Frequently Asked Questions About Liver Cancer

Here are some answers to frequently asked questions about liver cancer.

Q: Where is the liver in the body, and what does it do?

A: The liver is the largest solid organ in the body. It weighs almost 3 pounds. It is located behind the ribs on the right side of the body, under the right lung. It is important for many metabolic functions.

Q: Can a person live without a liver?

A: No. The liver stores nutrients that help feed the body when a person has not eaten for a few hours. It also changes other nutrients into more basic elements before sending them to other parts of the body to be used. The liver helps break down sugars, starch, fats, and proteins.

The liver also makes albumin, a protein that helps the body balance fluids. The liver makes clotting factors, which help blood thicken or clot when a person is bleeding. Bile made in the liver is important for digesting food and for other bodily functions.

One of the liver’s most important functions is to collect and destroy poisons in the body. The liver breaks down and removes medications. When the liver is not working well, chemicals can build up inside the body and cause damage.

Q: What is liver cancer?

A: Liver cancer is cancer that starts in the cells of the liver. It is not the same as cancers that start somewhere else in the body and then spread to the liver. Doctors call those cancers liver metastases.

Liver cancer is rare in the United States and Europe . It is the most common form of cancer in some African and East Asian countries, though. There are 4 main kinds of liver cancers.

  • Hepatocellular carcinoma

  • Cholangiocarcinoma

  • Hepatoblastoma

  • Angiosarcoma

Q: Who gets liver cancer?

A: Liver cancer is rare in the United States. In 2009, the American Cancer Society estimates, there will be 22,620 new cases of primary liver cancer and bile duct cancer (16,410 in men and 6,210 in women). Men are about twice as likely to get liver cancer as women. Liver cancer is more common in some African and East Asian countries than in North America and Europe . In some areas of Africa and Asia , it is the most common type of cancer.

Q: What are the symptoms of liver cancer?

A: A person can have liver cancer for months or years before having symptoms of the disease. People do not usually show symptoms of liver cancer until the cancer grows large enough to push against other parts of the liver or against other organs in the abdomen.

People with liver cancer may have any or all of these symptoms.

  • Weight loss

  • A sudden lack of appetite that lasts for a long time or a feeling of being very full after eating a small meal.

  • Lump or mass in the upper-right side of the abdomen or the stomach

  • Pain in the abdomen

  • Swollen abdomen (bloating)

  • Jaundice, which is eyes and skin that turn yellow

  • Cirrhosis that gets worse

  • Fever

All these symptoms can be caused by many other medical problems. If you have any of these symptoms, you should see your doctor as soon as possible.

Q: How is liver cancer diagnosed?

A: If you think you have liver cancer, you should have a medical exam. Many tests may be needed to confirm liver cancer. The steps to diagnosing liver cancer are a medical history, physical exam, and imaging tests. Tests for liver cancer include the MRI (magnetic resonance imaging) and CT (computed tomography) scan.

Q: Should everyone get a second opinion for a diagnosis of liver cancer?

A: Many people with cancer get an opinion from a second doctor. There are many reasons to get a second opinion. Here are some of those reasons.

  • Not feeling comfortable with the treatment decision

  • Being diagnosed with a rare type of cancer

  • Having several treatment options

  • Not being able to see a cancer expert

Many people have a hard time deciding on a liver cancer treatment. It may help to have a second doctor review the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion. Many other companies will pay for a second opinion if asked.

Q: How can someone get a second opinion?

A: There are many ways to get a second opinion.

  • Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

  • Call the National Cancer Institute’s Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

  • Consult the Official ABMS Directory of Board Certified Medical Specialists. This book lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries. You can also view it online at www.abms.org.

  • Seek other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of doctors who can give you a second opinion. Or ask other people who’ve had cancer for their recommendations.

Q: How is liver cancer treated?

A: You may have one treatment or many treatments together.

  • Surgery. The goal of surgery is to remove the whole tumor from the liver but leave as much of the healthy liver intact as possible. Surgery is the best chance for curing liver cancer. It should be done whenever possible. Newer local treatments have been developed. One of these is radiofrequency ablation. It uses high heat to “burn out” tumor cells. It can be performed at the time of surgery or done through a small incision in the skin (laparoscopically).

  • Chemotherapy. The goal of chemotherapy is to shrink the liver cancer. The other goal is to stop the cancer from spreading to other parts of the body. Chemotherapy can be given through the veins, called systemic treatment. It can also be given right into the hepatic arteries. This is called intrahepatic chemotherapy.

Doctors are always finding new ways to treat liver cancer. These new methods are tested in clinical trials. Before beginning treatment, you should ask your doctor if there are any clinical trials you should consider.

Q: What’s new in liver cancer research?

A: Here’s an overview of some new prevention and treatment being studied.

  • Ways to prevent hepatitis infections that cause this cancer

  • Drugs that treat chronic hepatitis. Scientists think hepatitis vaccinations may help prevent many cases of liver cancer.

  • New forms of chemotherapy, including drugs that can be taken in higher doses

  • Local chemotherapy, which is injected into or near the tumor, with the goal of having fewer side effects than systemic chemotherapy, which goes into the bloodstream.

  • Improved identification of which people with this cancer might benefit from liver transplants. Advances continue to be made in transplantation.

  • Gene therapy, which may improve a person’s chance of surviving liver cancer.

Q: What are clinical trials?

A: Clinical trials are studies of new cancer treatments. Doctors do clinical trials to learn how well new treatments will work. They also do trials to test for side effects. A promising treatment is compared to the current treatment to see if it works better or has fewer side effects.

People who participate in these studies may benefit from new treatments before the Food and Drug Administration (FDA) approves them. Research studies also help further our understanding of cancer and help future cancer patients.


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