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Hepatocellular Carcinoma: Liver Cancer is also often referred to as Hepatic Cancer and is cancer that starts in the Liver. Cancer that starts in the liver is actually less common than cancer that moves (metastasis) from other parts of the body into the liver.

When cancer is determine primary – it originated in the Liver. When cancer is secondary – it originated in some other part of the body

It can be difficult to treat Liver Cancer and complete removal by surgery is successful in less then 20% of the cases. Cases of this cancer increases progressively with age – typically seen after 5th decade. There is a predominance that this cancer is found more often in men than women.

Cirrhosis of the liver is seen in 80% of those with cancer of the liver. Liver cancer can also develop from other structures inside the liver such as: Bile Duct, Blood Vessels, Immune Cells

Types of Liver Cancer

–  Hepatocellular Carcinoma  (HCC)  – 80% of cases
–  Cholangiocarcinoma  (Bile Duct) – 6-8% of casees
–  Hepatoblastoma
–  Mucinous Cystic Neoplasm
–  Papillary Bilary Neoplasm
–  Angiosarcoma   (Blood Vessels)
–  Hemangioendothelioma  (Blood Vessels)
–  Embyronal Sarcoma  (Blood Vessels)
–  Fibrosarcoma  (Blood Vessels)

Symptoms

–  Pain on the right side of upper Abdomen
–  Swelling on the right side of upper Abdomen
–  Lump on right side
–  Yellowing skin
–  Fever
–  Chills
–  Weight loss
–  Itching
–  Fatigue
–  Weakness
–  Easy bruising
–  Emesis
–  Anemia

Causes Worldwide include:

–   Hepatitis B and C
–  Metastases  (secondary cause)
–  Alcoholic Liver Cirrhosis
–  Hemochromatosis
–  Fungal infection:  Aspergillus flavus
–  Genetics

Diagnosis

–  Blood work including Alpha-fetoprotein
–  Ultrasound of abdomen
–  CT
–  MRI can be used for further evaluation
–  Liver biopsy can help staging.

TNM staging

T0: No evidence of primary tumor
T1: Solitary tumor without vascular invasion
T2: Solitary tumor with vascular invasion or multiple tumors none more than 5 cm
T3: Multiple tumors larger than 5 cm or tumor involving a major breach of the portal or hepatic vein
T4: Tumors with direct invasion of adjacent organs other than the gallbladder or with perforation of the visceral peritoneum

Treatment:

–  Surgical resection of the cancer may be curative in less then 20%
–  Liver transplant in individuals with advance cirrhosis
–  Chemotherapy
–  Cryosurgery – is a newer technique designed to freeze tissue
–  Radiotherapy
–  Hormone therapy with Tamoxifen=
–  Long-acting Octreotide

Some drug therapy used for Palliative

  –  Interferon
  –  Cisplatin
  –  Fluorouracil
  –  Taxol
  –  Doxorubicin
  –  Epirubicin
  –  Sorafenib – a new drug that has shown some promising results