Whats Involved In Liver Cancer Screening
You can have very early-stage liver cancer without symptoms. Liver cancer screening is how healthcare providers monitor your livers health for signs of liver cancer. While there arent any standard liver cancer screening tests, your healthcare provider may recommend you have ultrasounds and blood tests every six months.
Heavy And Harmful Drinking
The liver is a tough and resilient organ. It can endure a high level of damage that would destroy other organs and is capable of regenerating itself. But despite the liver’s resilience, excessive alcohol intake over many years can damage it.
Every time you drink alcohol, your liver filters out the poisonous alcohol from your blood and some of the liver cells die. The liver can regenerate new cells, but if you drink heavily for many years, your liver will lose the ability to do this and it can become damaged and scarred over time.
Liver Cancer Causes Risk Factors And Prevention
Worldwide, liver cancer is the sixth most common cancer and the third leading cause of cancer death. In the United States, rates are highest in American Indian/Alaska Native individuals. The number of new cases of liver cancer continues to increase, making it the sixth leading cause of cancer deaths in the United States.
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Other Signs And Symptoms Of Liver Cancer
Other signs and symptoms include:
- Enlarged spleen felt as a mass under the ribs on the left side
- Feeling of fullness after eating a small amount of food
Many of these symptoms may be caused by other types of benign liver infections or diseases. In the case of liver cancer, the symptoms may continue to evolve and worsen as the tumor grows and the disease advances. If the patient notices potential symptoms, its important to see a doctor for an accurate diagnosis. Pain is especially common in patients with advanced-stage liver cancer. Because the cancer has likely spread by that point, the patient may be experiencing pain in both the primary liver cancer site and in areas the cancer has spread.
Questions To Ask Your Doctor
If you have been diagnosed with liver cancer, you may feel shocked and scared. This is understandable. You will want to get as much information as you can from your doctor so that you will understand what is going on. Here are some questions that you can ask when you have your appointment.
- Do I have primary or secondary liver cancer?
- How many tumors do I have?
- What size are these tumors?
- Are there other tests I will need such as biopsy, imaging scans or PET scans?
- Has the cancer remained in the liver or has it spread?
- What treatment options do I have?
- Will I have to stay in the hospital for my treatments?
- What can be done to relieve my symptoms from the cancer?
- How effective is the treatment for liver cancer?
- What are the side effects of the treatment?
- Is it possible for my tumors to return after I finish treatment?
- Would I benefit from participation in a clinical trial? If so, where can I find more information about trials?
- Is liver transplant a possibility for me?
- Should I change my diet before and during treatment? If so, what should I eat? What should I avoid?
- Are there any supplements or medications that I should take or avoid?
- Can you recommend any support groups for me, my caregivers, and my family?
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Reduce Your Risk Of Cirrhosis
Changes you can make to lower your risk of cirrhosis include the following:
If you drink alcohol, drink in moderation
Limiting the amount of alcohol you drink can help prevent liver damage. Because of the differences in how alcohol is processed in your body, moderate drinking guidelines differ by sex:
- Female: up to one alcoholic drink per day
- Male: up to two alcoholic drinks per day
Take steps to treat obesity
Having obesity increases your risk of liver cancer. Obesity is associated with a higher risk of nonalcoholic fatty liver disease, which can lead to cirrhosis.
Talking with a doctor is a good way to determine lifestyle changes or other treatments for obesity.
Live a healthy lifestyle
Higher levels of physical activity may reduce your risk of liver cancer. Exercising regularly can improve your general health. Its also an important part of maintaining your weight within a healthier range.
Eating a balanced diet is important for cancer prevention. Make sure you incorporate lean protein, whole grains, and vegetables into your meals.
If being overweight or having obesity is a concern for you, talk with a doctor or dietician about creating a meal plan for healthy weight loss.
If you already have one of these conditions and youre concerned about your risk for liver cancer, talk with your doctor about a liver cancer screening.
Treatment Of Pediatric Liver Cancer
Certain factors affect prognosis and treatment options. The chance of recovery and treatment options depend on the following:
- The stage of the cancer .
- Whether the cancer can be removed completely by surgery.
- The type of liver cancer.
- Whether the cancer has just been diagnosed or has recurred.
Prognosis may also depend on:
- Certain features of the cancer cell .
- Whether the AFP blood levels go down after chemotherapy begins.
Childhood liver cancer may be cured if the tumor is small and can be completely removed by surgery. Complete removal is possible more often for hepatoblastoma than for hepatocellular carcinoma.
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Can Liver Cancer Be Prevented
One way of preventing liver cancer is not to get hepatitis B or C. You can have a vaccination against hepatitis B. If you are exposed to these infections, for example, if you have sex or share needles with someone who has hepatitis, you should be tested to make sure you are not infected.
If you have hepatitis B or C, then your doctor may prescribe antiviral drugs to suppress the infection and reduce your risk of getting liver cancer. Your doctor may also monitor you regularly to detect problems early.
Is Liver Cancer A Common Disease
No, its not common, but liver cancer cases are steadily increasing. Healthcare providers estimate about 1% of all men and women in the United States will be diagnosed with a form of liver cancer during their lifetime.
There are three kinds of primary liver cancer:
- Hepatocellular carcinoma : This is the most common form of liver cancer, representing nearly all liver cancer cases.
- Intrahepatic cancer : This is a form of cholangiocarcinoma. IHC is cancer in your livers bile ducts. It represents about 10% to 20% of all primary liver cancer cases.
- Angiosarcoma: This type is very rare, representing about 1% of all primary liver cancer cases. This cancer begins in the lining of blood cells in your liver.
Overall, HCC and IHC represent about 2% of all new estimated cancer cases in the United States, and 5% of all new cancer deaths. Healthcare providers often diagnose and treat HCC and IHC the same way.
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Embolization For Liver Cancer
Some patients with tumors that cannot be removed by surgery can have embolization. It can be used for tumors that are too large to be treated with ablation. Embolization can also be used with ablation. Substances are injected into the tumor or nearby blood vessels, to try to block or reduce some of the blood supply to the cancer. This causes the cancer cells to die.
There are different types of embolization procedures . But this treatment may not be a good choice for some patients whose liver has been damaged by diseases like hepatitis or cirrhosis.
Side effects of embolization: Possible side effects after embolization include abdominal pain, fever, nausea, infection in the liver, gallbladder inflammation, and blood clots in the main blood vessels of the liver. Serious complications are not common, but they are possible.
Targeted Therapy For Liver Cancer
Targeted therapy uses drugs, different from chemotherapy, to treat certain types of liver cancer. These drugs affect mainly cancer cells and not normal cells in the body. They may work even if other treatment doesnt. They come as pills that you can take at home. These drugs have different side effects from chemo.
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Duration Of Liver Cancer
How long a person has liver cancer depends on the same factors that influence their prognosis. But many people who cant be cured are able to live with the cancer for years, and may die of other causes.
Some patients die with hepatocellular carcinoma, not from it, Strazzabosco notes. Patients with liver cancers require a really holistic approach, and they need to remain under close medical control, as in most cases the hepatocellular carcinoma recurs and needs to be treated again.
Selective Internal Radiation Therapy
Also known as radioembolisation, this treatment targets liver tumours directly with high doses of internal radiation in tiny beads. It is used for both primary and secondary cancers in the liver when the tumours can’t be removed with surgery. It is not available in all areas, so talk to your doctor about availability and costs involved.
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Medications For Liver Cancer
- Targeted drugs block specific abnormalities in cancer cells. Targeted treatments for liver cancer include kinase inhibitors and monoclonal antibodies .
- Immunotherapy uses the bodys own immune system to attack and destroy cancer cells. Medicines that target immune checkpoints proteins on immune cells that turn on or off to start a response are being used for liver cancer.
- Chemotherapy uses drugs to kill cancer cells. In liver cancer it is primarily used when other treatments have not been helpful.
Search For A Clinical Trial
Clinical trials are research studies that test how well new medical approaches work in people. Before an experimental treatment can be tested on human subjects in a clinical trial, it must have shown benefit in laboratory testing or animal research studies. The most promising treatments are then moved into clinical trials, with the goal of identifying new ways to safely and effectively prevent, screen for, diagnose, or treat a disease.
Speak with your doctor about the ongoing progress and results of these trials to get the most up-to-date information on new treatments. Participating in a clinical trial is a great way to contribute to curing, preventing and treating liver disease and its complications.
Start your search here to find clinical trials that need people like you.
Support for this page and the 2nd Annual The Educated Patient: A Liver Cancer Conferencemade possible by a grant from Exelixis
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How Does Liver Cancer Spread
Abnormal cells usually die off and are replaced by healthy cells. Sometimes, instead of dying off, these cells reproduce. As the cell numbers grow, tumors begin to form.
The overgrowth of abnormal cells can invade nearby tissue. By traveling through lymph or blood vessels, the cancerous cells can move all around the body. If they invade other tissues or organs, new tumors can form.
If the cancer invades nearby tissue or organs, its considered regional spread. This can happen during stage 3C or stage 4A liver cancer.
In Stage 3C, a liver tumor is growing into another organ . A tumor could also be pushing into the outer layer of the liver.
In Stage 4A, there are one or more tumors of any size in the liver. Some have reached blood vessels or nearby organs. Cancer is also found in nearby lymph nodes.
Cancer that has metastasized to a distant organ, such as to the colon or lungs, is considered stage 4B.
In addition to telling how far the cancer has spread, staging helps determine which treatments may be most helpful.
Remission means that you have fewer or no signs or symptoms of liver cancer after treatment. It doesnt mean that youre cured. You still might have cancer cells in your body, but your disease is under control.
Thanks to new targeted therapies like sorafenib , a very small percentage of people with late-stage liver cancer may go into complete remission.
How Is The Stage Determined
There are several staging systems for liver cancer, and not all doctors use the same system. The staging system most often used in the United States for liver cancer is the AJCC TNM system, which is based on 3 key pieces of information:
- The extent of the tumor : How large has the cancer grown? Is there more than one tumor in the liver? Has the cancer reached nearby structures like the veins in the liver?
- The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes?
- The spread to distant sites : Has the cancer spread to distant lymph nodes or distant organs such as the bones or lungs?
The system described below is the most recent AJCC system, effective January 2018.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a persons T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more information see Cancer Staging.
Liver cancer is usually staged based on the results of the physical exam, biopsies, and imaging tests , also called a clinical stage. If surgery is done, the pathologic stage is determined by examining tissue removed during an operation.
Cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.
* The following additional categories are not listed on the table above:
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What Is Liver Cancer
Liver cancer is a life-threatening illness and one of the fastest-growing cancer types in the United States. There are two kinds of liver cancer: primary and secondary. Primary cancer starts in your liver. Secondary cancer spreads to your liver from another part of your body. This article is an overview of primary liver cancer.
Like many kinds of cancer, healthcare providers can do more to treat liver cancer during the diseases early stage. Unlike many kinds of cancer, healthcare providers have a good idea of what increases someones risk of developing liver cancer. With that in mind, healthcare providers are intent on identifying who may be at increased risk so they can catch and treat primary liver cancer as early as possible.
Symptoms Of Liver Cancer
There are many signs and symptoms of liver cancer, but these can also be symptoms of other less serious conditions. Patients experiencing new symptoms should call their doctor to schedule an exam. For patients diagnosed with liver cancer, its important to start receiving treatment as early as possible.
Some of the symptoms of liver cancer include:
- Yellowing of the skin and eyes
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How Is Liver Cancer Treated
A team of medical specialists, nurses and other health professionals is likely to coordinate your liver cancer treatment.
The type of treatment you are given will depend on the stage of your cancer and your overall health, medical history, age and personal preferences.
Often a combination of therapies is used. Treatment options include destroying or slowing the growth of cancer through heating or freezing or surgery to remove the cancer.
The growth of cancer can also be slowed or stopped with chemotherapy or radiation therapy.
How Can I Prevent Liver Cancer
While you cant completely prevent liver cancer, you can do the following to lower your chances of getting liver cancer:
- Avoid behaviors that lead to cirrhosis.
- Reach or maintain a healthy weight.
- Get a hepatitis B vaccine. This vaccine is safe for nearly everyone. Ask your doctor about the hepatitis A vaccine.
- Avoid hepatitis C.
- If you have any liver disease, have diabetes, obesity or are a heavy drinker, ask your healthcare provider about liver cancer screenings.
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Other Liver Cancer Staging Systems
Several liver cancer staging systems have been developed that take into account how the function of the liver may affect the prognosis:
- Barcelona-Clinic Liver Cancer system
- Cancer of the Liver Italian Program system
Though the TNM system is the most common, theres no single staging system consistently used by the medical community, so if you have questions about your liver cancer stage, make sure to discuss them with your oncology team.
Tests That Might Be Done
If signs are pointing to liver cancer, more tests may be done. Here are some of the tests you may need:
Ultrasound: For this test, a small wand is moved around on your skin. It gives off sound waves and picks up the echoes as they bounce off tissues. The echoes are made into a picture on a computer screen. This test is often the first test used to look at the liver.
CT or CAT scan: This scan uses x-rays to make detailed pictures of your body. It can show the size, shape, and place of any tumors in or near the liver.
MRI: This scan uses radio waves and strong magnets instead of x-rays to make detailed pictures. MRI scans can help tell if tumors in the liver are cancer. They can also be used to look at blood vessels in and around the liver. They can help find out if liver cancer has spread.
Lab tests: Blood tests can check a protein called AFP . AFP is often very high in people with liver cancer. Other blood tests can also help find out how well the liver is working.
Liver biopsy: In a biopsy, the doctor takes out a small piece of tissue where the cancer seems to be. The tissue is checked for cancer.
There are many types of biopsies. Ask your doctor what kind you will need. Each type has risks and benefits. The choice of which type to use depends on your own case.
Sometimes MRI or CT scans clearly show liver cancer and a biopsy isnt needed.
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