Liver Cancer

Liver cancer is the formation of malignant tumors in the liver due to the uncontrolled proliferation of liver cells.

Although secondary or metastatic liver cancer—where the liver presents metastases from another cancerous organ—is more common, there are different types of primary liver cancer:

• Hepatocellular carcinoma (HCC) or hepatocarcinoma: Originates in hepatocytes, the main liver cells. It accounts for 80-90% of liver cancers.
• Intrahepatic cholangiocarcinoma: Cancer that originates in the cells lining the bile ducts within the liver.
• Hepatoblastoma: The cancerous cells resemble fetal liver cells. This is a rare type of cancer that primarily affects children under three years old and rarely spreads.
• Hepatic angiosarcoma: Develops from the cells lining the liver’s blood and lymphatic vessels. It is extremely rare.
• Fibrolamellar hepatocellular carcinoma: Occurs in adolescents and adults under 40 with a healthy liver. It is extremely rare.

Hepatocellular carcinoma has a high mortality rate, ranking as the fifth leading cause of cancer-related death worldwide. This is mainly because it is usually detected in very late stages. However, research and new screening and early detection techniques have increased survival rates in recent years.

Symptoms

Liver tumors often do not cause symptoms in their early stages. Additionally, initial signs, when they appear, can be similar to those of other digestive conditions. The most common symptoms include:

• Jaundice: Yellowing of the skin and the whites of the eyes.
• Loss of appetite.
• Unintentional weight loss.
• Nausea and vomiting.
• Swelling under the ribs due to liver or spleen enlargement.
• Abdominal pain.
• Abdominal bloating due to fluid buildup.
• Weakness and fatigue.
• Itching.
• Pale-colored stools.

Causes

Carcinomas develop due to genetic mutations in cells that disrupt their division mechanisms, causing them to reproduce uncontrollably and form tumors. The exact cause of these mutations is unknown, but in the case of hepatocellular carcinoma, they almost always result from chronic liver disease, such as hepatitis or cirrhosis.

Risk Factors

The risk of developing liver cancer increases with the following factors:

• Presence of cirrhosis, hepatitis B, or hepatitis C.
• Excessive alcohol consumption.
• Hereditary liver disorders, such as hemochromatosis or Wilson’s disease.
• Non-alcoholic fatty liver disease.
• Diabetes.
• Obesity (increases the risk of fatty liver disease).
• Exposure to aflatoxin B1, a toxic substance produced by certain fungi in crops like corn, wheat, rice, or nuts.
• Smoking.

Complications

Hepatocellular carcinoma can cause:

• Systemic metabolic complications such as hypoglycemia, hypercalcemia, hyperlipidemia, or erythrocytosis, leading to additional symptoms like anemia, lethargy, tachycardia, dizziness, or circulatory disorders.
• Internal bleeding that appears as bruising when small tumors rupture.
• Portal vein hypertension, which can lead to spleen problems, leg swelling, and the formation of esophageal and gastric varices.
• Metastasis: Cancer cells spread through the bloodstream or lymphatic system to nearby organs, making treatment more difficult and significantly reducing chances of recovery.

Prevention

Preventing liver cancer involves protecting against the main diseases that contribute to its development:

• Getting vaccinated against hepatitis B.
• Limiting alcohol consumption.
• Maintaining a healthy weight.
• Practicing safe sex.
• Undergoing early detection tests if at risk.

Which Doctor Treats Liver Cancer?

Liver cancer is evaluated and treated in the gastroenterology (digestive diseases) and medical and radiation oncology departments.