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.
Liver cancer - everything you need to know
13th March 2023
Liver cancer was the 6th most common cancer worldwide in 2020, diagnosed in over 900,000 people. In the UK, liver cancer is less common compared to other cancers, but cases are rising. We want to make a difference, and thanks to you, we can fund the most innovative liver cancer discovery research there is. So what is liver cancer? How does it start, and who is at risk? Find out in our quick explainer below.
What is liver cancer?
The liver is a large organ that is part of our digestive system. It removes toxins from our blood, and helps to turn our food into energy.
Primary liver cancer begins in the liver. It starts when liver cells accumulate DNA damage, and this damage affects their ability to grow normally. These abnormal cells clump together and form tumours.
Sometimes liver cancer can 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 types of liver cancer are there?
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 2 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.
What are the symptoms of liver cancer?
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- yellowing of the whites of the eyes, and skin
- Appetite changes, like feeling full quickly
- Weight loss
- Feeling bloated and swollen around tummy
- Right shoulder pain (as swelling around the liver irritates nerves to the shoulder)
What can cause 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.
How is research helping?
Researchers are still trying to understand why some cases of liver cancer develop. Understanding in detail how liver cancer develops will ultimately give more options for new and effective treatments.
That’s why projects like those led by Professor Raul Mendez and his team in Spain are so important. The researchers have been using Curestarter funding to explore a molecular ‘weak spot’ in liver cancer as a possible new target for therapy. His work should ultimately help researchers better understand some of the molecular mechanisms that control liver cancer, and how treatments could make use of them.
How is liver cancer treated?
Treatment options for liver cancer can include surgery, chemotherapy or radiotherapy. Sometimes a liver transplant may be needed.
Surgery 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. These can include:
- 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.
For some people a liver transplant might be the only option.
Worldwide Cancer Research supporter Sam was diagnosed with advanced liver cancer and needed a liver transplant when he was just 11 years old. Read Sam’s inspiring story here.
Why are liver cancer rates rising?
Liver cancer rates are increasing globally. 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.
In the UK, the British Liver Trust recently reported that liver cancer deaths are rising faster than any other major cancer, and cases have increased by 45% in the last decade alone.
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.
Finding ways to reduce the impact of these and other potentially modifiable risk factors on liver cancer is a current major focus of research.
How is your support helping liver cancer research?
Thanks to the vital support of our dedicated band of Curestarters, we have already been able to put over £3 million into 23 liver cancer research projects. Each project is focused on helping to unravel how and why liver cancer starts, and how to stop it.
Professor Georg Halder (shown in photo) and his colleagues in Belgium are using Curestarter funding to investigate the possibility of a brand-new treatment approach for bile duct cancer and liver cancer.
The team already have early data suggesting that stimulating healthy liver growth around tumours may help to reduce tumour size. Now this funding has made it possible for them to investigate this finding further. They hope to find out whether this approach may one day be able to help patients.
And in a brand new project starting later this year, Dr Fulvio Chiacchiera and his team in Italy are exploring how mutated proteins could make liver cancer more likely to develop.