Liver Cancer

Liver cancer begins in the cells of the liver, the football-sized organ in the upper right area of the belly. Around 1 percent of adults in the U.S. will be diagnosed with liver cancer.

Types & Stages

The most common type of liver cancer for adults is called hepatocellular carcinoma. Another type of liver cancer, called intrahepatic cholangiocarcinoma, is less common.

Children and infants can also develop liver cancer such as hepatoblastoma.

Many kinds of cancer, like colon and breast, can spread to the liver when they are more advanced. In this case, it is not liver cancer; it is metastatic cancer that has spread to the liver.

If you are diagnosed with liver cancer, your doctor will run tests to find out what stage it is. The stage means how big the tumor or tumors are and whether they have spread outside of the liver. Knowing the stage will help your doctor figure out the best treatment for you.

Signs & Symptoms

When liver cancer is in the early stages, it doesn’t usually cause symptoms.

When liver cancer gets more advanced, it can cause symptoms like:

• weight loss
• belly pain
• vomiting
• yellowing of the skin and eyes (jaundice)

Causes & Risk Factors

There are several factors that raise the risk of getting liver cancer, namely:

• Cirrhosis, a chronic liver disease that happens when scar tissue replaces healthy liver tissue.
   
• Chronic infection with hepatitis B or hepatitis C virus.
   
• Drinking a lot of alcohol, which can cause cirrhosis.
   
• Metabolic dysfunction-associated steatohepatitis (MASH), also called non-alcoholic steatohepatitis (NASH). This is a liver disease that happens when there is too much fat in the liver. It can damage the liver and lead to cirrhosis.

Not everyone with these risk factors will develop liver cancer. Sometimes people with no risk factors develop liver cancer.

Screening

If you don’t have any risk factors or signs of liver cancer, screening tests for liver cancer are not recommended for you.

If you are at higher risk of getting liver cancer, such as if you have cirrhosis, experts recommend getting screened with a blood test for AFP (alpha-fetoprotein) and an ultrasound. You should get these tests every 6 months.

Diagnosis

Doctors use different tests to diagnose liver cancer, including:

• Blood tests to see how the liver is working.
   
• Imaging tests, like ultrasound and CT, to look inside the liver.
   
• Biopsy, to look at a sample of the liver under the microscope.

Treatment

What liver cancer treatment you will get depends on many factors, including the size of your tumors and whether the cancer has spread outside of the liver.

Your treatment may include:

• Surveillance, which means being closely monitored every few months but not getting any active treatment.
   
• Surgery to remove part of the liver where the tumors are growing.
   
• A liver transplant.
   
• Ablation therapy, which is therapy that uses high-energy radio waves, hot or freezing temperatures, or pure alcohol to destroy tumors.
   
• CRS-HIPEC (cytoreductive surgery and heated intraperitoneal chemotherapy), a combination of surgery and chemotherapy for abdominal tumors. First, all visible cancer cells are removed with surgery, and then remaining cancer cells are killed with heat and chemotherapy. Stony Brook University Hospital is the only hospital on Long Island to provide CRS-HIPEC.
   
• Embolization therapy, a type of therapy that stops or slows blood flow to liver tumors. Some kinds of embolization therapy also deliver chemotherapy or radiation directly to liver tumors.
   
• Radiation therapy. At Stony Brook Medicine, most of our radiation treatments are given with x-rays and electron beams generated by machines called linear accelerators.
   
• Targeted therapy, which is therapy that is targeted to the genetic or molecular changes in your tumors.
   
• Immunotherapy, a type of therapy that helps your immune system find and attack your tumors.

At Stony Brook Medicine, our Palliative Care Service is available to everyone, no matter the stage of your cancer. This specialized team helps patients and their families cope with the physical, emotional, and spiritual distress of cancer. They can provide relief from symptoms of liver cancer and/or its treatment, such as pain, nausea, fatigue, and loss of appetite.