If You Have been diagnosed or may have Liver Cancer

Liver cancer is a cancer that starts in the liver. It happens when cells in the liver start to change and grow out of control, crowding out normal cells. This makes it hard for the body to work the way it should. The liver makes bile to help the body use food. It also cleans the blood and helps the blood clot when you are cut. Liver cancer cells can spread to other parts of the body. When cancer does this, it is called metastasis. But even if a liver cancer spreads to your bones, it is still called and treated like a liver cancer, not bone cancer.

Types:

Primary liver cancer

If a cancer starts in the liver, it is called primary liver cancer. There are many types of liver cancer. Some are very rare. Your doctor can tell you more about the type you have.

Secondary liver cancer

Most of the time when cancer is found in the liver it didn’t start there. It spread there (metastasized) from somewhere else in the body. Because the cancer has spread from where it started, it’s called a secondary liver cancer. So, cancer that started in the lung and spreads to the liver is called lung cancer with spread to the liver, not liver cancer. And this cancer is treated like lung cancer.

Signs & Symptoms:

Liver cancer often doesn’t cause signs and symptoms until it has grown very large or spread.

Some symptoms of liver cancer are:

• unplanned weight loss
• don’t feel like eating
• feeling full after a small meal
• belly pain and swelling
• itchy, yellow skin.

The doctor will ask you questions about your health and do a physical exam.

Tests:

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 (alpha-fetoprotein). 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.

Understanding your stage:

If you have liver cancer, the doctor will want to find out how far it has spread. This is called staging. The stage describes the growth or spread of the cancer through the liver. It also tells if the cancer has spread to other organs of your body that are close by or far away. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

Staging the cancer Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means the cancer has spread outside the liver.

Be sure to ask about your cancer stage and what it means.

Treatment:

What kind of treatment will I need?

There are many ways to treat liver cancer, but the main types of treatment are:

The treatment plan that’s best for you will depend on:

• The stage of the cancer
• How well your liver is working
• The chance that a type of treatment will cure the cancer or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

Surgery for liver cancer is the only way to try to cure liver cancer. Surgery can be done to take out the part of the liver with the tumor or to do a liver transplant. Talk to the doctor about the kind of surgery planned and what you can expect.

Ablation is a treatment that destroys small liver tumors without taking them out. There are a number of ways to do this, such as heating the tumor with radio waves or microwaves, freezing the tumor, or killing the tumor by putting alcohol in it. Talk to the doctor about the planned treatment and what you can expect.

Embolization for liver cancer is an option for 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.

Radiation uses high-energy rays (like x-rays) to kill cancer cells. There are different kinds of radiation. One kind, called external beam radiation can be aimed at the liver from a machine outside the body. Another type of radiation treatment uses radiation and embolization (called radioembolization). It's done by using a needle to put small radioactive beads into the hepatic artery, a large blood vessel in the liver, so the radiation is very close to the cancer.

Chemo is the short word for chemotherapy – the use of drugs to fight cancer. The drugs may be given into a vein. These drugs go into the blood and spread through the body. Chemo is given in cycles or rounds. Each round of treatment is followed by a break. Chemo may be used to treat liver cancer, but it doesn’t work as well as other treatments for liver cancer.