Liver Cancer

Liver cancer is a type of cancer that begins in the cells of the liver. The most common form is hepatocellular carcinoma (HCC), which arises from the main liver cells called hepatocytes. Other, less common types include intrahepatic cholangiocarcinoma (bile duct cancer) and angiosarcoma (cancer of the blood vessels in the liver).

Causes and Risk Factors

• Chronic liver diseases, especially from:

  • Hepatitis B or C infections

  • Cirrhosis (from alcohol, fatty liver disease, etc.)

• Nonalcoholic fatty liver disease (NAFLD)

• Aflatoxin exposure (a toxin from certain molds)

• Genetic conditions (e.g., hemochromatosis, Wilson’s disease)

• Diabetes and obesity

  
  

Symptoms

Liver cancer may not show early symptoms. When present, symptoms may include:

• Unexplained weight loss

• Loss of appetite

• Abdominal pain or swelling

• Jaundice (yellowing of skin and eyes)

• Fatigue

• Nausea or vomiting

Diagnosis

• Blood tests: including alpha-fetoprotein (AFP) levels

• Imaging tests: Ultrasound, CT scan, MRI

• Biopsy: Sometimes used to confirm the diagnosis

• Liver function tests

  
  

Treatment Options

Treatment depends on the cancer’s stage, liver function, and overall health of the patient.

1. Curative Treatments

   • Surgery

     • Liver resection: Removing part of the liver

     • Liver transplantation: Replacing the diseased liver with a donor liver (for eligible patients)

   • Ablation therapies: Destroy tumors without removing them

     • Radiofrequency ablation (RFA)

     • Microwave ablation

     • Cryoablation

       
       

2. Locoregional Therapies

   • Transarterial chemoembolization (TACE): Injects chemotherapy directly into the liver tumor and blocks its blood supply

   • Transarterial radioembolization (TARE) or SIRT: Uses radioactive beads to target cancer cells

   • External beam radiation therapy: Sometimes used for symptom relief

     
     

3. Systemic Therapies

   • Targeted therapies: e.g., sorafenib, lenvatinib, regorafenib (Nexavar, Lenvima, Stivarga)

   • Immunotherapy: e.g., checkpoint inhibitors like atezolizumab + bevacizumab

   • Chemotherapy: Less commonly used due to limited effectiveness in liver cancer

     
     

4. Supportive (Palliative) Care

   • Focuses on quality of life and symptom management for advanced stages

Prognosis

• Depends heavily on:

  • Cancer stage

  • Liver function (often measured by the Child-Pugh score)

  • Overall health

• Early-stage liver cancer has a better prognosis, especially if curative treatment is possible.

• Advanced-stage liver cancer typically has a poorer prognosis but may benefit from new systemic therapies.