MultiCare Health System

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Cancer

Liver Cancer

If you’ve been recently diagnosed with liver cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field on oncology. Our world-class treatment facility offers cutting edge technology in a welcoming and positive healing environment.

Learn about our comprehensive treatment approach, our cancer care team or more about liver cancer in the tabs below.


Liver Cancer Facts

Basics

The liver is one of the largest organs in the body. It’s responsible for filtering harmful substances from the blood, making bile to help digest fats and storing glycogen (sugar), which the body uses for energy.

Liver cancer is the fourth most common cancer in the world yet is relatively uncommon in the United States. Chinese America men over 40 have a greater risk of developing liver cancer.

The most common form of liver cancer in adults is hepatocellular carcinoma (HCC). About 3 out of 4 cancers that start in the liver are this type. Some start as a single tumor that grows larger. Others start with many spots throughout the liver, as seen in people with ongoing liver damage (cirrhosis).

Symptoms

Some symptoms of liver cancer don’t appear until the disease has advanced. However, the following symptoms could be caused by liver cancer:

  • Unexplained weight loss
  • Lack of appetite and indigestion
  • Nausea or vomiting
  • Feeling very full after a small meal
  • Yellowing of the skin and eyes (jaundice)
  • Dark urine
  • White and chalky stool
  • Fever without infection
  • Worsening of chronic hepatitis or cirrhosis
  • Swelling in the leg or abdomen
  • A swollen liver or a mass that can be felt under the ribs on the right side
  • A swollen spleen, felt as a mass under the ribs on the left side
  • Pain in the belly or near the right shoulder blade
  • Swelling in your belly (abdomen)
  • Swollen veins on the belly that can be seen through the skin
Prevention

Causes and Risk Factors

Anything that increases the chance of getting a disease is called a risk factor. People who think they may be at risk should discuss this with their doctor. 

Taking steps to improve your health may lower your risk of getting kidney cancer. Ways to improve your health include quitting smoking, eating a healthy, balanced diet, getting regular exercise, lowering your blood pressure and avoiding exposure to environmental toxins.

Risk factors for liver cancer include:

  • Having Hepatitis B or Hepatitis C - having both types increases the risk
  • Being an African American, Chinese American, Hispanic or Caucasian male over 60 years of age
  • Family history hepatitis, metabolic diseases and liver cancer
  • Long-term exposure to anabolic steroids, birth control pills or arsenic
  • Having cirrhosis , which can be caused by:

o    Hepatitis (especially hepatitis C)
o    Drinking large amounts of alcohol for many years or being an alcoholic
o    Eating foods tainted with aflatoxin (poison from a fungus than can grow on foods, such as grains and nuts, that have been stored improperly)


Liver Cancer Screening

Liver cancer often does not cause symptoms until it is in its later stages, so it is seldom found early. Screening tests are not advised for people at average risk for liver cancer, but they may be done in people at high risk because some screening tests may cause harm.

Diagnosis

Detecting, Diagnosing and Staging Tests

Liver cancer can be diagnosed through blood tests, imaging, or invasive procedures such as a surgical biopsy or laparoscopy.

A blood test measures the level of alpha-fetoprotein , a specific protein produced by the liver. Elevated levels of alpha-fetoprotein are often high in people with hepatocellular carcinoma, the most common type of liver cancer.

Imaging tests include:

  • Ultrasound, which uses sound waves to produce a picture of the inside of the body
  • Computed Tomography or CT scan, which uses X-rays to take pictures of the body that are then combined by a computer to give a detailed cross-sectional image
  • Magnetic Resonance Imaging or MRI scan, which uses radio waves and strong magnets to provide a detailed image of the body
  • Angiography, an X-ray procedure for examining blood vessels


Invasive diagnostic techniques include:

  • Laparoscopy, which provides a view of the liver and other organs through a lighted tube
  • Endoscopy, which examines the interior lining of a body using an endoscope.
  • Cholangiography, which uses a needle, inserted into the bile ducts within the liver.


The only way to be certain if you have liver cancer is for your doctor to do a biopsy, in which a sample of tissue is taken and examined under a microscope. A pathologist can look at the tissue sample and see if it contains cancer.

Treatments

Surgery

Most liver cancers are treated by surgery to remove part of the liver. Up to 80 percent of the liver can be removed and subsequently regenerate itself if the rest of the liver is functioning properly. Surgery is done if the cancer has not spread to other lymph nodes or parts of the body.

Chemotherapy

Advanced liver cancer, cancer that is found in both lobes of the liver or that has spread to other parts of the body, cannot be cured but it is usually treated with chemotherapy (using drugs to kill cancer cells) and radiation therapy.

Other Treatments

Other treatments that can help control the disease and potentially help the patient live longer and better include:

  • Cryosurgery, which involves freezing and killing the tumor cells
  • Radiofrequency ablation, which involves a special probe to kill the cancer cells with heat
  • Alcohol ablation, which involves injecting ethanol directly into the tumor to kill the cancer cells
  • Chemoembolization, which involves injecting an anticancer drug through a catheter into the hepatic artery and then cutting off the blood supply to the tumor, depriving the tumor of life-giving oxygen.
  • Clinical trials may offer other treatment options as well.


Supportive and Integrative Therapies

In addition to the therapies described above, we offer integrative therapies such as nutritional therapy, physical therapy, yoga, massage and emotional counseling. Many of these therapies are remarkably effective in addressing the side effects of chemotherapy, surgery and radiation by easing tension, reducing pain and improving quality of life.