Liver Cancer: Symptoms, Diagnosis and Treatment

This information is useful for children and adults
older man worried, possibly about a liver cancer diagnosis

Your liver is the largest organ in your abdomen (and your body). It weighs about the same as a half-gallon of milk you’d buy at the supermarket. It’s not only big in size, but also in importance—the liver performs essential functions, like removing waste and filtering out toxins (including medications and alcohol) from the blood. It also secretes bile and enzymes that allow the body to digest food and extract its nutrients, among other things.

Liver cancers are the 6th most common cancer type worldwide. Here in the United States, more than 40,000 liver cancer cases are diagnosed each year. People at the highest risk for liver cancer are those with viral infections of the liver (such as hepatitis) and chronic liver disease (cirrhosis). Fatty liver disease and alcohol-induced liver cirrhosis are other potential causes.

“It’s important to know that most liver diseases, which can lead to liver cancer, are treatable,” says Yale Medicine’s Mario Strazzabosco, MD, director of the Liver Cancer Program at Yale Cancer Center and a professor of medicine at Yale School of Medicine. “Also, many cases of hepatocellular carcinoma (HCC), the most common type of primary liver cancer, can be diagnosed early if high-risk patients are closely monitored by their doctor. There is a lot that we can do for patients diagnosed at an early stage, and some patients can be cured.”

Cancer, in general, occurs at the cellular level. In a healthy body, new cells are generated to replace old, dying ones. But when there’s a disruption—new cells form unnecessarily or old cells don’t die as they should—a collection of extra cells can form a tumor, or growth, that is either benign (not cancerous) or malignant (cancerous). To better understand and properly treat liver cancer, doctors will need to know whether the cancer is primary (started in the liver) or secondary (metastatic, meaning it is cancer that has spread from elsewhere in the body).

Primary Liver Cancer

Cancer that originates in the liver is called primary liver cancer. This includes any malignant growth of liver cells that can eventually spread (or metastasize) to other sites of the body. The most common type of primary liver cancer is called HCC, which is derived from hepatocytes (liver cells), most likely as a result of cirrhosis-related hepatitis B or C virus infections, steatohepatitis and alcoholic liver disease. HCC accounts for 90 percent of all primary liver cancer cases.

Other types of primary liver cancer include:

  • Fibrolamellar carcinoma: a variant of HCC with fibrous layers between tumor cells
  • Angiosarcoma: a cancer of the blood or lymph vessels in the liver
  • Hepatoblastoma: a rare type of childhood liver cancer
  • Cholangiocarcinoma: bile duct cancer

Secondary Liver Cancer

Secondary liver cancer (or liver metastasis) is a cancer that has spread to the liver from somewhere else in the body, such as the colon, breast or lung. When this occurs, the new growth contains the same type of cancer cells as the primary tumor. So, if colon cancer spreads to the liver, the liver tumor will contain colon cancer cells, not liver cancer cells. Secondary liver cancer occurs more frequently than primary liver cancer.