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Liver Cancer

There are two types of liver cancer, hepatocellular carcinoma, which is defined as cancer of the liver, and metastatic liver cancer, which is cancer that starts in another organ (such as the breast or colon) and spreads to the liver.  Cancer that has spread to the liver is more common than hepatocellular carcinoma.

In most cases, the cause of liver cancer is due to scarring of the liver, known as cirrhosis. Cirrhosis may be caused by alcohol abuse, too much iron in the body, certain autoimmune diseases of the liver, including those that cause long-term inflammation of the liver, and hepatitis B or C virus infection. People with hepatitis B or C are at risk for liver cancer, even if they do not have cirrhosis. 

Diagnosing Liver Cancer

Tests used to help diagnose liver cancer may include physical examinations, abdominal CT scans, liver biopsy, liver function tests, a liver scan and serum alpha fetoprotein tests. If some patients are considered to be at a high-risk for liver cancer, they may receive periodic blood tests and ultrasounds to see if tumors are developing. Early screenings for liver cancer are normally performed on individuals with pre-existing liver disease, such as Hepatitis B or C. Typically, this screening is conducted by a gastroenterologist. 

Treating Liver Cancer

Treatment for liver cancer is often dictated by the stage and location of the disease.  In the case of liver cancer, surgery is the only curative treatment. Surgery consists of removing the cancerous tumor and nearby tissue, as well as possibly the nearby lymph nodes. Chemotherapy or radiotherapy may be given preoperatively to both lessen the size of a tumor and to increase the chance of a cure.

Surgical treatments include minimally invasive procedures such as transcatheter treatment, microwave and radiofrequency ablation. If the patient cannot tolerate surgery, chemotherapy and radiation may be given, alone or in combination, to prolong survival and can be given as a palliative measure (to help reduce symptoms).

Selective Internal Radiation Therapy with Yttrium 90 is a special form of radiation used to treat primary liver cancers or metastases to the liver.  In a minimally invasive procedure radioactive beads are injected directly into the liver to kill cancer cells.