Mayo Clinic explains liver cancer

Sean P. Cleary, M.D., Hepatobiliary and Pancreatic Surgeon, Mayo Clinic: Hello. I’m Dr. Sean Cleary, a liver surgeon at Mayo Clinic. In this video, we’ll cover the basics of liver cancer: What is it? Who gets it? What are the symptoms, diagnosis and treatment? Whether you’re looking for answers for yourself or someone you love, we’re here to give you the best information available. First, before we get into liver cancer, let’s talk about what your liver actually does. Your liver is a football-sized organ that sits under the right portion of your abdomen, beneath your diaphragm and beside your stomach. The liver has over 500 known functions. But the most common way the liver works is by balancing the chemicals in your blood, making bile–which is a crucial part of the digestive process, clearing toxins from the blood and regulating blood clotting. Each year, about 24,500 men and 10,000 women are diagnosed with liver cancer in the United States. Most people who have cancer in the liver have cancer that spreads, or metastasizes, to the liver from another site, such as the colon, breast, stomach or other organs. It is important to differentiate this type of cancer from liver cancer that begins in the liver cells. The treatment of cancer that spreads to the liver, rather than starting in the liver, is determined by the original organ in the body where the cancer started. So for example, if the cancer started in your colon and then spread to the liver, it would be called metastatic colon cancer. Today we’ll be focusing on liver cancer that starts in the liver. As with all cancers, liver cancer start when changes or mutations accumulate in the DNA of those liver cells. The cells DNA is the material that provides instructions for every chemical and structural process in your body. DNA mutations cause changes in these instructions. And when enough of these mutations accumulate and affect important genes the cells can begin to grow out of control and eventually form a tumor or a mass of cancerous cells.

Who gets it?

Most liver cancers occur in people with an underlying liver disease. But sometimes liver cancer happens in people with no underlying liver disease and it’s not exactly clear why. Liver disease can cause longstanding inflammation in the liver and accumulate mutations that can lead to cancer. One of the big problems is that many people can have liver disease and not be aware of it until their liver is quite damaged or a cancer forms. Here are some things that we know increase your risk of developing liver cancer: If you have chronic infections of hepatitis B or C, cirrhosis, certain inherited liver diseases such as hemochromatosis and Wilson’s disease, diabetes, non-alcoholic fatty liver disease, or an exposure to aflatoxins, you have a greater chance of developing liver cancer. Excessive alcohol consumption over many years can also lead to irreversible liver damage and lead to liver cancer.

What are the symptoms?

Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include unintentional weight loss, loss of appetite, upper abdominal pain, nausea and vomiting, general weakness and fatigue, abdominal swelling, jaundice where your eyes and skin turn yellow, and white, chalky stools. Other symptoms can include fever, enlarged veins on the abdomen that can be seen through the skin, and abnormal bruising or bleeding. Screening programs using ultrasound are very effective at finding liver cancer before symptoms develop. And we encourage everyone with known liver problems to talk to their doctor about whether screening is right for you.

How is it diagnosed?

Tests and procedures used to diagnose liver cancer include blood tests. These may reveal liver function abnormalities. Imaging tests such as an ultrasound, CT, and MRI. And if you are diagnosed, the next step is determining the extent of liver cancer or stage. Your doctor will then ask for staging tests to help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CT scans, MRI, and bone scans. There are different methods of staging liver cancer. For example, one method uses Roman numerals one through four, and another uses letters A through D. Your doctor evaluates your cancer stage to determine your treatment options and your prognosis.

How is it treated?

There are a number of ways your doctor can help you develop a strategy to combat liver cancer. Surgery may be scheduled to remove the tumor or remove the entire liver to perform a liver transplant. Your treatment may include radiation therapy, which uses high-powered energy from sources such as X-rays and protons, to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to liver while sparing the healthy surrounding tissue. Chemotherapy is a common treatment and is the use of powerful chemicals to combat and hopefully kill the cancer. Targeted drug therapy focuses on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

What now?

Liver cancer is a frightening diagnosis, but finding a team of experts to work together can help you sort out your best options for treatment using the latest technology, most advanced research and specialized care techniques. With new therapies worked on every day. We have lots of hope for positive outcomes. If you’d like to learn even more about liver cancer, here are related videos, or visit mayoclinic.org. We wish you well.

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