Published by Bupa's Health Information Team, April 2010.
This factsheet is for people who have liver cancer, or who would like information about it.
Liver cancer is a lump created by an abnormal and uncontrolled growth of cells in the liver.
Cancer that starts in your liver is called primary liver cancer. About 3,200 people are diagnosed with primary liver cancer each year in the UK.
Cancerous tumours can grow through your liver and spread to other areas of your body, through your bloodstream or your lymphatic system, where they may grow and form secondary tumours. Your lymphatic system is the tissues and organs, including your bone marrow, spleen, thymus and lymph nodes, that produce and store cells that fight infection and disease. This spread of cancer is called metastasis.
Tumours may also spread from other parts of your body, such as from your bowel, breast or lungs, to your liver - this is called secondary liver cancer. Secondary liver cancer is much more common than primary liver cancer.
This factsheet will concentrate on primary liver cancer.
Your liver is a large organ found in the top part of your abdomen (tummy), just under your ribcage. It's split into sections called lobes.
Your liver carries out about 500 different jobs, including:
It can also repair itself and still functions when much of it is damaged.
There are two main types of primary liver cancer - hepatocellular carcinoma and cholangiocarcinoma. Hepatocellular carcinoma (also known as hepatoma or HCC) is the most common type of liver cancer. It starts in the main cells of your liver called hepatocytes.
Cholangiocarcinoma starts in the cells that line your bile duct and is commonly known as cancer of the bile duct. Your bile duct is a tube that connects your liver to your small bowel. For more information, see Related topics.
More rare types of liver cancer include:
Everyone with liver cancer will be affected differently, but it's quite likely that at first you won't have any symptoms. Later, symptoms may include:
These symptoms aren't always caused by liver cancer but if you have them, contact your GP.
In the UK, most people get HCC because of cirrhosis - scarring of the liver. Cirrhosis affects how well your liver is able to function. The most common cause of cirrhosis in the UK is drinking too much alcohol. It can also be caused by infections such as hepatitis B and hepatitis C. About three or four people out of every 100 with cirrhosis will develop liver cancer.
Other factors that put you more at risk of developing HCC include:
HCC is also more common as you get older - it's rare in people under 45.
In Africa and Asia, where liver cancer is more common, a frequent cause is a substance called aflatoxin that is found in mouldy peanuts and grain. If eaten over a long period of time it can lead to liver cancer.
Doctors don't yet understand why people develop cholangiocarcinoma. However, if you have an inflammatory bowel condition such as ulcerative colitis you may be slightly more at risk.
Your GP will ask about your symptoms and examine you. He or she may also ask about your medical history.
Your GP may refer you to a specialist at a hospital, where you're likely to have tests including liver function tests. These tests check whether your liver is working properly by looking at a sample of your blood. Your doctor may also check for a particular cancer marker - a protein that shows up in higher amounts if you have HCC.
Other tests you may have include the following.
Treatment depends on how advanced your cancer is and on your general health. It will also vary according to exactly where the cancer is and whether it has spread to other parts of your body.
Surgery is the only treatment that offers a cure. However, fewer than one in three people who have HCC can have surgery to remove it. This may be because the tumour is too big, the cancer has spread to other areas or your liver is too badly damaged by cirrhosis.
Surgery options include:
A large part of your liver may be taken away if you have a liver resection or lobectomy. However, your liver can repair itself and grow back to its original size over time.
Ethanol injections
Ethanol (pure alcohol) injections can be used to treat small tumours. Ethanol is injected through your skin into the affected area during an ultrasound. It stops the blood supply to your tumour, killing the cancer cells.
Radiofrequency ablation
During an ultrasound or CT scan, a thin needle is placed in your tumour and radiowaves are passed down the needle. The radiowaves heat up the tumour and destroy it.
Chemotherapy and chemoembolisation
Chemotherapy involves using medicines to shrink the tumour and reduce your symptoms. Chemotherapy isn't very successful at treating liver cancer, but a procedure called chemoembolisation may be more effective. This means that chemotherapy medicines are mixed with an oily substance called lipiodol, which helps them to stay in your liver for longer and so have a greater effect. At the same time, tiny beads of gel are injected to block off the blood supply to your tumour.
Cryosurgery
Liquid nitrogen is placed on the tissue around the tumour to freeze and destroy the cancer.
Biological therapies
These are medicines that use substances occurring naturally in your body to kill cancer.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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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.
Publication date: April 2010
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