Primary liver cancer begins in the liver and starts when liver cells accumulate DNA damage - this damage affects their ability to grow normally, and these abnormal cells clump together and form tumours. Liver cancer can also be a secondary type of cancer, meaning it has spread from somewhere else in the body. Secondary liver cancer is more common than primary liver cancer in the UK.
What causes liver cancer?
As with many cancers, a combination of different factors can influence a person’s individual risk of developing liver cancer. These can include genetics, age, or the presence of certain health conditions. The risk of developing primary liver cancer is increased if the liver becomes severely damaged (cirrhosis).
Severe liver damage can take a long time to develop. It can be caused by having a long-term condition which affects the health of the liver, such as non-alcoholic fatty liver disease, long-term exposure to alcohol or chemicals, or certain immune or inherited conditions.
Ongoing infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) can also cause cirrhosis, and are major risk factors for liver cancer. Worldwide, around 8 in 10 cases of primary liver cancer are linked to HBV and HCV infection. However, not all cases of liver cancer are linked to cirrhosis, and not everyone with cirrhosis will develop liver cancer. Ongoing international cancer research like ours is crucial to uncover new information about what causes liver cancer, and how we can better prevent, diagnose, and treat it.
Is liver cancer curable?
If liver cancer is diagnosed early on then it can sometimes be completely removed with surgery. Unfortunately if liver cancer spreads then it becomes much harder to treat and advanced stage liver cancer is often incurable.
We urgently need more research into liver cancer to help people around the world who have been diagnosed.
What type of cancer is liver cancer?
- Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It can grow as a single tumour, or many tumours can spread through liver. Most people diagnosed with HCC are older adults, but fibrolamellar HCC is a rare form of HCC which is more common in younger adults under 40.
- Bile duct cancer is a type of cancer that starts in the bile duct. These are small tubes which connect different organs involved in digestion, and are partly embedded in the liver.
- Hepatoblastoma is a very rare type of childhood liver cancer that is most common in children under two years old.
- Angiosarcoma is another very rare type of cancer that grows in the blood vessels or lymph vessels. This cancer sometimes grows in blood vessels which feed the liver.
How does liver cancer develop?
Cancer develops when mutations in your DNA accumulate and cause your cells to divide uncontrollably. Hepatocellular carcinoma, the most common type of liver cancer, develops when this happens to cells in the liver called hepatocytes. Other types of liver cancer develop in different liver cells.
In most cases, people who are diagnosed with liver cancer have pre-existing liver damage or cirrhosis. This damage makes liver cells more susceptible to cancer.
How is liver cancer diagnosed?
There are a variety of tests and scans that can help to diagnose liver cancer. These include:
- Blood tests: To see how well your liver is working and check the number of blood cells
- Scans: An ultrasound scan can show changes including abnormal growths; a CT scan can show a 3D image of the inside of your body; and MRI scans use magnetism and radio waves to take pictures.
- A biopsy: This involves removing a small piece of your liver which can then be studied under a microscope.
A combination of these methods is normally used to tell if someone has liver cancer and to help inform what treatment they need.
Why do we need more research into liver cancer?
The International Agency for Research on Cancer (IARC) estimates that new cases and deaths from liver cancer will rise by more than 55% by 2040. Researchers are not sure exactly why rates are rising, but links do exist between liver cancer and other conditions that are also on the rise, such as obesity and type- 2 diabetes.
Advanced liver cancer is particularly hard to treat, so we urgently need to find innovative ways to cure more patients worldwide. The more we can support researchers in the lab, the more time we can give patients with their loved ones.
What are common symptoms of liver cancer to be aware of?
Liver cancer in the early stages may not have any symptoms, and any that do appear may be quite non-specific, like feeling sick or tired and run-down. Other symptoms of liver cancer might include:
- Jaundice, which is yellowing of the whites of the eyes, and skin
- Appetite changes, like feeling full quickly
- Weight loss
- Itching
- Feeling bloated and swollen around the stomach
- Right shoulder pain (as swelling around the liver irritates nerves to the shoulder)
How is liver cancer staged?
Like a lot of cancers, liver cancer is described in stages and grades. The stage of the cancer describes its size and whether it has spread.
Understanding what stage of liver cancer a patient has helps medical teams to recommend the most suitable treatment options.
Stage 1
There is a single tumour in the liver.
Stage 2
The cancer might have grown into the blood vessels of the liver, or there might be two or more tumours in the liver.
Stage 3
There might be two or more tumours, or the cancer might have grown into the blood vessels of nearby organs.
Stage 4
The liver cancer has spread into lymph nodes or other parts of the body. Advanced liver cancer like this is much more difficult to treat.
How is liver cancer treated?
Treatment options for liver cancer can include surgery, chemotherapy or radiotherapy. Sometimes a liver transplant may be needed, like Curestarter Sam, who was diagnosed with advanced liver cancer when he was just 11 years old.
Surgery: This involves removing part of the liver. It is usually only an option if the cancer is in early stages, and the liver is healthy enough to regrow and repair over time. If surgery is not possible, other types of treatment might be used.
Embolization: This involves injecting tiny beads into blood vessels that feed the liver to block the tumour’s blood supply. Sometimes chemotherapy is also delivered locally to the liver alongside embolization. Or radioactive beads might be used, which can deliver radiation directly to the tumour.
Thermal ablation: Targeted microwaves or radiowaves are used to generate heat and destroy liver cancer cells.
Radiation therapy: External stereotactic radiation is a very accurate form of radiation. It might sometimes be used if surgery is not possible.
Targeted therapies: If the cancer has spread outside of liver cells to blood vessels or lymph nodes, doctors might also use targeted therapies. These aim to kill the cancer cell by exploiting specific molecular vulnerabilities.
Worldwide Cancer Research exclusively funds discovery research, the first step in the research journey, where scientists seek to uncover brand new information about the nature of cancer. Because we cannot cure what we don't understand.
Thanks to Curestarter support, Dr Pau Sancho-Bru in Spain hopes to find new ways to treat hepatoblastoma by investigating how liver cancer grows in children and how we can stop it.
Professor Giannino Del Sal and his team in Italy are working to understand why some people with a common liver disease go on to develop liver cancer. They hope to find vital information which could reveal new treatment approaches for people with non-alcoholic fatty liver disease (NAFLD) and liver cancer.
Your liver cancer FAQs:
How common is liver cancer?
Liver cancer is one of the most common cancers worldwide. In 2022 over 750,000 people worldwide died from liver cancer. In the UK it is not as common, but still around 7000 people in the UK are diagnosed with liver cancer every year.
What type of cancer is hepatocellular carcinoma?
Hepatocellular carcinoma is the most common type of liver cancer. It is also sometimes called HCC or hepatoma.
Can liver cancer spread to other organs?
Yes, liver cancer can spread to other organs. Unfortunately this makes it much harder to treat.
Is liver cancer linked to hepatitis?
Yes, there is a link between hepatitis and liver cancer. Both long-term hepatitis B and hepatitis C are risk factors for developing liver cancer.
Are liver cancer rates increasing?
Worryingly liver cancer rates are rising around the world. It is difficult to unpick exactly why this is, but some research indicates this could be related to increases in obesity and other lifestyle factors.
What research is being done on liver cancer?
Thanks to you, international cancer research is helping find new cures for liver cancer. From finding out how liver cancer grows in children to exploring potential new treatments, our researchers are answering some of the biggest questions about liver cancer. This sort of discovery research is vital to find new ways to prevent, diagnose and treat this deadly disease.
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