Liver Cancer

What is Liver Cancer?

Liver cancer is cancer that starts in the liver. The most common type of liver cancer is Hepatocellular carcinoma. This is different from secondary liver cancers that start elsewhere and spread to the liver from other organs.

Cancers that start in other organs and spread to the liver are called liver metastases or metastatic cancer to the liver.

What causes Liver Cancer?

The most common causes of Hepatocellular carcinoma are:

1. Chronic Hepatitis B and C infections,
2. Heavy Alcohol Abuse, and
3. Cirrhosis of the Liver,

Other causes include:

1. An aggressive form of Fatty Liver Disease associated with Obesity and Diabetes called NASH,
2. Certain iron storage disorders, and
3. Certain carcinogens.

What are the risk factors for Liver Cancer?

1. Gender: Hepatocellular carcinoma is much more common in men than in women.
2. Ethnicity: Asian Americans and Pacific Islanders have the highest rates of liver cancer
3. Heavy alcohol use
4. Having a history of Chronic Hepatitis B and/or C infections
5. Cirrhosis of the Liver
6. Non-alcoholic fatty liver disease: People with the subtype NASH have an increased risk of developing cirrhosis and liver cancer.
7. Primary biliary cirrhosis
8. Inherited metabolic diseases such as hereditary hemochromatosis
9. Tobacco use
10. Obesity, Type 2 diabetes, Metabolic Syndrome
11. Certain rare diseases such as Alpha1-antitrypsin deficiency, Glycogen storage diseases, and Wilson disease
12. Aflatoxin exposure

How common is Liver Cancer?

Liver cancer is the fifth most common cause of cancer death in men. It is the seventh most common cause of cancer death in women.

What are the symptoms of Liver Cancer?

Symptoms may include:

• Abdominal pain, swelling or heaviness in your upper abdomen
• Bloating
• Loss of appetite or early satiety
• Weight loss
• Weakness, Fatigue, Generalized malaise
• Jaundice or yellowing of the skin or eyes
• Clay colored stools
• Dark Urine
• Back Pain
• Fever, chills, sweats
• Easy bleeding or bruising
• Enlarged spleen
• Swelling in the lower extremities
• Confusion or mental status changes

How is Liver Cancer Diagnosed?

Liver cancer is diagnosed based on history, physical exam findings, imaging studies and laboratory tests. Diagnostic tests may include ultrasound, CT scan, MRI, endoscopy, EUS and biopsy.

What are the Treatment Options for Liver Cancer?

It depends of the extent of disease. Treatment options may include surgery or transplant, chemotherapy, and radiation.

Benign Liver Tumors

What are Benign Liver Tumors?

Noncancerous, or benign, liver tumors are tumors that do not spread to other areas of the body, and usually do not pose a serious health risk.

The three most common types of benign liver tumors are:

1. Hemangiomas,
2. Focal nodular hyperplasias, and
3. Hepatocellular adenomas.

Rarely do any of these conditions require treatment. Hemangiomas are the most common form of benign liver tumors. They are masses of abnormal blood vessels.

How are benign liver tumors detected?

Typically, these tumors are asymptomatic. As such, they tend to be found incidentally during a medical procedure (such as an ultrasound, CT test or MRI) performed for another reason.

What is a Hemangioma?

Hemangiomas are the most common form of benign liver tumors. They are masses of abnormal blood vessels. It’s estimated that up to 5% of adults in the U.S. may have small hemangiomas. They are more common in women than men. Usually hemangiomas are asymptomatic and do not need to be treated.

What is focal nodular hyperplasia (or FNH)?

Focal nodular hyperplasia is the second most common type of benign liver tumor. It is thought to be caused by a localized hyperplastic liver cell response to an underlying congenital arteriovenous (or AV) malformation. FNH may be related to oral contraceptive use.

FNH has no malignant potential. These tumors are mainly seen in premenopausal women ages 20-30. They typically produce no symptoms and surgical intervention is almost never required.

They’re most commonly found incidentally during imaging studies such as ultrasound or MRI performed for other reasons. Treatment is almost never required. If they are large, surgical removal may be recommended to avoid the risk of rupture.

What is focal hepatocellular adenomas?

Hepatocellular adenomas are uncommon solid, benign liver lesions that develop in an otherwise healthy appearing liver. They’re typically found in women of childbearing age, and are associated with estrogen-containing medications like birth control pills.

In rare cases, these tumors can rupture and bleed. If they are large, surgical removal may be recommended to prevent this from happening.

Hepatocellular adenomas may enlarge in women who take hormone pills, so discontinuing birth control pills or hormone replacement therapy may be advised.