Liver cancer
What is liver cancer?
Liver cancer is a cancer that can occur anywhere in the liver. The liver is a large organ located in the upper right side of the abdomen; it helps with digestion and removes toxins. Liver cancer can develop in the liver (primary) or spread from another organ (secondary). The severity of liver cancer depends on its location in the liver, as well as the size of the tumor, whether it has spread or not, whether it is primary or secondary, and the person's overall health.
Symptoms of liver cancer can be asymptomatic or difficult to detect. Symptoms are non-specific and may be similar in primary and secondary (metastatic) liver lesions.
Symptoms of liver cancer may include:
- Yellowing of the sclerae of the eyes and skin, as well as skin itching, dark urine and more colorless than normal stools
- Unexplained decreased appetite or weight loss
- Feeling tired, weak
- General discomfort or flu-like symptoms
- Swelling in the right side of the abdomen
Other symptoms may affect digestion, such as:
- A feeling of discomfort
- Pain in the right upper abdomen or right shoulder
- Symptoms of indigestion, such as feeling quickly full during meals
- Abdominal pain not related to food intake
Who can get liver cancer?
Primary liver cancer can occur in anyone. What causes it is not always clear. At-risk groups include:
- People over 60 years of age (most often over 85 years of age)
- Men
- People with certain medical histories such as hepatitis, cirrhosis, gallstones, diabetes, parasites in the liver
- Having this disease in close relatives is a genetic factor
- Secondary liver cancer occurs as a result of the spread of cancer cells from tumors in other organs (metastases)
Tests and further action
To detect liver cancer, laboratory and radiological tests such as blood tests, ultrasound, computer tomography (CT) or magnetic resonance imaging (MRI) and biopsy - taking liver tissue with a needle to determine the nature of the tumor - are required on the advice of a doctor.
If the patient has already had another type of cancer and the doctor thinks it may have spread to the liver (secondary liver cancer), a PET scan may be performed. These tests can also help us detect problems in other nearby organs - the bile ducts, pancreas or liver.
Treatment for liver cancer
A patient with liver cancer is monitored by a team of specialists to ensure that the right treatment tactics are chosen.
Treatment depends on the following factors:
- Whether the tumor process is primary (started in the liver) or secondary (spread from another organ)
- The size and type of the liver tumor
- Localization of the tumor
- The spread of the tumor
- The general health of the patient
Treatment may include surgery, chemotherapy, destroying the tumor by cutting off its blood supply (vascular ablation), destroying the tumor by heat (thermal ablation), and use of targeted drugs and radiotherapy.
Surgical treatment of liver cancer
If liver cancer is detected at an early stage, is small in size and has not spread, surgery to remove it is possible. The surgery involves removing the affected part of the liver or the entire organ; in the latter case, a liver transplant is needed to replace the liver. Recovery from liver cancer surgery can take a long time. The team of specialists planning the patient's treatment and care considers all the benefits and side effects.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. For liver cancer, a chemotherapy drug may be injected into the blood vessels that feed the cancerous tumor. This intervention aims to stop the growth of the cancerous tumor and reverse its progression. This is called chemoembolization (vascular ablation). Chemoembolization is done to reduce the size of the cancerous tumor or to control and improve symptoms. It is done if surgery or surgical removal of the cancerous tumor is not possible.
Thermal ablation
Thermal ablation uses an electric current or microwaves to destroy the cancerous tumor. Thermal ablation may be used to treat liver cancer if surgery or removal of the cancerous tumor is not possible.
Targeted drugs
Targeted drugs aim to stop the growth of the cancerous tumor. Treatment of liver cancer with targeted drugs may be prescribed if surgery or surgical removal of the cancerous tumor is not possible. It may also be prescribed in cases where cancer has spread to other organs.
Radiotherapy
Radiotherapy is the use of ionizing radiation to kill cancer cells. Radiotherapy in which selective internal radiation therapy is given using a beta-emitting radioisotope is called SIRT or TARE. It is a type of so-called brachytherapy in which microspheres containing a beta-emitting radioisotope are injected into the blood vessels feeding the liver tumor to stop it from growing. Radiotherapy may be given to treat liver cancer if the cancer cannot be removed by surgery.
