Liver Cancer (Hepatocellular Carcinoma, Cholangiocarcinoma)
Overview
Liver cancer is a type of malignancy that begins in the cells of the liver. The two main primary liver cancers are:
- Hepatocellular carcinoma (HCC) – the most common type, usually arises in the setting of chronic liver disease
- Intrahepatic cholangiocarcinoma (bile duct cancer) – develops in the bile ducts within the liver
Symptoms
- Abdominal pain or swelling
- Weight loss and loss of appetite
- Jaundice (yellowing of the skin/eyes)
- Nausea or vomiting
- Fatigue
- Dark urine or pale stool
Causes & Risk Factors
- Chronic hepatitis B or C infection
- Cirrhosis (from alcohol, NAFLD, autoimmune hepatitis)
- Aflatoxin exposure
- Hemochromatosis and other genetic liver diseases
- Age >50, male sex
Diagnosis
- Liver function tests (ALT, AST, bilirubin)
- Tumor markers: AFP (for HCC), CA 19-9 (for cholangiocarcinoma)
- Imaging: CT, MRI with contrast, ultrasound
- Biopsy (if imaging is inconclusive)
Treatment Options
- Surgical resection (for localized disease)
- Liver transplantation (for select patients with cirrhosis and small tumors)
- Ablation (e.g., RFA or microwave)
- Transarterial chemoembolization (TACE) or radioembolization
- Systemic therapy (e.g., sorafenib, lenvatinib, immunotherapy)
Prognosis
- Depends on liver function and tumor stage
- 5-year survival:
- Localized HCC: ~35%
- Advanced/metastatic: <10%
- Cholangiocarcinoma often has poorer prognosis
Living with this Cancer Type
- Monitoring for liver function and complications (ascites, encephalopathy)
- Nutritional support and alcohol abstinence
- Managing side effects of systemic therapy
- Emotional and palliative care support
Prevention & Screening
- Hepatitis B vaccination
- Antiviral therapy for chronic HBV/HCV
- Regular surveillance (ultrasound and AFP every 6 months) for high-risk individuals
- Avoid alcohol and hepatotoxic drugs
FAQs
Q: Is liver cancer common?
A: It’s more common in Asia and Africa due to viral hepatitis prevalence.
Q: Can liver cancer be cured?
A: Yes, if detected early and treated with surgery or transplant.
Q: Who should get screened?
A: People with cirrhosis, chronic hepatitis B/C, or other liver disease.
Resources
- American Liver Foundation
- World Health Organization (Viral Hepatitis Program)
- ClinicalTrials.gov
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