What is Liver Cancer? What is Liver Cancer Treatment? 

October 12, 2021 Cancer Hub 558 Views

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What is the meaning of Liver Cancer? 

Liver cancer, also called hepatic/hepatocellular cancer or carcinoma, occurs when the liver cells start growing abnormally and destroy or damage the normal cells. Due to this,  the liver stops performing its normal functions. It is said to be occurring more commonly in males and above the age of 60 years.

The liver has various functions in the body like filtering blood circulating in the body, adding nutrients from the digested food to blood, absorbs drugs and converts them into chemicals to be taken up by the blood, removing harmful toxins and free radicals from blood, etc. Since the blood in the body has to pass through the liver, cancer cells from different parts of the body can easily affect the liver ( secondary liver cancer).

Primary cancer of the liver ( cancer that begins in the liver cells ) is rare and is mostly caused due to hepatic viral conditions like hepatitis, etc. Metastatic liver cancer is secondary to cancer occurring in other parts of the body and spreading to liver cells via the bloodstream. 

 Let us tell you in detail about liver cancer in today’s article.

  • What are the types of Liver Cancer?
  • What are the stages of Liver Cancer?
  • What are the causes of Liver Cancer?
  • What are the risk factors for Liver Cancer? 
  • What are the symptoms of Liver Cancer? 
  • How do you diagnose Liver Cancer? 
  • What are the treatments for Liver Cancer? 
  • How to prevent Liver Cancer? 
  • What are the complications of Liver Cancer?
  • What is the cost of Liver Cancer Treatment in India?

What are the types of Liver Cancer? 

Broadly, liver cancer can be classified as-

Benign tumors of liver- These are the non- cancerous tumors, which may be surgically removed if painful or bleeding occurs. Most commonly occuring are-

  • Leiomyoma of the liver
  • Fibroma of the liver
  • Lipoma of the liver
  • Cysts in liver
  • Focal nodular hyperplasia
  • Hepatic adenoma
  • Hepatic hemangioma

Malignancies of liver ( liver cancer)-  These are the cancerous types, spreading to other parts of the body and can be life threatening, thus need surgery or cancer therapy. These are-

  • Hepatocellular carcinoma (HCC)- Liver cancer
  • Cholangiocarcinoma- These are the cancers of the bile duct and need surgery.

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Following are some of  the types of liver cancer- 

  • Angiosarcoma of the liver – Also known as hemangiocarcinoma, this type of liver cancer accounts for about 1% of all liver cancer cases. This cancer starts in the blood vessels of the liver and grows rapidly.
  • Bile duct cancer – Also known as cholangiocarcinoma, this type of cancer is present in the small tube of the liver, i.e., the bile duct. This tube connects the liver to the gallbladder and is at risk of cancer. They account for 10-20% of all liver cancers. 
  • Hepatocellular carcinoma – Also referred to as hepatoma, is the most common type of liver cancer. It accounts for 75% of all liver cancers. This condition develops in hepatocytes, which are the main cells in the liver. This spreads from the liver to other parts of the body, such as the intestines, pancreas, and stomach. It is more likely to occur in people who have severe liver damage due to alcohol abuse or in patients of fatty liver, hepatitis, etc. If diagnosed at an early stage, patients can be treated with surgery or liver transplant. However, in advanced cases life of the patient can be prolonged by supportive treatment, but can not be cured.
  • Fibrolamellar hepatic cell carcinoma – It is comparatively more responsive to treatment than other types of liver cancer and is a rare type of Hepatocellular carcinoma (HCC).
  • Secondary liver cancer – It is also referred to as liver metastasis. It develops when primary cancer originating from another part of the body eventually spreads to the liver. A majority of liver metastases originate from colon or colorectal cancer. More than half of the patients diagnosed with colorectal cancer go on to later develop secondary liver cancer.

What are the stages of Liver Cancer?

  • Very early stage – The tumour is smaller than 2 centimeters (cm). There is no marked rise in pressure in the portal vein, which is one of the most important blood vessels of the liver. Bilirubin levels are normal. Surgery is usually recommended.
  • Early stage – The tumour is smaller than 5 cm in size. Liver function varies. There may be a rise in pressure in the portal vein, increased portal vein pressure and normal or increased bilirubin levels.
  • Intermediate stage – The tumour may be one single, large tumour or there may be multiple, smaller tumors. Doctors usually recommend regional therapies as the mode of treatment, such as transarterial chemoembolization.
  • Advanced stage – The tumour has either infiltrated the portal vein or has spread to various parts of the body, such as the lymph nodes, bones, and lungs. Targeted therapy is the preferred mode of treatment.

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What are the causes of Liver Cancer?

Liver cancer occurs when liver cells develop different mutations in their DNA. Liver cancer often occurs when there is a change in DNA in the cells. Due to this, the cells start growing uncontrollably and start forming tumors. 

Following are some of the common causes for developing liver cancer-

  • Viral infections like Hepatitis B or Hepatitis C- These spread through stools of infected persons or needle prick cross contamination, and symptoms of liver cancer may appear years after the viral infection. 
  • Liver cirrhosis – This is a very serious liver condition where liver cells are damaged and replaced by scar tissue, caused due to multiple reasons like chronic alcohol abuse, toxins, drugs, excessive iron stored in liver, viral infections, etc. 
  • Excessive drinking- Chronic intake of alcohol ( especially combined with smoking ) , daily intake of more than 2-3 drinks over years, has a very high risk of developing liver cancer. 
  • Obesity- This leads to fatty liver disease that increases the risk of liver cancer.
  • Diabetes- This may cause liver cancer in patients with uncontrolled diabetes and liver damage. 
  • Anabolic steroids- Muscle enhancing testosterone drugs used by males or athletes has very insulting effects on the liver cells in the long run and can cause liver cancer. 
  • Metabolic diseases like Iron storage diseases
  • Aflatoxins- This is a very harmful chemical, formed from the fungal molds present on peanuts, corn, nuts and grains. This causes liver cancer in many patients.

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What are the risk factors for Liver Cancer?

The following factors increase the chance of acquiring liver cancer:

  • Chronic hepatitis infection with the HBV or HCV virus raises the risk of liver cancer.
  • The accumulation of excessive fat in the liver increases the risk of liver cancer.
  • In some cases, liver cancer can occur due to genetic reasons or inherited diseases of metabolism such as Wilson’s disease or hemochromatosis, Tyrosinemia, alpha-1-antitrypsin deficiency,etc. 
  • People with diabetes are at a higher risk of liver cancer.
  • Obesity or being overweight can enhance the risk of developing liver cancer.
  • People who drink more alcohol are at higher risk of liver cancer and irreversible liver damage.
  • Exposure to aflatoxins (poisons produced by molds that grow on crops that are stored poorly) increases the risk of liver cancer. 
  • Males are at higher risk than females to develop liver cancer.
  • Certain communities and races are said to be more prone to developing liver cancer like Asian Americans and Pacific Islanders. 
  • Anabolic steroid abuse or excessive use of muscle enhancing male hormones, used by athletes, increases the risk of liver cancer upon prolonged use. 

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What are the symptoms of Liver Cancer?

Usually, symptoms of liver cancer may not be present in the beginning, but once cancer progresses, you may experience the following symptoms:

  • Nausea and vomiting
  • Swelling or bloating in the upper right part of the abdomen
  • Enlargement of the liver and spleen
  • Lump like feeling in the upper part of abdomen

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  • Swelling in the legs, feet
  • Loss of appetite
  • Pain or tenderness(pain upon touching) in the upper right part of the abdomen
  • Pale, chalky and dark stools, urine
  • Weight loss (unexplained)
  • Fatigue and tiredness 
  • Mental confusions
  • Yellowing of eyes and skin (jaundice)

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  • Itching in the different parts of the body
  • Feeling very full after a small meal
  • Fever
  • Abnormal bruising or bleeding
  • Spider veins or spider like skin lesions are seen in body
  • Loss or sexual drive

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How do you diagnose Liver Cancer? 

To diagnose liver cancer, your doctor will first do a physical examination and ask questions about any history of liver disease and alcohol addiction. The following tests can be done to confirm the exact diagnosis of liver cancer.

  • Physical examination – Your doctor will touch the abdomen to feel and check for swelling and lumps in the liver, spleen and other nearby organs. The abdomen is also checked for an abnormal buildup of fluid and for signs of jaundice (yellowing of the skin and the eyes).
  • Imaging Tests – In this screening process, your doctor may recommend imaging tests like ultrasound, CT, MRI, etc. This is done to identify any tumors and spread of tumors in the liver.
  • Blood tests – To find out the abnormal functioning of the liver, the doctor does a blood test of the patient. Your doctor will do a blood test to look for a substance called alpha-fetoprotein (AFP). It is found to be elevated in the blood of about 50% to 70% of people who have liver cancer. 
  • Angiogram – An angiogram is used to get a clear x-ray picture of the blood vessels. A dye is injected into the bloodstream to be able to visualise blood vessels of the liver. 
  • Liver biopsy – During a liver biopsy, your doctor either inserts a thin needle through the skin into the liver to take a small sample of your tissue , or, makes a small cut in the abdomen near the site of liver and takes the tissue biopsy directly from the liver.  This is done under anesthesia ( to prevent pain ).  In the lab, doctors examine the tissue sample under a microscope to look for cancer cells. However, liver biopsy carries the risk of injury, infection, and bleeding.
  • Biomarker testing of the tumor – Also called as molecular testing, your doctor may suggest conducting tests on a tumor sample to identify specific proteins, genes and other factors unique to the tumour. 
  • Laparoscopy – It is a test that allows the doctor to see the inside of the body with a thin, lighted, flexible tube called a laparoscope. It is not used often for diagnosing liver cancer.

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What are the treatments for Liver Cancer?

Treatment of liver cancer depends on the condition of the patient and the severity of the disease. These include:

  • Alcohol Injection – Also known as  percutaneous ethanol injection, where a thin needle is inserted with ultrasound assistance into the tumor and ethanol (alcohol) is injected directly into the tumor to destroy the cancer cells. The person remains unconscious during the procedure so that he does not feel any pain. For those who cannot get a liver transplant, it is considered a better treatment.
  • Radiofrequency ablation (RFA)– Here the radio waves are used to destroy the tumor cells. This method is used to treat some cases of liver cancer. 
  • Cryotherapy/ Cryoablation – This is the method where the tumor cells are frozen to stop the spread of the tumor. This is done with a thin metal probe that is inserted into the tumor or cancer growth and a cold gas is released that destroys the cancer cells. 
  • Surgery – Also known as partial hepatectomy, in this procedure that part of the liver which has cancer is removed.  Patients may experience pain, discomfort, weakness, diarrhea  and other symptoms for a few days. These symptoms subside with healing time and medications.

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  • Chemotherapy – Also called as chemoembolization, it is the use of medications to destroy or kill cancer cells. It is very effective in the treatment of cancer. But some people may experience some side effects during chemotherapy such as vomiting, loss of appetite, feeling cold, etc. Chemotherapy is also associated with an increase in the risk of infection.

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  • Radiation therapy – Radiation therapy is an attempt to kill cancer cells. Although, radiation therapy can be done either internally or externally. Radiation reduces symptoms outside of the liver and relieves pain within the liver by shrinking the tumor. Radioembolization therapy uses substances to shut down the blood supply to the tumor.
  • Immunotherapy-Here the drugs are used to activate the immune cells which find and kill the cancer cells. 
  • Targeted Therapy- In this method, drugs are given that target the cancer cells directly. These drugs then work by either blocking new blood vessels formation around the tumor, or attacking tumor growing proteins present on the cancer cells. This therapy might have side effects like – rashes, blisters, loss of appetite, pain and diarrhea, intestinal holes, bleeding, etc. 
  • Liver Transplant – Often in severe cases of liver cancer, the doctor may suggest a liver transplant. In this, your damaged and diseased liver is replaced by a healthy liver. If the medications fail to stop cancer, then a liver transplant is the only option. This procedure can be risky and offers some chance of long-term survival.
  • Medication – The drug sorafenib (Nexavar) is the first drug to significantly improve the rate of survival of patients with advanced liver cancer and is considered the drug of choice for such patients.

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How to prevent Liver Cancer? 

One can reduce the risk of developing liver cancer by the following methods or life style modifications-

  • Healthcare professionals at higher risk of exposures to hepatitis and other viral infections, must get immunized.
  • Excessive alcohol consumption must be avoided
  • Quit smoking or illegal drug abuse.
  • Follow safe sex measures.
  • Avoid IV drug usage ( unless no other option and incase of hospitalizations or emergencies)
  • Professionals working in an environment of toxic chemicals like pesticide factories, or other chemicals, etc must take safety precautions to prevent unnecessary or harmful chemical exposures.
  • Do not take iron supplements unless advised by the doctor.
  • Avoid over usage or long term usage of anabolic steroids. 
  • Weight should be kept within the BMI range, fatty liver patients need to consult with a doctor regularly for proper treatments.
  • Diabetics must keep these blood sugar levels monitored and controlled ( with lifestyle modifications, diet and medications ).

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What are the complications of Liver Cancer?

Liver cancer can lead to various complications due to pressure by the tumor on the bile duct or hormones that are produced by the cancer cells, or improper liver functioning or due lack of toxin releases from the body, etc. 

Some of the common complications are-

  • Anemia ( common complication of liver cancer, has symptoms like fatigue, shortness of breath, increased heart rate, etc )
  • Bile Duct Obstruction ( occurs when bile duct or liver cancer tumor growth exerts pressure inside, leading to symptoms like severe pain in upper right abdomen region, jaundice, vomiting, diarrhea )
  • Bleeding ( this happens because liver is responsible for making blood clotting factors, and when liver gets affected by cancer these factors are not produced enough leading to external bleeding like nose bleeds, gum bleeds or internal bleeding )
  • Portal Hypertension ( this can lead to varicosities in the small portal veins and increased pressure in the portal vein , which may rupture and can cause life threatening bleeding)
  • High blood calcium ( hypercalcemia)- Liver cancer may raise the blood calcium levels to toxic levels, leading to symptoms like nausea, vomiting and confusion and may result in coma and death in extreme cases. 
  • Hepatorenal syndrome- In this condition , there is kidney disease due to lack of blood supply to the kidneys. It is an irreversible condition.
  • Hepatic encephalopathy- This happens due to toxins getting accumulated in the brain, resulting in symptoms like memory loss, disorientation, confusion and personality changes. Symptoms may mimic Alzheimer’s disease. 

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What is the cost of Liver Cancer Treatment in India?

The total cost of Liver Cancer Treatment in India can range from INR 1,40,000 to INR 4,00,000. There are different specialized doctors and hospitals across India for the treatment of Liver cancer. However, cost varies across different hospitals.

If you are coming from abroad, in addition to the expenses of liver cancer treatment, there will be a cost of staying in a hotel, cost of living, and cost of local travel. Apart from this, after the surgery, the patient is kept in hospital for  days and in the hotel for 7 days for recovery. So, the total cost of Liver cancer treatment in India comes to be around INR 2,00,000 to INR 5,00,000. 

We hope that we could answer your questions regarding Liver Cancer Treatment through this article.

If you want more information and the treatment for Liver Cancer, then you can contact an Oncologist.

We only aim to provide you with information through this article. We do not recommend any medicine or treatment to anyone. Only a doctor can give you the best advice and correct treatment plan.

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