Cancer is an abnormal and uncontrolled growth of cells. The cells multiply to form a tumour. Tumours can either be benign or malignant. Benign tumours are not cancerous. They normally stay in your liver and don’t spread to other parts of your body. Malignant tumours are cancerous and can spread to other parts of your body.
Primary liver cancer is a type of cancer that starts in your liver.
There are two groups that liver cancer falls into: primary and secondary.
Cancer that starts in your liver is called primary liver cancer. This type of cancer is not that common in the UK, with around 3,400 people diagnosed with it each year. But, it’s the sixth most common form of cancer worldwide. The most common type of primary liver cancer is called hepatocellular carcinoma (HCC).
Most people in the UK that have been diagnosed with tumours in the liver, will have secondary liver cancer. This is when cancer from another part of your body, such as your bowel, breast or lungs spreads to your liver. The spread of cancer is called metastasis.
Our information here will concentrate on primary liver cancer.
Your liver is a large organ, found beneath your right lung, just under your ribcage. It’s divided into two sections, called lobes.
Your liver carries out many important jobs, including:
If your liver is healthy it can also repair itself and can still function when much of it is damaged.
There are four main types of primary liver cancer.
Primary liver cancer affects people in different ways. Most of the time there are no symptoms in the early stages. However, as the cancer cells grow, you may have symptoms including:
These symptoms may be caused by problems other than liver cancer. But, if you have any of these symptoms, see your GP.
Primary liver cancer, particularly HCC, may be caused by cirrhosis. This is when your liver becomes scarred and damaged. Drinking too much alcohol over time can cause cirrhosis. It can also be caused by infections, such as hepatitis B, hepatitis C and non-alcoholic steatohepatitis (a type of fatty liver disease).
Other factors that may put you more at risk of developing liver cancer include:
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP will organise for you to have a blood test to see how well your liver is working.
If the results of your blood test show anything unusual, your GP may refer you to a hospital to have further tests. You may have one or more of the tests described below. They may help to determine if you have liver cancer, its stage and if it has spread to other parts of your body.
The treatment you have will depend on how advanced your cancer is, whether it has spread to other areas and your general health. Treatments will try to either:
Surgery may help to cure your liver cancer. However, it’s important to remember that surgery isn’t always possible and is only offered to a small number of people. Surgery will depend on:
There are a number of surgery options. Some examples are listed below.
Ablation means to remove or destroy. There are two different ways of ablating a tumour in your liver which are described below.
Percutaneous ethanol injection
A percutaneous ethanol injection (PEI) is when ethanol (pure alcohol) is injected directly into your tumour to try and destroy the cancer cells.
If you can’t have surgery, you may be offered this treatment option. However, you might only be able to have PEI if your tumour is no bigger than 5cm. PEI will involve you having more than one injection on separate days.
It’s important to remember that PEI doesn’t always work. However, it may be more effective in destroying the cancer cells in tumours that are between 1 to 2cm in size.
You might receive radiofrequency ablation (RFA) if you’re waiting to have a liver transplant.
During an ultrasound or CT scan, a thin needle will be placed in your tumour. Radiowaves will then be passed down the needle – they heat up your tumour and destroy it. RFA may be a better treatment option than PEI if your tumour is larger.
Chemotherapy involves using medicines to help shrink your tumour and reduce your symptoms. You may receive chemotherapy if your cancer is at an advanced stage. If you have chemotherapy you might have it through a drip into one of your veins or as tablets. It’s important to remember that liver cancer doesn’t always respond well to chemotherapy.
Chemoembolisation is when chemotherapy medicines are given directly to your liver through the artery (hepatic) that is connected to your liver. Chemotherapy medicines are mixed with a substance called lipiodol. This helps them stay in your liver for longer and increase their effectiveness. This is followed by an injection of a gel or tiny plastic beads which help to block the blood flow to your tumour. This may limit the oxygen supply to your tumour, and will therefore destroy the tumour cells.
You might have chemoembolisation if you’re waiting to have a liver transplant. You may also receive chemoembolisation in a palliative way. This is when a treatment is given to you to help reduce how severe your symptoms are or to slow down the growth of your tumour.
Sorafenib is a medicine that is sometimes used to treat liver cancer. You may only receive sorafenib if you have advanced liver cancer as this treatment can be expensive. If you do receive sorafenib, you will continue to receive it as long as it helps to improve your symptoms. Some evidence suggests that sorafenib may help to improve your symptoms when compared to chemotherapy. However, some research indicates that sorafenib might increase your chance of getting high blood pressure.
Radiotherapy uses radiation to destroy cancer cells. Radiotherapy isn’t often used to treat primary liver cancer as your liver may not respond well to radiation. However, you may receive radiotherapy if your cancer has spread to your bones as it may help treat any pain you have.
Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors (oncologists) and nurses are experts in providing the support you need. You may also find it helpful to join a support group.
If you have more advanced cancer, further support is available to you in hospices or at home, and this is called palliative care.
Reviewed by Kuljeet Battoo, Bupa Health Information Team, April 2014
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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