Liver Cancer: Symptoms, Signs, Causes & Treatment

Janis

By Janis | Updated January 1, 2024

Liver cancer is a grave and life-threatening disease that has emerged as one of the fastest-growing types of cancer in the United States. 

The liver is an essential organ responsible for various functions, such as detoxification and nutrient storage. The liver is composed of different types of cells, and liver cancer can originate in any of them. 

Most liver cancer cases originate in the hepatocytes, the primary cells of the liver responsible for making proteins and metabolizing nutrients. When hepatocytes grow abnormally and develop into cancerous tumors, this condition is called hepatocellular carcinoma.

Understanding the symptoms, causes, diagnosis, treatment options, and preventive measures is crucial in battling this disease and improving the prognosis for those affected.

Recognizing the disease indicators early is vital, as early detection improves the likelihood of successful treatment. 

Symptoms

Liver cancer often does not show signs and symptoms in its early stages. However, as the cancer progresses, some symptoms may become apparent. It is essential to be aware of these symptoms to seek medical attention as soon as possible.

Yellowing of Skin and Eyes

One common symptom is jaundice, which is the yellowing of the skin and eyes due to the buildup of bilirubin in the blood. 

This discoloration occurs when the liver is unable to process and eliminate bilirubin properly. 

Change in Appetite and Weight Loss

Another symptom that might manifest is unexplained weight loss, which may be accompanied by a loss of appetite. 

These symptoms are often a result of the body’s decreased ability to metabolize and absorb nutrients.

Tiredness and Feeling Sick

Patients may also experience nausea and fatigue, which can be general and persistent. 

This is due to liver dysfunction, which affects the body’s energy levels and digestion. 

Bruising and Bleeding

In some cases, patients may notice bruising and bleeding more easily than usual. 

This is because the liver plays a vital role in blood clotting, and its impairment can lead to coagulation issues.

Other Symptoms

Other symptoms that may develop as the cancer progresses include enlarged veins, particularly in the abdomen, and general weakness.

This is caused by the liver’s decreasing capacity to filter blood efficiently and maintain proper circulation. Additionally, a fever may be present, which could be the body’s response to infection or inflammation.

It is essential to consult a medical professional if any of these symptoms persist or worsen. Early detection can be crucial for effective treatment and better prognosis.

Causes and Risk Factors

Liver cancer has several causes and risk factors that may increase the likelihood of developing the disease. 

Long-Term Liver Infection

One of the leading causes of liver cancer is chronic hepatitis B or C infections. 

Hepatitis B (HBV) and hepatitis C (HCV) viruses cause liver inflammation, which can lead to scarring, cirrhosis, and eventually liver cancer.

Alcohol and Scars on the Liver

Cirrhosis, the scar tissue that forms in the liver due to chronic inflammation or injury, is another significant risk factor for developing primary liver cancer. 

Cirrhosis increases the risk of liver cancer, as the damaged tissue creates a favorable environment where cancerous cells can grow. Cirrhosis can be caused by a variety of factors, including heavy alcohol use, nonalcoholic fatty liver disease, and chronic hepatitis infections. 

Heavy alcohol users with cirrhosis are ten times more likely to develop liver cancer compared to those who do not have cirrhosis.

Age, Gender, and Genetics

Age and gender also play a role in liver cancer risk. Men are more likely to develop liver cancer than women, and the risk increases with age.

Certain genetic conditions, such as hemochromatosis and aflatoxin exposure, can also contribute to liver cancer development. 

Hemochromatosis is an inherited condition where the body absorbs too much iron, which can lead to liver damage. 

Food Contamination

Aflatoxins are toxins produced by certain fungi that can contaminate food. 

Long-term exposure to high levels of aflatoxins can increase the risk of liver cancer.

Smoking and Obesity

Smoking and obesity are additional risk factors for liver cancer. 

Smoking can damage the liver by increasing inflammation and hindering the liver’s ability to process toxins. 

Obesity can lead to nonalcoholic fatty liver disease, which may progress to cirrhosis and liver cancer.

Maintaining a healthy lifestyle and undergoing regular medical check-ups can help minimize these risks.

Types of Liver Cancer

Liver cancer is a life-threatening illness that affects a vital internal organ responsible for many important functions in the body. Let’s discuss the different types of liver cancer.

Primary Liver Cancer

Hepatocellular carcinoma (HCC) is the most common type of liver cancer, constituting about 75% of cases. 

It originates in the hepatocytes, the primary cells of the liver. HCC can be further divided into two subtypes: single and multiple nodules. 

The single nodule subtype usually affects people with cirrhosis, while the multiple nodule subtype often affects individuals with chronic liver diseases such as Hepatitis B or C.

Bile Duct Cancer

Cholangiocarcinoma, also known as bile duct cancer, develops in the bile ducts within the liver and accounts for approximately 10% to 20% of liver cancer cases. 

It can be classified as either intrahepatic cholangiocarcinoma, which begins inside the liver, or extrahepatic cholangiocarcinoma, which starts outside the liver.

Rare Types of Liver Cancer

Angiosarcoma is a rare form of liver cancer arising from the liver’s blood vessels. This aggressive cancer type has a poor prognosis, as it often spreads rapidly and is typically diagnosed in later stages.

Hepatoblastoma is a rare pediatric liver cancer that primarily affects children under the age of 3. Early diagnosis and treatment are crucial in the successful management of this cancer type.

The proper identification of these cancer types is essential for appropriate treatment and management.

Diagnosis

Diagnosing liver cancer involves several tests and procedures to identify the presence of cancerous cells in the liver accurately. 

Blood Tests

One of the initial steps taken is blood tests, which can indicate abnormal liver function and may prompt further investigation.

Blood tests play a crucial role in detecting liver cancer. Elevated liver enzymes may indicate liver damage and potential malignancy. 

Imaging Tests

Imaging tests, such as ultrasounds, CT scans, and MRI scans, are helpful tools in liver cancer diagnosis. 

An ultrasound uses sound waves to capture images of the liver, allowing doctors to identify any potentially cancerous liver cells. 

CT scans and MRI scans are additional imaging techniques that provide more detailed images of the liver tissue, which can help doctors determine if a tumor is present.

Liver Sample Examination

In some cases, a liver biopsy may be performed to confirm liver cancer. A biopsy involves the removal of a small sample of liver cells or tissue using a thin needle or a slightly wider needle, known as a core needle biopsy. 

This sample is then examined under a microscope to look for cancerous cells.

Screening and Liver Function Tests

Screening for liver cancer may be recommended for individuals with risk factors, such as chronic hepatitis B virus or hepatitis C virus infections. 

Regular liver function tests can help detect liver cancer in its early stages, increasing the chances of successful treatment.

Being aware of risk factors and symptoms can greatly aid in early detection and treatment success.

Staging

Staging is an essential process in determining the extent of liver cancer in a patient’s body. It helps medical professionals understand how serious the cancer is and identify the most effective treatment options. 

The staging of liver cancer generally involves assessing the size of the tumor, the involvement of nearby lymph nodes, and the dispersion to distant organs or tissues. 

There are commonly four stages of liver cancer, from stage I to stage IV. 

Stage I

In stage I, the tumor is still confined to the liver and has not spread to other organs or lymph nodes. 

At this early stage, treatment options like surgical removal or liver transplant may be highly effective. 

Stage II

As the disease progresses to stage II, the tumor may have grown larger and started to invade nearby blood vessels but has not yet affected lymph nodes or distant organs.

Constant monitoring and regular tests are conducted to monitor for the cancer progression and measure the effectiveness of the treatment.

Stage III

Stage III liver cancer suggests that the cancerous tumor has propagated to nearby lymph nodes but not to other distant organs. 

In this stage, more aggressive treatments may be necessary, such as chemotherapy or targeted therapies. 

Stage IV

Finally, stage IV liver cancer is the most advanced stage, where the cancer has spread to distant organs or tissues, making treatment more challenging and focusing on relieving symptoms and improving the patient’s quality of life.

Although liver cancer can be challenging to treat, early detection and targeted therapies can significantly enhance a patient’s chances of recovery.

Treatment Options

There are several treatment options available for liver cancer, depending on the stage, type, and overall health of the patient. These options aim to remove or destroy cancer cells, control liver function, and alleviate symptoms such as swelling.

Surgery and Transplant

Surgery is often the first course of action for liver cancer treatment. 

In some cases, a section of the liver containing the cancerous cells can be removed, allowing the remaining healthy liver tissue to regenerate and function. 

For patients with severe liver damage or those who are not candidates for surgery, a liver transplant may be considered.

A liver transplant is a viable treatment option for patients with early-stage liver cancer, especially when their liver isn’t healthy or if the tumor is located near large blood vessels, making it difficult to remove during surgery. 

A liver transplant includes replacing the patient’s impaired liver with a healthy one from a donor.

Radiation Therapy

Radiation therapy involves the use of high-energy rays to target and destroy cancer cells. This technique can help control the growth of liver cancer without affecting healthy tissue.

Radiation may be delivered externally, through the skin, or internally, with radioactive materials placed inside the body.

Ablation Therapy

Ablation techniques destroy cancer cells by delivering high-frequency alternating electrical current precisely at the site or applying extreme heat or cold directly to the tumor. 

Radiofrequency ablation (RFA) and cryoablation are two common methods used to treat liver cancer.

Chemotherapy

Chemotherapy is a treatment option that utilizes potent anti-cancer drugs to destroy fast-growing cancer cells in the body. 

It can be administered through the bloodstream, allowing it to travel throughout the body, or as chemoembolization, injected directly into the blood vessels that feed the tumor.

Targeted Drug Therapy

Targeted drug therapy is designed to attack specific aspects of cancer cells, such as proteins or enzymes that contribute to their growth and survival. 

This type of therapy is often more precise than traditional chemotherapy and may cause fewer side effects.

Immunotherapy

Immunotherapy helps the body’s immune system to detect and eliminate cancer cells. 

Medications that support the immune system can help fight liver cancer, mainly when used in combination with other treatment options.

Supportive Care

In addition to these primary treatment options, it is essential for liver cancer patients to maintain proper nutrition and manage any swelling or pain associated with the disease. 

By working closely with a healthcare team, patients can explore various treatments to find the best approach for their specific situation.

Disease Progression and Survival Rate

Several factors that affect the prognosis for liver cancer include the stage of the disease, the individual patient’s overall health, and the effectiveness of the treatment options chosen. 

In general, liver cancer has a relatively low overall survival rate, especially in its advanced stages.

US statistics show the relative survival rate five (5) years after liver cancer is detected based on the localization as around 36% if the tumor is localized, approximately 13% if spread regionally, around 3% if the cancer has metastasized to distant parts of the body- with a combined average of around 21% who survive for five (5) years post-diagnosis compared to the overall population.

One key factor in determining the prognosis for liver cancer is the amount of energy a patient has. Maintaining sufficient energy levels is vital for the body’s ability to fight cancer. 

A person’s immune system can also play a significant role in their prognosis. A strong immune system is better equipped to recognize and destroy cancer cells and can also improve the body’s response to treatment. 

Women tend to have a slightly better prognosis for liver cancer than men, although the reasons for this difference are not yet fully understood. 

Some studies suggest that hormonal differences may play a role or that men may be more likely to have other risk factors that contribute to liver cancer development and progression.

Patients’ lifestyle choices can also support their prognosis, potentially improving survival rates. For example, reducing or eliminating alcohol consumption can positively impact liver health.

This is particularly important for individuals who already have liver cancer, as alcohol can further damage an already weakened liver.

Prevention

Preventing liver cancer involves reducing exposure to risk factors, promoting a healthy lifestyle, early detection and treatment of hepatitis infections, and vigilant monitoring of existing liver conditions. 

Vaccination

One of the most effective ways to do this is through vaccination against hepatitis B virus (HBV). 

The hepatitis B vaccine is essential in reducing the risk of developing liver cancer, as chronic HBV infection is a significant contributing factor to the disease.

Healthy Lifestyle

Maintaining a healthy lifestyle is another vital aspect of prevention. This involves eating a balanced diet loaded with fruits, vegetables, and whole grains, exercising regularly, limiting intake of alcohol, and avoiding exposure to harmful chemicals.

By focusing on overall physical health, you can help maintain the healthy tissue found in your liver and reduce the risk of cancerous growth.

Early Detection and Regular Check-ups

In addition to the above lifestyle changes, early detection and treatment of hepatitis B and C infections is vital. Getting tested for these viruses is essential in addressing the risk, as they often lead to chronic liver disease, which can develop into liver cancer.

Another critical step is monitoring any existing liver conditions. Regular check-ups with your healthcare provider will help identify any changes in liver function that may indicate an increased risk of cancer. 

Frequently Asked Questions

What are the early signs of liver cancer?

Most individuals don’t exhibit signs and symptoms in the initial stages of primary liver cancer. 

When signs and symptoms do emerge, they may include unintended weight loss, loss of appetite, pain in the upper abdomen, nausea and vomiting, general weakness and fatigue, and swelling in the abdomen.

How is liver cancer diagnosed?

To diagnose liver cancer, doctors may recommend imaging tests, such as ultrasound, CT, and MRI. 

In some instances, it’s required to obtain a piece of liver tissue for lab testing in order to diagnose liver cancer conclusively.

What factors contribute to causing liver cancer?

Cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue, increases the risk of developing liver cancer. 

The scar tissue obstructs the flow of blood through the liver and prevents it from functioning correctly. 

Chronic alcoholism and chronic hepatitis infections are common causes of cirrhosis.

What treatment options are available for liver cancer?

Treatment approaches for liver cancer rely on the stage and location of the tumor, as well as the overall health of the patient. 

Common treatments include surgery, radiation therapy, targeted therapy, immunotherapy, and chemotherapy. In some cases, liver transplantation may also be considered.

How can liver cancer be prevented?

Prevention is highly significant when it comes to liver cancer. Some strategies to prevent liver cancer include maintaining a healthy weight, eating a balanced diet, exercising regularly, limiting alcohol consumption, and avoiding exposure to toxic chemicals. 

Additionally, getting vaccinated against hepatitis B and practicing safe sex can help reduce the risk of developing liver cancer.

What is the survival rate for liver cancer?

Survival rates for liver cancer depend on various factors, such as the stage at which the cancer is diagnosed and the patient’s overall health. Early detection and treatment can significantly increase the chances of survival. 

It’s important to discuss prognosis and survival rates with a healthcare professional, as individual cases may vary.