Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach.
Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte).
Cancer that spreads to the liver is more common than cancer that begins in the liver cells. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. This type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver.
Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:
Liver cancer happens when liver cells develop changes (mutations) in their DNA. A cell’s DNA is the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.
Sometimes the cause of liver cancer is known, such as with chronic hepatitis infections. But sometimes liver cancer happens in people with no underlying diseases and it’s not clear what causes it.
Factors that increase the risk of primary liver cancer include:
Reduce your risk of cirrhosis
Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce your risk of cirrhosis if you:
You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems.
No vaccine for hepatitis C exists, but you can reduce your risk of infection.
Treatments are available for hepatitis B and hepatitis C infections. Research shows that treatment can reduce the risk of liver cancer.
Ask your doctor about liver cancer screening
For the general population, screening for liver cancer hasn’t been proved to reduce the risk of dying of liver cancer, and it isn’t generally recommended. People with conditions that increase the risk of liver cancer might consider screening, such as people who have:
Discuss the pros and cons of screening with your doctor. Together you can decide whether screening is right for you based on your risk. Screening typically involves a blood test and an abdominal ultrasound exam every six months.
Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health, and personal preferences.
Operations used to treat liver cancer include:
Whether this is an option for you also depends on the location of your cancer within the liver, how well your liver functions and your overall health.
Localized treatments for liver cancer are those that are administered directly to the cancer cells or the area surrounding the cancer cells. Localized treatment options for liver cancer include:
This treatment uses high-powered energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the liver, while sparing the surrounding healthy tissue.
Radiation therapy might be an option if other treatments aren’t possible or if they haven’t helped. For advanced liver cancer, radiation therapy might help control symptoms.
During external beam radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body.
A specialized type of radiation therapy, called stereotactic body radiotherapy, involves focusing many beams of radiation simultaneously at one point in your body.
Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.
Many targeted drugs are available for treating advanced liver cancer.
Some targeted therapies only work in people whose cancer cells have certain genetic mutations. Your cancer cells may be tested in a laboratory to see if these drugs might help you.
Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy treatments are generally reserved for people with advanced liver cancer.
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.
Chemotherapy is sometimes used to treat advanced liver cancer.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.