LIVER CANCER

General Information

DEFINITION--Uncontrolled growth of malignant cells in the liver. Liver cancer may be primary--resulting from abnormal liver or bile-duct cells--or it may result from spread of cancer from another site (metastases). The most common sources are cancers of the rectum, colon, lung, breast, pancreas, esophagus or skin (melanoma).

BODY PARTS INVOLVED--Liver; bile ducts.

SEX OR AGE MOST AFFECTED--All ages, but most common in men over 60.

SIGNS & SYMPTOMS

• Loss of appetite and weight loss.
• Tender mass in the right upper abdomen.
• Pain in the upper abdomen.
• Low fever, usually less than 101F (38.3C).
• Yellow eyes and skin (sometimes).
• Swollen abdomen from fluid retention (sometimes).
• Lethargy.

CAUSES--Unknown. It occurs most often in population groups with a high incidence of viral hepatitis and other chronic liver diseases.

RISK INCREASES WITH

• Primary liver disease, such as cirrhosis of the liver.
• Use of anabolic steroids.
• Excess alcohol consumption.
• Previous hepatitis B infection.
• Chronic use of oral contraceptives.
• Hemochromatosis.
• Metabolic disorders.
• Gallstones, choledochal cysts, clonorchiasis (infection with a liver fluke commonly found in the Far East).

HOW TO PREVENT

• Hepatitis B vaccination and prevention education for high-risk individuals.
• Cancer screening and early diagnosis for high-risk individuals (laboratory test called alpha-fetoprotein or AFP).

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• A variety of diagnostic tests may be used to confirm diagnosis including blood studies, liver biopsy, x-ray, ultrasound, CT scan, MRI, arteriography, angiography and radioactive studies (See Glossary for all).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Anticancer drugs and radiation therapy are often used. They may afford some relief but won't cure (palliative).
• Surgery to remove the tumor may be recommended, depending on type and spread of the disease.
• Liver transplant may be considered for some patients.

POSSIBLE COMPLICATIONS

• Sodium retention, leading to life-threatening fluid accumulation in the abdomen and lower body parts.
• Kidney failure.
• Spread of cancer to other organs.
• Death from loss of liver function.

PROBABLE OUTCOME--This condition is currently considered incurable and fatal within a short time. However, pain can be controlled. Treatment is usually attempted, although it is not likely to be successful. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Patient care should involve comprehensive supportive care and emotional support.
• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Anticancer drugs.
• Pain relievers.

ACTIVITY--

• No restrictions. Stay as active as your strength allows.
• Hospice care, as an outpatient or inpatient, may be recommended as disease progresses.

DIET--High-calorie, low-protein diet.

Call Your Doctor If

• You have symptoms of liver cancer, especially unexplained weight loss, low fever or a mass in the abdomen.
• You develop a swollen abdomen during treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.