Tumors are changes in the shape of liver tissue and an accelerated rate of cell proliferation. There are two well-known types of tumors in the liver: benign tumors and malignant tumors (cancers).
Benign liver tumors, which are relatively common, are often asymptomatic. They are frequently undiagnosed until imaging tests are performed. There are several types of benign liver tumors:
- Hepatocellular Adenoma: A benign tumor associated with certain medications. Most of these tumors go unnoticed, although in some cases, an adenoma may rupture and cause bleeding into the abdominal cavity, requiring surgery. Adenomas rarely transform into cancer.
- Hemangioma: This is a type of benign tumor that usually does not require treatment. Large liver hemangiomas in infants may occasionally require surgery to prevent bleeding into the heart.
Malignant liver tumors, or liver cancers, are classified into two types:
- Primary liver cancer originates in the liver itself. The most common type is Hepatocellular Carcinoma, often associated with chronic hepatitis B or C infection, as well as other factors like exposure to carcinogenic substances, alcoholism, and chronic liver disease. Other types include:
- Cholangiocarcinoma: Cancer originating in the bile ducts within or outside the liver.
- Hepatoblastoma: Cancer primarily affects infants and children, which can sometimes lead to the release of hormones causing early puberty.
- Angiosarcoma: A rare cancer originating in the blood vessels of the liver.
- Secondary liver cancer, also known as metastatic liver cancer, originates from tumors in other organs, usually the lungs, breasts, colon, and rectum. Other types include leukemia and various blood cancers that may occasionally spread to the liver. The majority of liver cancers are metastatic.
What are the symptoms of liver cancer?
- Abdominal pain
- Weight loss
- Nausea
- Vomiting
- Sensation of fullness in the upper right abdomen
- Fever
- Jaundice - yellowing of the skin and eyes
Patients diagnosed with metastatic liver cancer may experience additional symptoms, including:
- Poor appetite
- Fever
- Enlarged liver
- Ascites - fluid accumulation in the abdominal cavity
- Confusion
- Fatigue
Each individual may experience symptoms differently, and it is possible to have only some of them. Additionally, the symptoms of liver cancer can resemble other medical conditions. Therefore, it is always recommended to consult a doctor for a proper diagnosis.
How is liver cancer diagnosed?
The doctor will review the complete medical history, perform a physical examination, and may recommend one or more of the following tests:
- Special blood tests to assess liver function and tumor markers.
- Abdominal ultrasound, also called sonography, which uses high-frequency sound waves to create images of the internal organs, including the liver, gallbladder, and kidneys.
- Computed tomography (CT) scan, an imaging procedure combining X-rays and computer technology to produce detailed cross-sectional images of the body.
- Hepatic angiography, where contrast material is injected into the hepatic artery followed by X-rays of the liver.
- Liver biopsy, the procedure in which samples of liver tissue are taken using a needle or during surgery for microscopic examination.
Treatment for liver cancer
The specific treatment for liver cancer is determined by the doctor based on individual parameters such as age, overall health status, medical history, the extent of the disease, the patient's ability to tolerate medical interventions, and personal preferences.
The treatment plan may include one or more of the following treatments:
- Surgical removal of cancerous liver tissue. Surgical intervention is offered when the tumor is small and localized.
- Radiation therapy, which uses high-energy beams to kill or shrink cancer cells.
- Chemotherapy, which uses anti-cancer drugs to kill cancer cells.
- Liver transplantation.
Stages of liver cancer
When a doctor diagnoses liver cancer, the next step is to determine the extent of cancer spread, a process called staging. The National Cancer Institute defines the following stages of primary liver cancer:
- Localized cancer that is confined to the liver and can be completely removed surgically.
- Locally advanced cancer that is confined to the liver but cannot be completely removed.
- Advanced cancer that has spread extensively within the liver or to other parts of the body.
- Recurrent cancer that has returned after treatment.
What can be done?
In a healthy population, it is important to prevent the risk factors for liver tumor development, such as vaccination for Hepatitis B and maintaining a balanced risk profile in patients with fatty liver. In certain high-risk populations, regular ultrasound monitoring and alpha-fetoprotein protein levels are accepted practices.
For some benign liver tumors, hormone levels may be of importance, and therefore, discontinuing contraceptive pills to prevent pregnancy and discussing treatment and monitoring before conception is advisable.