Liver Cancer: Causes, Symptoms, Diagnosis & Treatment

What is Liver Cancer?

Liver cancer, also known as hepatocellular carcinoma (HCC), is a type of cancer that originates in the cells of the liver. It occurs when normal liver cells undergo genetic mutations, leading to uncontrolled growth and the formation of tumors.

There are two types of liver cancer: primary liver cancer, which starts in the liver, and secondary liver cancer, which starts somewhere else and spreads to the liver.

Liver cancer is a serious condition that requires prompt medical attention and comprehensive care. Like many types of cancer, liver cancer is not as difficult to treat if it is diagnosed early.

There are three types of primary liver cancer:

• Hepatocellular carcinoma: Known as HCC, this is the most common type of liver cancer, representing most cases.
• Intrahepatic cancer: IHC is a type of cholangiocarcinoma and is a cancer in the liver’s bile ducts. It makes up between 10% and 20% of cases.
• Angiosarcoma: A very rare type of primary liver cancer, this begins in the lining of blood cells in the liver.

What are the Symptoms of Liver Cancer?

In the early stages, liver cancer may not present noticeable symptoms. HCC and IHC often have similar symptoms as the disease progresses, which may include:

• Abdominal pain or discomfort
• Unexplained weight loss
• Loss of appetite
• Fatigue or weakness
• Yellowing of the skin and eyes (jaundice)
• Swelling in the abdomen or legs
• Nausea and vomiting.

What Causes Liver Cancer?

Liver cancer happens when something has affected the DNA of healthy liver cells. Our DNA has genes which tell our cells what to do, such as when to divide, when to grow and when to die. Other genes, such as tumor suppressor genes, help to control cell growth and make sure cells die when they are meant to. If the liver cell’s DNA mutates in any way, new, or incorrect instructions may be given. In HCC, the liver cell’s DNA doesn’t tell the cells to stop multiplying or to die when they are supposed to, and healthy cells can become cancerous. Infections such as Hepatitis B and C can cause these changes in cell DNA and lead to cancer. IHC is believed to be caused by long-term inflammation within the bile ducts. Over time, this inflammation damages the cell’s DNA. Several other factors can contribute to the development of liver cancer, including:

• Chronic liver diseases: As well as hepatitis, other long-term liver diseases, such as cirrhosis or non-alcoholic fatty liver disease (NAFLD), can increase the risk of liver cancer.
• Alcohol consumption: Excessive and prolonged alcohol consumption can lead to liver damage and increase the likelihood of liver cancer.
• Obesity and diabetes: These conditions are associated with an increased risk of liver cancer.

How Can I Prevent Liver Cancer?

While some risk factors for liver cancer, such as genetic predisposition or certain liver diseases, cannot be controlled, you can take steps to reduce your risk. Here are some preventive strategies:

• Vaccination: Get vaccinated against hepatitis B, as this viral infection is a leading cause of liver cancer.
• Risk factors for Hepatitis C: Be aware of the risk factors for contracting this preventable disease.
• Limit alcohol consumption: Drink alcohol in moderation or avoid it altogether to protect your liver.
• Maintain a healthy weight: Adopt a balanced diet and engage in regular physical activity to prevent obesity and reduce the risk of liver cancer. If you have any sort of liver disease, or any of the risk factors listed above, talk to your doctor about liver cancer screening.

How is Liver Cancer Diagnosed?

If you are displaying symptoms or have risk factors for liver cancer, your doctor may recommend various diagnostic tests. Advances in technology have improved the accuracy and efficiency of many gastrointestinal cancer diagnostic tests, including the tests for Liver cancer. These may include:

• Imaging tests: These include ultrasound, CT scan, or MRI to visualize the liver and detect any abnormalities.
• Blood test: This helps assess liver function and identify markers associated with liver cancer.
• Liver biopsy: A small sample of liver tissue is extracted for examination under a microscope to confirm the presence of cancer cells.
• Angiogram: A dye is injected into an artery which shows any tumors in the liver.
• Laparoscopy: A thin tube with a light provides high-definition images of the liver and other organs inside the stomach.

What are the Treatment Options for Liver Cancer?

The treatment approach for liver cancer depends on factors such as the stage of the cancer, the liver's condition, and your overall health. Thanks to advances in technology, doctors can now provide personalized treatment plans for patients diagnosed with liver cancer. At Cleveland Clinic Abu Dhabi, experts create a personalized treatment plan tailored to each patient. Treatment options include:

• Surgery: Surgical options may include tumor resection (removal), liver transplantation, or ablative techniques to destroy the cancer cells. Minimally invasive surgery options reduce the size of incisions, meaning faster recovery and fewer complications. There are two main types of surgery for liver cancer:
• Partial hepatectomy:Involves removing part of the liver.
• Total hepatectomy and liver transplant:Removing the entire liver and replacing it with one from a donor.
• Partial hepatectomy: Involves removing part of the liver.
• Radiation therapy: High-energy radiation is used to target and kill cancer cells. It can be delivered externally or internally (brachytherapy).
• Transarterial chemoembolization (TACE): This procedure involves delivering chemotherapy drugs directly to the tumor via a catheter, along with blocking the blood supply to the tumor.
• Targeted therapy: Medications are used to target specific molecules or pathways involved in cancer growth.
• Immunotherapy: This approach stimulates the body's immune system to fight against cancer cells

Liver cancer is a life-threatening illness that often has no symptoms until the disease has progressed. There are treatment options available for liver cancer that aim to relieve the symptoms of the disease, slow its progression, and improve the patient’s quality of life. Talk to your doctor if you think you may have any of the early signs or symptoms of liver cancer.