LIVER CANCER

Liver cancer has no symptoms of its own, but when the tumor grows it may cause pain in the upper section of the abdomen.  This may be accompanied by:

• Feeling tired all the time (fatigue),
• fever,
• chills, and
• night sweats
• Weight loss
• Loss of appetite
• Jaundice — yellowing of the skin and whites of the eyes
• Itching all over the body
• Swollen legs

Although the symptoms may be related to another liver disorder or some other ailment, it is best not to let them go undiagnosed. Early detection of cancer ensures better response to treatment.

DIAGNOSIS

Screening for early detection of primary liver cancer is not performed routinely, but it may be considered for people at high risk for the disease. It is done by performing ultrasound every six months.  However, studies haven’t determined if screening is beneficial for anyone. To diagnose liver cancer, a doctor must rule out other causes of liver dysfunction.

Patients at high risk include patients with a condition called hemochromatosis, chronic hepatitis, and alcoholics.

Additional tests include:

• Imaging with ultrasound is the initial diagnostic test as it can detect tumors as small as one centimeter.
• Blood tests that measure tumor markers, called alpha fetoprotein (AFP) that is normally present in fetuses may indicate liver cancer when it is elevated in adults. Elevated levels of iron may also be a tumor marker.
• A liver biopsy will distinguish a benign tumor from a malignant one. However, depending on the results of other tests, a biopsy might not be required to diagnose cancer. During a liver biopsy, a sample of the liver is taken and examined under a microscope.
• High resolution CT scans and contrast MRI scans are used to diagnose and stage these tumors.
• Laparoscopy, using tools and cameras through small incisions, is useful for detecting small tumors, determining the extent of cirrhosis, or obtaining a biopsy, and confirm previous tests, among other things.

RECOMMENDED MEDICATIONS

Treatments for liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.

Liver cancer treatment options may include:

• Surgery to remove a portion of the liver. In certain situations, your doctor may recommend partial hepatectomy to remove the liver cancer and a small portion of healthy tissue that surrounds it if your tumor is small and your liver function is good. This is recommended for smaller sizes of liver cancer.
• Liver transplant surgery. During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. This is reserved for advanced cases of liver cancer with very small, unresectable liver cancer.
• Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells.
• Heating cancer cells. In a procedure called radio frequency ablation, electric current is used to heat and destroy cancer cells.
• Injecting alcohol into the tumor. During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol causes the tumor cells to die.
• Injecting chemotherapy drugs into the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver. This technique is used on patients with large liver cancer.
• Radiation therapy. This treatment uses high-powered energy beams to destroy cancer cells and shrink tumors. During radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body. Radiation therapy for liver cancer may involve a technique called stereotactic radio surgery that simultaneously focuses many beams of radiation at one point in the body.
• Targeted drug therapy. Targeted drugs work by interfering with a tumor’s ability to generate new blood vessels. They have been shown to slow or stop advanced hepatocellular carcinoma from progressing for a few months longer than with no treatment.