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Here are some answers to frequently asked questions about liver cancer.
Q: Where is the liver in the body, and what does it do?
A: The liver is the largest solid organ in the body. It weighs almost 3 pounds. It is located behind the ribs on the right side of the body, under the right lung. It is important for many metabolic functions.
Q: Can a person live without a liver?
A: No. The liver stores nutrients that help feed the body when a person has not eaten for a few hours. It also changes other nutrients into more basic elements before sending them to other parts of the body to be used. The liver helps break down sugars, starch, fats, and proteins.
The liver also makes albumin, a protein that helps the body balance fluids. The liver makes clotting factors, which help blood thicken or clot when a person is bleeding. Bile made in the liver is important for digesting food and for other bodily functions.
One of the liver’s most important functions is to collect and destroy poisons in the body. The liver breaks down and removes medications. When the liver is not working well, chemicals can build up inside the body and cause damage.
Q: What is liver cancer?
A: Liver cancer is cancer that starts in the cells of the liver. It is not the same as cancers that start somewhere else in the body and then spread to the liver. Doctors call those cancers liver metastases.
Liver cancer is rare in the United States and Europe. It is the most common form of cancer in some African and East Asian countries, though. There are 4 main kinds of liver cancers:
Q: Who gets liver cancer?
A: Liver cancer is rare in the United States. In 2013, the American Cancer Society estimates there will be 30,640 new cases of primary liver cancer, and 2,000 to 3,000 people will develop bile duct cancer. Men are more likely to get liver cancer than women. Liver cancer is more common in some African and East Asian countries than in North America and Europe. In some areas of Africa and Asia, it is the most common type of cancer.
Q: What are the symptoms of liver cancer?
A: A person can have liver cancer for months or years before having symptoms of the disease. People do not usually show symptoms of liver cancer until the cancer grows large enough to push against other parts of the liver or against other organs in the abdomen.
People with liver cancer may have any or all of these symptoms:
A sudden lack of appetite that lasts for a long time or a feeling of being very full after eating a small meal.
Lump or mass in the upper-right side of the abdomen or the stomach
Pain in the abdomen
Swollen abdomen (bloating)
Jaundice (yellowing of the eyes and skin)
Cirrhosis that gets worse
All these symptoms can be caused by many other medical problems. If you have any of these symptoms, you should see your doctor as soon as possible.
Q: How is liver cancer diagnosed?
A: If you think you have liver cancer, you should have a medical exam. Many tests may be needed to confirm liver cancer. The steps to diagnosing liver cancer are a medical history, physical exam, imaging tests, and a liver biopsy. Tests for liver cancer include MRI (magnetic resonance imaging) and CT (computed tomography) scan.
Q: Should everyone get a second opinion for a diagnosis of liver cancer?
A: Many people with cancer get an opinion from a second doctor who is a liver specialist. There are many reasons to get a second opinion. Here are some of those reasons:
Not feeling comfortable with the treatment decision
Being diagnosed with a rare type of cancer
Having several treatment options
Not being able to see a cancer expert
Many people have a hard time deciding on a liver cancer treatment. It may help to have a second doctor review the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion. Many other insurance companies will pay for a second opinion if asked.
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion:
Ask a primary care doctor. He or she may be able to suggest a specialist who is a liver expert. This may be a hepatologist, surgeon, liver transplant surgeon, medical oncologist, interventional radiologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.
Call the National Cancer Institute’s Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.
Seek other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of doctors who can give you a second opinion. Or ask other people who’ve had cancer for their recommendations.
Q: How is liver cancer treated?
A: You may have one treatment or many treatments together:
Surgery. The goal of surgery is to remove the whole tumor from the liver, but leave as much of the healthy liver intact as possible. Surgery is the best chance for curing liver cancer. It should be done whenever possible. Newer local treatments have been developed. One of these is radiofrequency ablation. It uses high heat to “burn out” tumor cells. It can be performed at the time of surgery or done through a small incision in the skin (laparoscopically).
Chemotherapy. The goal of chemotherapy is to shrink the liver cancer. The other goal is to stop the cancer from spreading to other parts of the body. Chemotherapy can be given through the veins called systemic treatment. It can also be given directly into the hepatic arteries, the major blood vessels in the liver. This is called intrahepatic chemotherapy. Chemotherapy is almost never used to treat liver cancer.
Doctors are always finding new ways to treat liver cancer. These new methods are tested in clinical trials. Before beginning treatment, you should ask your doctor if there are any clinical trials you should consider.
Q: What’s new in liver cancer research?
A: Here’s an overview of some new prevention and treatment methods being studied:
Ways to prevent hepatitis infections that cause liver cancer
Drugs that treat chronic hepatitis. Scientists think hepatitis vaccinations may help prevent many cases of liver cancer.
New forms of targeted therapy, including drugs that can be taken in higher doses
Local chemotherapy with beads or oil injected into or near the tumor, with the goal of having fewer side effects than systemic chemotherapy, which goes into the bloodstream and throughout the entire body.
Radiation using radioactive beads or external beam radiation therapy.
Improved identification of which people with this cancer might benefit from liver transplants. Advances continue to be made in transplantation.
Gene therapy (research only), which may improve a person’s chance of surviving liver cancer.
Q: What are clinical trials?
A: Clinical trials are studies of new cancer treatments. Doctors do clinical trials to learn how well new treatments will work. They also do trials to test for side effects. A promising treatment is compared to the current treatment to see if it works better or has fewer side effects.
People who participate in these studies may benefit from new treatments before the FDA approves them. Research studies also help further our understanding of cancer and help future cancer patients.
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