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The most common form of primary liver cancer is hepatocellular carcinoma. Chronic infection with hepatitis B or C, alcoholism, chronic liver cirrhosis (scarring) and cancer-causing agents increase the risk of developing this type of tumor. Most liver cancers, however, have spread (metastasized) from other primary cancer sites. Beaumont's GI/Hepatobiliary Cancer Multidisciplinary Clinic streamlines care so that treatment can begin quickly. A Nurse Navigator helps gather the results of tests and schedules any additional screenings. Within a week, a team of specialists will meet with the patient to review the recommendations for treatment. For more information, or an appointment at the GI/Hepatobiliary Cancer Multidisciplinary Clinic, call 877-BEAT-CANCER (877-232-8226) today. If liver transplantation is an option, Beaumont offers minimally invasive procedures for living donors. Minimally invasive surgery shortens the recovery time and reduces the risk of complications.

Learn more about: Liver Transplantation

What is a tumor?

Tumors are abnormal masses of tissue that form when cells begin to reproduce at an increased rate. The liver can grow both non-cancerous (benign) and cancerous (malignant) tumors.

What are noncancerous liver tumors?

Noncancerous (benign) tumors are quite common and usually do not produce symptoms. Often, they are not diagnosed until an ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) scan is performed. There are several types of benign liver tumors, including the following:

• hepatocellular adenoma This benign tumor occurs most often in women of childbearing age. Most of these tumors remain undetected. Sometimes, an adenoma will rupture and bleed into the abdominal cavity, requiring surgery. Adenomas rarely become cancerous.
• hemangioma This type of benign tumor is a mass of abnormal blood vessels. Up to five percent of adults have small liver hemangiomas that cause no symptoms. Treatment is usually not required. Sometimes, infants with large liver hemangiomas require surgery to prevent clotting and heart failure.

What are cancerous liver tumors?

Cancerous (malignant) tumors in the liver have either originated in the liver (primary liver cancer) or spread from cancer sites elsewhere in the body (metastatic liver cancer). Most cancerous tumors in the liver are metastatic.

What is hepatoma (primary liver cancer)?

Also called hepatocellular carcinoma, this is the most common form of primary liver cancer. Chronic infection with hepatitis B and C increases the risk of developing this type of cancer. Other causes include cancer-causing substances, alcoholism, and chronic liver cirrhosis.

What are the symptoms of a liver hepatoma?

The following are the most common symptoms of a liver hepatoma. However, each individual may experience symptoms differently. Symptoms may include:

• abdominal pain
• weight loss
• swollen abdomen
• nausea
• vomiting
• large mass can be felt in upper, right side of abdomen
• fever
• fatigue (feeling very tired)
• jaundice - yellowing of the skin and eyes

The symptoms of a liver hepatoma may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is liver hepatoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for a liver hepatoma may include the following:

• liver function tests - a series of special blood tests that can determine if the liver is functioning properly.
• abdominal ultrasound (Also called sonography.) - a diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels.
• computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
• hepatic arteriography - x-rays taken after a substance in injected into the hepatic artery.
• liver biopsy - a procedure in which tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope.

Treatment for liver hepatoma

Specific treatment for liver hepatoma will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance of specific medicines, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• surgery In some cases surgery may be used to remove cancerous tissue from the liver. However, the tumor must be small and confined.
• external radiation (external beam therapy) External radiation is a treatment therapy that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes. If the liver cancer is more advanced, radiation may be used to shrink the size of the tumor and to provide relief from symptoms.
• chemotherapy Chemotherapy is the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual.
  • intra-arterial chemotherapy - chemotherapy is delivered directly to the liver tumor by injecting the anticancer drugs into an artery that supplies the liver.
  • chemoembolization - the blood supply to the liver tumor is blocked surgically or mechanically and anticancer drugs are given directly into the tumor. This allows a higher concentration of an anticancer drug to be in contact with the tumor for a longer period of time.
• radiofrequency ablation A special probe is used to kill the cancer cells with heat. The physician may insert the probe through the skin, using local anesthesia, or it may be inserted though a small incision in the abdomen, using general anesthesia. Laser and microwave therapy are other treatment therapies that use heat to destroy tumors in the liver.
• liver transplantation A liver transplantation may be a surgical option for a few patients.

What are other types of primary liver cancers?

Other, less common primary liver cancers include the following:

• cholangiocarcinoma - a cancer that originates in the lining of the bile channels in the liver or in the bile ducts.
• hepatoblastoma -  a cancer in infants and children, sometimes causing the release of hormones that result in early puberty.
• angiosarcoma - a rare cancer that originates in the blood vessels of the liver.

What are the stages of liver cancer?

When liver cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the liver to other parts of the body. This is called staging, and is an important step toward planning a treatment program. The National Cancer Institute (NCI) defines the following stages for primary liver cancer:

What is metastatic liver cancer?

Cancer that has spread from other areas in the body to the liver usually originated in the lung, breast, colon, pancreas, and stomach. Leukemia and other blood cancers sometimes also spread to the liver.

What are the symptoms of metastatic liver cancer?

The following are the most common symptoms of metastatic liver cancer. However, each individual may experience symptoms differently. Symptoms may include:

• weight loss
• poor appetite
• enlarged, hard and tender liver
• fever
• enlarged spleen
• ascites - fluid build-up in the abdominal cavity.
• jaundice - yellowing of the skin and eyes.
• confusion
• drowsiness

The symptoms of metastatic liver cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is metastatic liver cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for metastatic liver cancer may include the following:

• liver function tests - a series of special blood tests that can determine if the liver is functioning properly.
• abdominal ultrasound (Also called sonography.) - a diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver spleen, and kidneys and to assess blood flow through various vessels.
• computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
• liver biopsy - a procedure in which tissue samples from the liver are removed (with a needle or during surgery) for examination under a microscope.