liver cancer

Liver cancer, also known as hepatocellular carcinoma (HCC), is a type of cancer that starts in the liver. It is a life-threatening illness and one of the fastest-growing cancer types in the United States.

Types of Liver Cancer

There are two kinds of liver cancer: primary and secondary. Primary liver cancer begins in the liver, while secondary liver cancer is cancer that has spread to the liver from another part of the body.

• Primary Liver Cancer: The most common type of liver cancer is hepatocellular carcinoma (HCC), which accounts for over 12,000 deaths per year in the United States. [1][5]
• Secondary Liver Cancer: This type of cancer occurs when a tumor grows on the liver as a result of metastasis from another cancer. [7]

Symptoms

Liver cancer symptoms can be non-specific and may include:

• Loss of appetite
• Weakness
• Bloating
• Jaundice (yellowing of the skin and eyes)
• Upper abdominal discomfort

Causes and Risk Factors

The exact cause of liver cancer is unknown, but certain risk factors have been identified, including:

• Chronic hepatitis infection
• Cirrhosis (scarring of the liver)
• Exposure to toxins such as aflatoxins
• Family history of liver cancer
• Obesity and diabetes

Treatment Options

Treatment for liver cancer depends on the stage and severity of the disease. Options may include surgery, chemotherapy, radiation therapy, or a combination of these.

References:

[1] May 15, 2024 — Primary liver cancer is a disease in which cancer forms in the liver. [2] Apr 28, 2023 — Several types of cancer can form in the liver. [5] Hepatocellular carcinoma (HCC), or liver cancer, occurs when a tumor grows on the liver. [7] Aug 14, 2024 — Primary liver cancer is a malignant tumour that begins in the liver.

Liver cancer symptoms can vary person to person, but some common signs and symptoms include:

• Unintended weight loss [3]
• Pain in the right upper abdomen or shoulder blade [3]
• Loss of appetite [3]
• Feeling or being sick [4]
• Pain at the top right side of your tummy or in your right shoulder [4]
• Symptoms of indigestion, such as nausea and vomiting [4]
• A hard lump on the right side just below the rib cage [5]
• Discomfort in the upper abdomen on the right side [5]
• Weakness and tiredness [6]
• Pain in the abdomen [6]
• Swelling of the abdomen due to a build-up of fluid (ascites) [6]
• Weight loss [7]
• Yellowing of the skin and whites of the eyes (jaundice) [7]
• Itching [7]
• Feeling sick [7]
• Swollen tummy (abdomen) [7]
• Loss of appetite [7]

It's worth noting that some people may not experience any symptoms at all until the cancer has advanced to a more serious stage. If you're experiencing any of these symptoms, it's essential to consult with a healthcare professional for proper evaluation and diagnosis.

References: [3] - Context result 3 [4] - Context result 4 [5] - Context result 5 [6] - Context result 6 [7] - Context result 7

Diagnostic Tests for Liver Cancer

Liver cancer diagnosis involves a combination of physical examination, medical history, and various tests to confirm the presence of cancer cells in the liver.

• Blood Tests: Blood tests can help doctors identify abnormal levels of certain proteins or enzymes that may indicate liver damage or cancer. However, blood tests alone cannot diagnose liver cancer [9].
• Imaging Tests: Imaging tests such as ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are used to visualize the liver and detect any abnormalities [1][2]. These tests can help identify tumors, cysts, or other lesions in the liver.
• Alpha-fetoprotein (AFP) Tumor Marker Test: The AFP test is a blood test that measures the level of alpha-fetoprotein protein in the blood. Elevated levels of AFP can indicate liver cancer [6].
• Liver Function Tests: Liver function tests measure the levels of certain enzymes and proteins in the blood to assess liver function and detect any abnormalities [3][5].
• Biopsy: A biopsy involves collecting a small sample of tissue from the liver, which is then examined under a microscope for cancer cells. This is considered the most accurate diagnostic test for liver cancer [5].

Additional Tests

Other tests that may be used to diagnose liver cancer include:

• Complete blood count (CBC) to assess overall health and detect any abnormalities
• Blood chemistry tests to evaluate liver function and detect any enzyme imbalances
• Physical examination and health history to identify risk factors and symptoms

It's essential to consult a healthcare professional for accurate diagnosis and treatment of liver cancer.

Liver cancer treatment has evolved over the years, and various drug options are now available to manage this condition.

First-line treatments

According to recent studies [1], sorafenib (Nexavar) and lenvatinib (Lenvima) can be used as first-line treatments for liver cancer that cannot be treated surgically. These drugs work by targeting specific molecules involved in tumor growth and angiogenesis [3].

Other treatment options

For locally advanced or metastatic liver cancer, transarterial embolization (TAE) or transarterial chemoembolization (TACE) may also be considered as part of the treatment plan [2]. Additionally, chemotherapy can be used to kill rapidly growing cancer cells in the liver [5].

Targeted therapy

Targeted therapy drugs such as sorafenib, lenvatinib, regorafenib (Stivarga), and cabozantinib (Cabometyx) are also used to treat liver cancer [6]. These medications specifically target molecules involved in tumor growth and angiogenesis.

Combination therapies

In some cases, combination therapies may be prescribed. For example, bevacizumab can be used with other targeted drugs to decrease blood supply to the tumor [7].

Recent developments

More recently, ipilimumab has been approved for use in combination with nivolumab to treat liver cancer that has previously been treated with targeted therapy [8]. This development offers new hope for patients with advanced liver cancer.

References:

[1] Context result 1: Jun 10, 2020 [2] Context result 2: May 15, 2024 [3] Context result 3: May 2, 2024 [5] Context result 5: Apr 28, 2023 [6] Context result 6 [7] Context result 7 [8] Context result 8

The differential diagnosis of liver cancer, also known as hepatocellular carcinoma (HCC), involves distinguishing it from other conditions that can cause similar symptoms and characteristics.

Common Differential Diagnoses

• Metastatic disease: Liver metastases from colorectal carcinoma are the most common type of metastasis to the liver [1]. Other cancers, such as breast, lung, and melanoma, can also metastasize to the liver.
• Focal nodular hyperplasia (FNH): A benign tumor that can mimic HCC in appearance and location [4].
• Hepatic adenoma: A rare, non-cancerous tumor that can be mistaken for HCC due to its similar characteristics [4].
• Hemangioma: A benign vascular tumor that can cause liver enlargement and mimic HCC symptoms [4].

Key Features to Distinguish

To accurately diagnose liver cancer, it's essential to consider the following features:

• Imaging studies: CT or MRI scans can help identify the size, location, and characteristics of the lesion.
• Biopsy results: A tissue sample from the liver can confirm the presence of cancer cells.
• Clinical presentation: Symptoms such as abdominal pain, jaundice, weight loss, and fatigue can be similar to those experienced by patients with HCC.

Challenges in Differential Diagnosis

The differential diagnosis of malignant hepatic tumors is challenging due to overlapping characteristics between different conditions [7]. Misdiagnosis prior to surgery can lead to inappropriate treatment. Therefore, a thorough evaluation and accurate diagnosis are crucial for effective management.

References:

[1] The liver is the most common metastatic site of colorectal carcinoma, and the main differential diagnosis of a liver metastatic lesion of colorectal carcinoma is HCC [2].

[4] Liver cirrhosis results from hepatocellular necrosis, fibrosis, and regeneration. Regenerative nodules can be mistaken for HCC due to their similar appearance [4].

[7] However, the differential diagnosis of malignant hepatic tumors is challenging, and misdiagnosis prior to surgery can mislead the treatment [7].