Liver Cancer

The liver is the largest internal organ in the body. It lies under the right ribs, just beneath the right lung and diaphragm (the membrane below the lungs that moves up and down as you breathe). The liver performs several vital functions. It processes and stores many of the nutrients absorbed from the intestine, makes some of the clotting factors needed to stop bleeding from a cut or injury, and secretes bile into the intestine to help absorb nutrients.

The liver also plays an important part in removing toxic wastes from the body. Because the liver is made up of several different types of cells, several types of tumors can form in the liver. Some of these are cancerous and some are benign (not cancerous).

Most of the time when cancer is found in the liver it spreads to the liver from a cancer that began somewhere else in the body. These tumors are named after the place where they began (primary site) and are further described as metastatic.

Facts: According to the Illinois State Cancer Registry, in 2008, about 650 new cases of liver cancer will be diagnosed in Illinois. Of these, about 460 will be in men and about 190 will be in women. About 520 Illinoisans are expected to die of liver cancer in 2008. Liver cancer occurs more often in people older than age 60.

The exact cause of liver cancer is not known. Scientists have found that people with certain risk factors are more likely than others to develop liver cancer. Common risk factors include:

Gender: Men are twice as likely as women to get liver cancer.
Obesity: Obesity increases the risk of developing liver cancer.
Family history: People who have family members with liver cancer may be more likely to get the disease.
Viral infection: The most important risk factor for liver cancer is a chronic infection (on-going) with the hepatitis B or the hepatitis C virus. These viruses can be passed from person to person through blood (such as sharing needles) or sexual contact. An infant may catch these viruses from an infected mother. Liver cancer can develop after many years of infection with the viruses.
Cirrhosis: Cirrhosis is a disease that develops when liver cells are damaged and replaced with scar tissue. It may be caused by alcohol abuse, certain drugs or chemicals and certain viruses or parasites. About 5 percent of people with cirrhosis develop liver cancer.
Smoking and alcohol: There is a link between smoking and liver cancer. The risk may be even greater for people who also abuse alcohol.
Aflatoxin: Liver cancer can be caused by aflatoxin, a harmful substance made by certain types of fungus that can contaminate peanuts, wheat, soybeans, ground nuts, corn and rice. Long-term exposure to aflatoxins increases the risk of liver cancer.

Most of the time liver cancer in the early stages does not cause symptoms. If symptoms are present, they may include:

• unexplained weight loss
• on-going lack of appetite
• fullness after a small meal
• a swollen liver or a mass that can be felt in the area of the liver
• ongoing stomach pain extending to the back and shoulder
• a swollen abdomen
• yellow-green color to the skin and eyes (jaundice)
• increased symptoms of illness in those who have chronic hepatitis or cirrhosis

The above symptoms could be caused by liver cancer, but they also can be caused by other cancers or conditions. It is important to report any of these symptoms to a doctor.

Measures that reduce exposure to risk factors can help prevent most liver cancer.

• Get a vaccine to prevent hepatitis B. All children and high risk adults should have this vaccination.
• Prevent exposure to hepatitis C by knowing the way it spreads (blood transfusions, sharing contaminated needles by IV drug abusers and having unprotected sex). Studies suggest that the drugs interferon and ribavirin may prevent the development of liver cancer in people who have hepatitis C.
• Do not abuse alcohol, which can prevent liver cirrhosis that can lead to liver cancer.
• Quit smoking.

• American Cancer Society
• National Cancer Institute
• American Liver Foundation