobe and monitor cell freezing.

  • Inject alcohol into the tumor

Pure alcohol injection is injected directly into the tumor, either through the skin or during surgery. Alcohol causes tumor cells to die.

  • Inject chemotherapy drugs into the liver

Chemoembolization is a type of chemotherapy treatment that supplies strong anticancer drugs directly to the liver.

  • Placing beads filled with radiation in the liver

Small balls containing radiation can be placed directly in the liver where they can send radiation directly to the tumor.

3. Radiation Therapy

This treatment uses high-pressure energy sourced from X-rays and protons that have the ability to destroy cancer cells and shrink tumors. Radiation therapy might be an option if other treatments don’t help. In the advanced stages, radiation therapy can help control symptoms.

In addition, there is a special type of radiation therapy called stereotactic body radiotherapy, which involves focusing multiple radiations together at one point in the body.

4. Drug Therapy

Targeted drug treatment focuses on specific abnormalities that exist in cancer cells. By blocking this disorder, targeted drug treatments can cause cancer cells to die.

Some targeted therapies only work in people whose cancer cells have certain genetic mutations. Cancer cells may be tested in a laboratory to see if this drug can help.

5. Immunotherapy

The immune system that fights disease may not attack cancer because cancer cells produce proteins that blind cells of the immune system. Immunotherapy works by interfering with that process. Immunotherapy treatment is generally reserved for advanced sufferers.

6. Chemotherapy

Another liver cancer drug that can be used is chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy can be given through a vein in the arm, in the form of a pill or both. This procedure is sometimes used to treat advanced liver cancer.

7. Supportive care (Palliative)

Palliative care is a special medical treatment that focuses on providing relief from pain and other serious illness symptoms. Palliative care can be used when undergoing other aggressive treatments such as surgery, chemotherapy or radiation therapy. This procedure aims to improve the quality of life of patients and their families.

Prevention of Liver Cancer

Although there are no proven effective ways to prevent liver cancer, you can do a number of things. Here are some steps that can be done, including:

  • Get Hepatitis B Vaccine

Hepatitis B vaccine is one vaccine that must be accepted by all children. As for adults who are at high risk for infection and those who abuse intravenous drugs, are also required to get the vaccine. Vaccinations are usually given in three injections for six months.

  • Measures to Prevent Hepatitis C

There is no vaccine for hepatitis C, but you can reduce your risk of infection by doing the following:

  • Always use protection. Sexual intercourse must use a condom with all sexual partners. You should not have unprotected sex unless you believe your partner is not infected with hepatitis or other sexually transmitted infections.
  • Do not use illegal drugs. Avoid the use of illegal drugs, especially those that can be injected, such as heroin or cocaine.
  • Be careful when you want to make tattoos and piercings. Go to a place you can trust if you want to make a piercing or tattoo. Make sure the place uses a sterile needle.


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