Liver Cancer

WHAT YOU SHOULD KNOW

Liver cancer is a stubborn disease that can rarely be cured. Treatment can, however, ease the symptoms and sometimes prolongs life.

Causes

When cancer starts independently in the liver, it is often linked to chronic infection with hepatitis B or C, or to the degenerative liver disease known as cirrhosis. Alcohol abuse increases the risk of liver cancer, and it's thought that certain contaminants in the diet, such as fungal aflatoxins, may also be at fault.

Signs/Symptoms

The first signs of liver cancer are similar to the early warnings of other types of cancer. They include loss of appetite, weight loss, fever, fatigue, and weakness. If left undetected, the cancer will grow and cause pain in the upper abdomen on the right side, possibly extending into the back and shoulder. You may also experience abdominal swelling and a bloated feeling. A few people also develop jaundice, a condition in which the skin turns yellow and the urine becomes a dark color.

Care

Liver cancer is difficult to detect in its early stages, and very hard to cure. Treatment typically focuses on relieving symptoms and improving the quality of life. The type of therapy employed depends on the extent, or stage, of the disease, the location and size of the cancerous tumor or tumors, your overall health, and the condition of the liver.

To verify the presence of liver cancer, your doctor will probably order images of the liver, typically produced by ultrasound (a device that bounces sound waves off the internal organs) or computed tomography (CT), a scan that generates cross-sectional views of the organs. The diagnosis is confirmed with a biopsy---a microscopic study of a tissue sample removed from the liver through a needle.

Once the diagnosis is established, the major treatment options include:

• Surgery: If the cancer is confined to the liver, it may be possible to remove the cancerous tumor surgically. In some cases, a liver transplant may also be an option.
• Chemotherapy: Often called "chemo," this type of therapy uses drugs to kill or shrink tumor cells. Many different chemo medicines are available. They may be taken as a pill or shot, or given through an IV. Typical chemo tends to be less effective on liver cancer than it is on other forms of cancer. For this reason, a technique called hepatic artery infusion may be used. In this procedure, the chemo drugs are injected directly into the artery that brings blood to the liver, enabling delivery of especially high doses. Although this form of treatment is known to shrink some liver tumors, it has not been shown to prolong life. You will probably need frequent blood tests to determine how your body is doing and how much chemo you need. The drugs can produce many side effects and may leave you susceptible to infection for a while.
• Other treatments: Although they are used infrequently, other forms of therapy sometimes help. Cryosurgery destroys cancer cells by freezing them with a metal probe. Ethanol ablation kills cells with alcohol injected directly into the tumor. Radiation therapy , while common for many types of cancer, is rarely used for liver cancer, since studies have shown that it fails to prolong life. It may, however, relieve some pain.

Risks

Although treatment can rarely be expected to cure liver cancer, it can improve the quality of life. Therapies such as chemo and radiation have severe and unpleasant side effects, but they offer a reduction in pain and other troubling symptoms.

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