What is Liver Cancer – Hepatocellular Carcinoma (HCC)?
HCC is characterized by the formation of a primary hepatic tumor. This is a cancerous tumor which forms directly within the liver tissue. (3)
Liver cancers usually occur in people who have sustained long term liver damage. Men are also more likely to develop liver cancer than women. (4)
Your liver is a vital organ, meaning you cannot survive without it. This organ, located in your abdomen, performs many essential functions in your body. (5)
If your liver is already damaged by illness or disease, you are more likely to develop hepatocellular carcinoma. Excessive alcohol consumption, hepatitis B and C and fatty liver disease significantly increase your risk of hepatocellular carcinoma. (6)
Unfortunately, HCC does not usually present with symptoms until it is advanced. Signs of this primary liver cancer can include: (7)
Abdominal Pain and Swelling
Abdominal pain in your upper right side can indicate hepatocellular carcinoma. You may feel the enlarged mass of your liver under your ribs, your abdomen could also swell up as a result.
Jaundice is a common sign of liver dysfunction. This is due to a buildup of bile in your body. This symptom manifests as your skin or the whites of your eyes developing a yellow tinge. (8)
Unintentional or unexplained weight loss which occurs rapidly can be a symptom of advanced HCC.
Loss of Appetite
Loss of appetite can be a warning sign of hepatocellular carcinoma. You may also feel full even if you have only consumed a small amount of food.
There are a multitude of staging methodologies for hepatocellular carcinoma (HCC).
TNM is an abbreviation for tumor – node – metastasis. Each stage covers information about these three factors.
Tumor (“T”) details the size, amount and spread of the growth within the affected area.
Node (“N”) describes whether the tumor has reached lymph nodes nearby. Metastasis (“M”) concerns the spread of liver cancer to distant organs or lymph nodes.
The stages of HCC according to the TNM system are as follows: (11)
A tumor at this stage is “Ta”, meaning it is two centimeters or smaller. It has not yet grown into nearby blood vessels
There are no malignant cells in lymph nodes nearby (N0) or distant regions of the body (M0).
The tumor hasn’t multiplied, but it is larger than two centimeters (T1b).
It is not yet growing into any blood vessels, lymph nodes, or distant areas (N0 and M0).
At this stage, two tumor scenarios are possible. The first, you have one tumor of two centimeters or larger growing into your blood vessels.
The second option is you have multiple tumors, but they don’t exceed five centimeters in size. In both cases the tumor is classified as T2.
The cancer is still contained exclusively to the liver (N0 and M0).
This stage is characterized by numerous tumors. One or more of the growths measure a diameter of over 5 centimeters.
Your lymph nodes and other parts of the body are still untouched by cancer (N0 and M0).
By now, a minimum of one tumor is advancing into a branch of the hepatic or portal veins. These are large veins inside your liver.
Tumors at stage 3b are classified as T4. Your lymph nodes and the rest of your body are still cancer-free (N0 and M0).
You have one or more tumors of any possible size (any T). The cancerous cells have begun to reach nearby lymph nodes (N1).
This is the most advanced stage of liver cancer. You may have one or numerous tumors which can be of any proportion (any T).
By now the cancer may have spread to surrounding lymph nodes (any N). However, it has definitely begun to appear in distant regions, such as the lungs or bones (M1).
If you present with symptoms of hepatocellular carcinoma (HCC), your doctor will perform a physical exam. During this exam, your doctor will check for physical manifestations of liver cancer, such as jaundice.
The next step is imaging tests to view and examine your liver. These can include an ultrasound, CT scan, or MRI.
If imaging tests do not conclusively reveal cancer, you may have a biopsy. A sample of tissue from your liver will be analyzed in a laboratory.
Finally, blood tests will check how your liver is functioning. These checks are essential for establishing what condition your liver is in before proceeding with treatment. (12)
Treatment for HCC aims to manage the spread of the cancer. You will receive one or more of the following treatment options: (13)
A liver transplant involves replacing your diseased liver with a healthy one from a deceased donor. Alternatively, a relative can donate a portion of their liver to transplant. (14)
This major operation offers the best possible outcome for early stage HCC. However, the operation itself comes with serious risks.
Unfortunately, donors are limited. For this reason, it is a difficult and lengthy process to qualify for a liver transplant. (15)
Surgical resection is the next best option for treating early stage HCC. The cancerous areas and growths in your liver are removed surgically.
As with a liver transplant, surgical resection is a major operation, which means there are risks involved. Approximately one in 30 patients die during the procedure or shortly after it. (16)
Ablation is an option when the cancer cannot be surgically removed. This treatment involves using chemicals or thermal waves (e.g. lasers) to destroy cancerous cells.
Needles are inserted through your skin or an incision to target the affected areas. You may have to be kept in the hospital overnight, depending on what stage your HCC is.
Ablation carries a low risk of complications compared to surgical resection and liver transplantation. You may experience discomfort for several days after the procedure. (17)
The chemotherapeutic drug sorafenib is used to treat advanced hepatocellular carcinoma. It is a type of cancer-killing drug administered in tablet form.
Sorafenib is often used alongside other treatments, such as transarterial chemoembolization (TACE). (18)
Transarterial Chemoembolization (TACE)
Transarterial chemoembolization (TACE) cuts off the blood supply to a cancerous tumor in an attempt to kill it off.
A substance such as gelatin, soaked in a chemotherapy drug, is inserted into the arteries which are responsible for tumor growth.
This treatment may result in the damage of healthy liver cells as a side effect. (19)
What is liver cancer – hepatocellular carcinoma (HCC)? Liver cancer consists of any type of cancer which affects your liver. Hepatocellular carcinoma (HCC) is the most prevalent form.
What are the signs of liver cancer – hepatocellular carcinoma (HCC)? The signs of HCC include abdominal pain and swelling, loss of appetite, jaundice and weight loss.
How do you develop liver cancer – hepatocellular carcinoma (HCC)? HCC typically develops in individuals with heavily scarred or damaged livers. People with hepatitis B and C are most at risk. (20)
How are you diagnosed for liver cancer – hepatocellular carcinoma (HCC)? Your doctor will perform imaging and blood tests to check your liver. A liver biopsy might also be performed. (21)
What is the best treatment for liver cancer – hepatocellular carcinoma (HCC)? A liver transplant is the ideal treatment for HCC. Other options include surgical resection, ablation, sorafenib or transarterial chemoembolization (TACE).
What are the long term complications of liver cancer – hepatocellular carcinoma (HCC)? Aside from damaging your liver, HCC can spread (metastasize) to other areas of the body, such as your lungs. (22)
Is liver cancer – hepatocellular carcinoma (HCC) considered a disability? Yes, liver cancer is considered a disability. (23)
Is there any cure for liver cancer – hepatocellular carcinoma (HCC)? It is very rare that HCC is cured completely. However, the condition can be managed with treatment, although it can return even after a liver transplant. (24, 25)
Is liver cancer – hepatocellular carcinoma (HCC) life threatening? Yes, this cancer can be life threatening, it is typically diagnosed in advanced stages. The average survival rate following diagnosis is between six and 12 months. (26)
Liver scarring (cirrhosis) and conditions such as hepatitis B or C put you at high risk of hepatocellular carcinoma.
If you are at threat, you may want to have regular screenings every six to 12 months in the form of imaging and blood tests. The earlier HCC is diagnosed, the better your prognosis will be. (27)
Liver cancer cannot entirely be prevented. However, you can lower your risk by reducing excess alcohol consumption, which can result in liver damage over time. You can also avoid viral hepatitis infections by practicing safe sexual intercourse and avoiding injecting narcotics.
Smoking is also a major risk factor for many types of diseases and cancer in general. Therefore if you are a smoker, you should make an effort to quit. (28)