Liver Cancer

Ask Glen!

Q. What is Liver Cancer?


A.Liver cancer is a form of cancer with a high mortality rate. Liver cancers can be classified into two types. They are either primary, when the cancer starts in the liver itself, or metastatic, when the cancer has spread to the liver from some other part of the body.

The liver continuously filters blood that circulates through the body, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. The liver performs many other important functions, such as removing toxins and other chemical waste products from the blood and readying them for excretion. Because all the blood in the body must pass through it, the liver is unusually accessible to cancer cells traveling in the bloodstream.

The liver can be affected by primary liver cancer, which arises in the liver, or by cancer which forms in other sites and then spreads to the liver. Most liver cancer is secondary or metastatic, meaning the malignancy originated elsewhere in the body -- usually the colon, lung or breast. Primary liver cancer, which starts in the liver, accounts for about 2% of cancers in the U.S., but up to half of all cancers in some undeveloped countries. This is mainly because of the prevalence of hepatitis, caused by contagious viruses, that predisposes a person to liver cancer. Worldwide, primary liver cancer strikes twice as many men as women and is most likely to affect people over 50.

Because the liver is made up of several different types of cells, several types of tumors can form in the liver. Some of these are benign (noncancerous), and some are cancerous and can spread to other parts of the body (metastasize). These tumors have different causes and are treated differently. The outlook for your health or recovery depends on what type of tumor you have.

The benign tumors of the liver include:

• Hemangioma
• Hepatic adenoma
• Focal nodular hyperplasia

None of these tumors are treated like liver cancer. They may need to be removed surgically if they cause pain or bleeding.

Liver cancers include:

• Hepatocellular carcinoma (HCC)
• Cholangiocarcinoma (These are really cancers of the bile duct. They will not be discussed in this article.)

This article discusses hepatocellular carcinoma. It's important to know what type of liver tumor you have. Be sure to get that information from your health-care provider.

What Causes It?

Primary liver cancer (hepatocellular carcinoma) tends to occur in livers damaged by birth defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, hemochromatosis (too much iron in the liver), and cirrhosis. More than half of all people diagnosed with primary liver cancer have cirrhosis (a scarring condition of the liver often caused by alcohol abuse, hepatitis B and C, and hemochromatosis that can cause permanent damage and liver failure), and those who suffer from a genetic condition called hemochromatosis, or iron overload, are at even greater risk.

Various cancer-causing substances are associated with primary liver cancer, including certain herbicides and such chemicals as vinyl chloride and arsenic. Smoking, especially if you abuse alcohol as well, also increases risk. Aflatoxins, cancer-causing substances made by a type of plant mold, have also been implicated. Aflatoxins can contaminate wheat, peanuts, rice, corn and soybeans. These are rare problems in most developed countries like the US.

Other risk factors include:

Your sex. Men are more likely to get hepatocellular cancer than women.

• Anabolic steroids. Male hormones used by athletes to increase muscle can slightly increase liver cancer risk with long-term use.
• Birth control pills. They may slightly increase the risk of liver cancer. Most of the ones linked to this cancer are no longer used.