Liver Cancer

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The incidence of the liver cancer increases worldwide. The tumor tends to behave aggressively and when not diagnosed early, it has a very serious prognosis.


The most important cause of liver cancer is liver cirrhosis and all its causes (alcoholism, certain types of viral hepatitis and others) – for more information, see the related article. In addition, the liver cancer may be caused by harmful substances released by some fungi such as the carcinogenic aflatoxin produced by aspergillus. This fungus can invade poorly stored food (nuts, cereals, rice) in a humid environment and fill them with aflatoxin. In many patients, the real primary cause of the liver cancer is not known.


There are many possible symptoms. Early stages may be asymptomatic, but as the tumor grows, it causes liver enlargement with pressure abdominal pain located in the upper right abdominal quadrant. Other symptoms include weight loss, fatigue, symptoms of liver failure and complications of cirrhosis (jaundice, portal hypertension, ascites, esophageal varices, etc.).


The best method to detect the presence of cancer is the liver ultrasound. This is the reason, why patients with liver cirrhosis should undergo regular examinations including the abdominal ultrasound. Computed tomography is even better imaging method, which can precisely show the location and extent of tumor. Liver cancer may damage liver cells, and thus increase the liver tests. When there is a suspicion of a liver cancer, it is wise to evaluate the serum level of a tumor marker known as alpha-fetoprotein (AFP). It is a substance, whose concentration is usually significantly increased in patients with primary liver tumors. When possible, liver biopsy of any suspicious lesion should be performed to obtain a sample of its tissue for histological confirmation.


It is especially important to prevent any risk factors of cirrhosis as the majority of them may cause liver cancer as well.


Early stages of the tumor may be treated with surgical intervention. The removal of the tumor mass and a part of the liver tissue may be combined with chemotherapy. The chemotherapy alone has not curative results.


Note: Primary tumors of the liver are much less common as liver metastases of other cancer diseases, especially tumors of the digestive tract. The blood from the gastrointestinal tract flows directly into the liver through the portal vein and any tumor cells have an easy way into the liver tissue. The metastases can be found randomly without obvious symptoms, or they may cause similar symptoms as the liver cancer. Of course, the presence of liver metastases considerably worsens the prognosis of any malignant tumor.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources