Primary liver cancer is a life-threatening illness and one of the fastest growing cancer types in the United States. Most primary liver cancer is cancer in your liver and cancer in bile ducts in your liver. Both cancer types have common causes, risk factors, symptoms and treatments. Healthcare providers focus on identifying who might be at increased risk so they can catch and treat primary liver cancer as early as possible.
Liver cancer is a life-threatening illness and one of the fastest-growing cancer types in the United States. There are two kinds of liver cancer: primary and secondary. Primary cancer starts in your liver. Secondary cancer spreads to your liver from another part of your body. This article is an overview of primary liver cancer.
Like many kinds of cancer, healthcare providers can do more to treat liver cancer during the disease’s early stage. Unlike many kinds of cancer, healthcare providers have a good idea of what increases someone’s risk of developing liver cancer. With that in mind, healthcare providers are intent on identifying who may be at increased risk so they can catch and treat primary liver cancer as early as possible.
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No, it’s not common, but liver cancer cases are steadily increasing. Healthcare providers estimate about 1% of all men and women in the United States will be diagnosed with a form of liver cancer during their lifetime.
There are three kinds of primary liver cancer:
Overall, HCC and IHC represent about 2% of all new estimated cancer cases in the United States, and 5% of all new cancer deaths. Healthcare providers often diagnose and treat HCC and IHC the same way.
HCC and IHC affect more men than women and are most often diagnosed between the ages of 55 and 64. People whose race includes Asian/Pacific Islander, Hispanic or American Indian/Alaskan Indian are more likely to develop primary liver cancer than people who are Black or white.
Your liver is the largest organ in your body, helping you digest your food. It’s also one of the most important organs, as no one can live without their liver. Some of the essential tasks your liver manages include:
Liver cancer happens when something affects healthy liver cells’ DNA. DNA carries the genes that tell our cells how to function. We all have genes that tell cells when to grow, multiply and die. For example, oncogenes help cells grow and divide. Other genes, called tumor suppressor genes, monitor cell activity, keeping cells from multiplying uncontrollably and making sure cells die when they’re supposed to die.
When our DNA mutates or changes, our cells get new instructions. In HCC, DNA changes turn on oncogenes and/or turn off tumor suppressor genes. For example, studies show cirrhosis related to hepatitis B virus (HBV) and hepatitis C virus (HCV) account for more than half of all HCC cases. When these viruses infect liver cells, they change cell DNA, turning healthy liver cells into cancerous cells.
Healthcare providers believe long-term inflammation in your bile ducts increases the risk for developing IHC. This long-term inflammation may cause DNA changes that turn healthy cells into abnormal cells.
When liver cancer is in its early stages, you might have no symptoms at all. Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHC) have similar symptoms:
Unfortunately, you can have very early liver cancer without any symptoms. If you know you’re at risk for liver cancer, talk to your healthcare provider about tests to monitor your liver and possibly catch liver cancer in its earliest stage.
Your healthcare provider may suspect you have liver cancer if they find liver cancer signs and symptoms during your physical examination. They may order the following tests to learn more:
Your healthcare provider may do the following tests if they think you may have IHC:
Healthcare providers stage HCC using standards set by the Barcelona Clinic Liver Cancer system (BCLC). This system evaluates HCC liver on characteristics, including whether your liver is working well, tumor size and your symptoms. Healthcare providers may use different terms for each BCLC stage; sometimes, presented as being stages I to IV or 0-C or by terms such as early and advanced stage HCC.
Hepatocellular carcinoma stages include the following:
Healthcare providers have several common treatments for HCC and IHC, including surgery to remove part of your liver, liver transplantation and liver-directed treatments like hepatic arterial embolization and ablation. They may also use several types of chemotherapy, chemoembolization, radiation therapy, radioembolization, immunotherapy and targeted therapy.
While you can’t completely prevent liver cancer, you can do the following to lower your chances of getting liver cancer:
You can have very early-stage liver cancer without symptoms. Liver cancer screening is how healthcare providers monitor your liver’s health for signs of liver cancer. While there aren’t any standard liver cancer screening tests, your healthcare provider may recommend you have ultrasounds and blood tests every six months.
Successful liver transplants can cure liver cancer, but not everyone who needs a liver transplant will be healthy enough to go through a transplant or able to find a donor. Studies show people who have surgery to remove part of their liver tend to live longer than people whose illness prevents surgery. When that happens, healthcare providers focus on treatments to help people live with quality of life for as long as possible.
Healthcare providers are making progress on liver cancer treatment so people can live longer. But liver cancer remains a life-threatening disease.
Data show that 35% of people treated for early-stage hepatocellular carcinoma (HCC) liver are alive five years after diagnosis. About 12% of people treated for HCC that has spread to nearby tissues organs or lymph nodes are alive five years after diagnosis. About 3% of people treated for HCC that has spread further are alive five years after diagnosis.
The five-year survival rates for intrahepatic bile (IHC) duct cancer are 24% for bile duct that hasn’t spread outside of your liver, 9% for cancer that’s spread to nearby lymph nodes and 2% for cancer that’s spread further.
Liver cancer and liver cancer treatments take a toll on your body. Some people have liver transplants or surgery to remove part of their liver. Other people may need treatment for as long as they live. Either way, you should plan on regular appointments with your healthcare provider so they can monitor your progress and watch for signs of recurring liver cancer (cancer that comes back). For example, people who don’t have signs of liver cancer after treatment should plan on follow-up imaging and blood tests every three to six months for the first two years after treatment.
If you’ve been treated for liver cancer, here are some steps you can take that may reduce your risk for recurrent liver cancer:
A note from Cleveland Clinic
Primary liver cancer is a life-threatening illness. Often, people don’t know they have liver cancer until the cancer is in an advanced stage, which limits treatment options. When that happens, healthcare providers focus on treatments to relieve symptoms and slow cancer growth while helping you maintain a quality of life. If you have an advanced form of liver cancer, talk to your healthcare provider about your treatment options, including benefits and side effects so you can feel confident about your choices going forward.
Last reviewed by a Cleveland Clinic medical professional on 05/09/2022.
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