Primary liver cancer is cancer that forms in the tissues of the liver. Secondary liver cancer is cancer that spreads to the liver from another part of the body. Most primary liver cancers begin in hepatocytes (liver cells). This type of cancer is called hepatocellular carcinoma or malignant hepatoma. Liver cancer cells can spread by breaking away from the original tumor. They mainly spread by entering blood vessels, but liver cancer cells can also be found in lymph nodes. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
When you get a diagnosis of cancer, it's natural to wonder what may have caused the disease. Doctors can't always explain why one person gets liver cancer and another doesn't. However, we do know that people with certain risk factors may be more likely than others to develop liver cancer. A risk factor is something that may increase the chance of getting a disease.Studies have found the following risk factors for liver cancer:
Infection with hepatitis B virus (HBV) or hepatitis C virus (HCV): Liver cancer can develop after many years of infection with either of these viruses. Around the world, infection with HBV or HCV is the main cause of liver cancer. HBV and HCV can be passed from person to person through blood (such as by sharing needles) or sexual contact. An infant may catch these viruses from an infected mother. Although HBV and HCV infections are contagious diseases, liver cancer is not. You can't catch liver cancer from another person. HBV and HCV infections may not cause symptoms, but blood tests can show whether either virus is present. If so, the doctor may suggest treatment. Also, the doctor may discuss ways to avoid infecting other people. In people who are not already infected with HBV, hepatitis B vaccine can prevent HBV infection. Researchers are working to develop a vaccine to prevent HCV infection.
Heavy alcohol use: Having more than two drinks of alcohol each day for many years increases the risk of liver cancer and certain other cancers. The risk increases with the amount of alcohol that a person drinks.
Aflatoxin: Liver cancer can be caused by aflatoxin, a harmful substance made by certain types of mold. Aflatoxin can form on peanuts, corn, and other nuts and grains. In parts of Asia and Africa, levels of aflatoxin are high. However, the United States has safety measures limiting aflatoxin in the food supply.
Iron storage disease: Liver cancer may develop among people with a disease that causes the body to store too much iron in the liver and other organs.
Cirrhosis: Cirrhosis is a serious disease that develops when liver cells are damaged and replaced with scar tissue. Many exposures cause cirrhosis, including HBV or HCV infection, heavy alcohol use, too much iron stored in the liver, certain drugs, and certain parasites. Almost all cases of liver cancer in the United States occur in people who first had cirrhosis, usually resulting from hepatitis B or C infection, or from heavy alcohol use.
Obesity and diabetes: Studies have shown that obesity and diabetes may be important risk factors for liver cancer.
The more risk factors a person has, the greater the chance that liver cancer will develop. However, many people with known risk factors for liver cancer don't develop the disease.
Treatment options for people with liver cancer are surgery (including a liver transplant), ablation, embolization, targeted therapy, radiation therapy, and chemotherapy. You may have a combination of treatments.
The treatment that's right for you depends mainly on the following:
At this time, liver cancer can be cured only when it's found at an early stage (before it has spread) and only if people are healthy enough to have surgery. For people who can't have surgery, other treatments may be able to help them live longer and feel better. Many doctors encourage people with liver cancer to consider taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of liver cancer. Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat liver cancer include surgeons (especially hepatobiliary surgeons, surgical oncologists, and transplant surgeons), gastroenterologists, medical oncologists, and radiation oncologists. Your health care team may also include an oncology nurse and a registered dietitian.
Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.