Liver Cancer (Liver Carcinoma): Causes, Symptoms & Treatment

Liver cancer is also known as liver carcinoma; this disease is malignant tissue located in the liver. Although this disease is rather rare in Western industrialized countries, the trend is increasing here as well. In Southeast Asia and Africa, however, liver cancer is one of the most common types of cancer.

What is liver cancer?

Malignant tissue in the liver is also called liver cancer. This form of the disease, which is quite rare in Germany, affects men significantly more often than women, with people over the age of 70 being particularly at risk. A distinction is made between primary and secondary liver cancer. The former is when the cancer develops directly from cells in the liver, while secondary liver cancer involves metastases that spread to the liver from other parts of the body. This latter form of liver cancer is much more common.

Causes

One of the most common causes of liver cancer is cirrhosis. This disease, also known as shrunken liver, in turn, is triggered by alcohol abuse as well as hepatitis. Alcohol is generally considered the number one trigger for liver cancer. Likewise, certain medications can cause the disease liver cancer – some sex hormones in particular should be mentioned here. Gallstones, cysts and ulcers on the gallbladder are also known to trigger liver cancer under certain circumstances. The so-called iron storage disease is the last known cause of liver cancer.

Symptoms, complaints, and signs

The signs of liver cancer are generally rather nonspecific in the early stages. The liver is not palpable in most healthy people. Repeated feelings of pain in the upper abdomen, which may radiate, and the sensation of feeling a swelling below the ribs should be quickly presented to the primary care physician. The same applies to loss of appetite and unwanted weight loss. Both may be signs of a problem with the liver. When the liver no longer functions as a detoxification organ due to liver cancer, yellowing of the eyes is observed in many patients. Yellowish eyes should therefore be clarified promptly by a physician. The same applies to spiderweb-like spots on the cheeks and a red discoloration of the palms. Both symptoms can be caused by a functional disorder of the liver. It does not necessarily have to be a carcinoma of the liver. Nevertheless, spots on the face and persistent discoloration of the palms should be presented to a specialist. Metastases in the liver are often due to a primary tumor that has spread elsewhere in the body. Cancer patients should therefore pay particular attention to pain in the upper abdomen and discoloration of the eyes so that an immediate search can be made for possible metastases to the liver, if necessary.

Diagnosis and course

The chances of recovery from liver cancer are greater the earlier the disease is detected and treated. Unfortunately, symptoms usually show up quite late and the cancer is already well advanced by then. In the early stages, there are often no symptoms at all, and only gradually do loss of appetite, general nausea and pain in the upper abdomen appear. Weight loss that is inexplicable to the patient may also indicate liver cancer. In the advanced stage, yellowing of the skin and eyes may then occur. In the event of any of the above symptoms, a doctor should be consulted as a precaution. However, these signs do not necessarily have to be caused by liver cancer, but can also have completely harmless causes. A special form of liver cancer is bile duct cancer – an unmistakable symptom of this is dark-colored urine. In order to clearly establish the diagnosis of liver cancer, several examinations are usually necessary. In addition to a comprehensive physical examination, i.e. palpation of the liver through the abdominal wall, an ultrasound examination is also necessary. This can also show the spleen and kidneys. Furthermore, the doctor will take blood – this blood test can provide information about the iron concentration in the blood. If it is not clear whether the liver cancer is primary or secondary, gastroscopy and colonoscopy may be necessary.

Complications

In general, liver cancer is a very serious disease.If left untreated, it leads to premature death of the patient and can significantly limit and reduce the quality of life of the affected person. In most cases, patients suffer from severe pain in the abdomen and also from nausea and vomiting. Likewise, there is a loss of appetite and thus also a loss of weight and deficiency symptoms. Those affected feel weak and tired and also suffer from a greatly reduced ability to cope with stress. Liver cancer can also lead to jaundice. Other organs can also be damaged by liver cancer, so that kidney insufficiency can occur, for example. This also leads to the death of the patient if left untreated. As a rule, liver cancer can only be treated by surgery. However, the affected person is dependent on a donor organ. Whether the transplant will be successful cannot be predicted. Furthermore, the affected person is also dependent on chemotherapy, which is not infrequently associated with various side effects. The patient’s life expectancy is usually significantly reduced by liver cancer.

When should you go to the doctor?

Pain or discomfort at the level of the stomach should be presented to a doctor. If the pain increases continuously or spreads further in the upper body, a doctor is needed. If there is a drop in usual performance, an increased need for sleep, or rapid fatigability, the affected person needs medical attention. If there is a yellowish discoloration of the skin, irregularity in bowel movements or changes in the face, a visit to the doctor should be made. Yellow palms or discoloration of the eyes should be presented to a physician as soon as possible. Swelling of the upper body, a tightness in the chest, or a general feeling of illness should be examined and treated. If changes develop below the ribs, a doctor’s visit is recommended. If disturbances in blood flow or heart rhythm are noticed, observations should be discussed with a physician. Interruptions in memory, a loss of appetite or a drop in body weight are also indications that should be followed up. If there are emotional abnormalities or a lack of interest, a visit to the doctor is recommended. In principle, regular check-ups and preventive examinations by a doctor are advisable in adulthood. Since liver cancer can lead to a fatal course of the disease, the controls are very helpful for early detection. In addition, it is vital for the further course of survival to consult a doctor already at the first signs and irregularities of liver activity.

Treatment and therapy

In many patients with liver cancer, surgery is inevitable. In this case, either individual parts of the liver are removed or a complete transplantation of the liver occurs, in which the patient’s own liver is replaced by a donor organ. The therapy depends on the type, location and size of the tumor on the one hand, and on the age and state of health of the patient on the other. In addition to surgery, local therapy methods can also be considered. These include, for example, obliteration of the liver as well as irradiation of the liver from the inside or contrast medium therapy. In some patients, treatment with tablets, such as chemotherapy, can also achieve good results.

Outlook and prognosis

The prognosis for liver cancer is given according to individual health conditions. If the disease is noticed in the early stages, relief of symptoms or recovery can be achieved with the help of cancer therapy. The treatment is extensive and associated with numerous side effects as well as risks. If the patient is basically healthy, has a stable immune system and is middle-aged, there is a chance of a cure. The older the patient and the more pre-existing diseases, the more difficult the course of the disease. If the liver cancer is already advanced, the prospects of relief decrease. If metastases have formed or the cancer cells have been able to spread in the organism via the bloodstream, there is often little prospect of recovery. In addition to surgical interventions, there may be a need for a donor organ. For some patients, this is the only way to increase the chances of survival. Organ transplantation is also associated with various complications.If the operation is successful, the organism must accept the donor organ. If this is successful, the prospects of alleviating the symptoms increase. Lifelong treatment is necessary to ensure that the organ’s ability to function is adequately monitored. Despite an achieved cure of the liver cancer, a recurrence of the carcinoma can occur at any time during the rest of life. The prognosis is worse in the event of recurrence.

Prevention

To prevent liver cancer, care should be taken to maintain a healthy lifestyle. This includes, in particular, the moderate use of alcohol, and cigarette consumption should also be limited as far as possible. Furthermore, the risk of hepatitis B should be reduced as far as possible – regular vaccination is recommended here. However, it is not only prevention that is important, but also appropriate aftercare once the disease has been successfully conquered. At the latest six months after the operation, the first follow-up should take place.

Aftercare

The type of follow-up care is related to the outcome of the initial treatment. If the tumor could not be completely removed, life expectancy decreases dramatically. Follow-up care then has a palliative character. This means that the patient receives support for the remaining time of life. Pain medication is important in this context. But clarification of elementary life issues can also be part of aftercare. If, on the other hand, the liver cancer has been defeated in an initial therapy, the prognosis is positive. The risk of new cancer formation must not be underestimated in the coming months and years. That is why physicians arrange scheduled follow-up examinations with their patients. In these, carcinoma should be detected at an early stage and then treated immediately. This results in the best chances of cure. Beyond the prevention of a recurrence, the therapy of possible secondary diseases also plays a major role. Complaints can be alleviated by medication. Social and psychological problems can be discussed in therapies. As a rhythm for follow-up care, a three-month interval is recommended at the beginning. This can be extended from time to time if there are no findings. From the fifth year after diagnosis, annual follow-up is sufficient. The examinations consist of magnetic resonance imaging, ultrasound examination and blood sampling.

What you can do yourself

When a liver carcinoma, which is also known as liver cancer, occurs, it is important for the affected person to be able to talk openly with his or her treating physician about the therapy and chances of cure. Due to the physical discomfort, it is advisable for the patient to be gentle with their own body. Regular rest and sufficient sleep are of great importance. In addition, maintaining a healthy diet is important. A healthy diet plan should be prepared together with a doctor or a nutritionist, which also takes into account a balanced acid-base balance of the body. Drinking alcohol should be completely avoided, as alcohol is harmful to the liver. In addition to the physical complaints associated with such a disease, the psyche is also heavily burdened. Psychooncologists, psychologists who specialize in cancer patients, offer such care. In addition, it can help the patient if he or she participates in a self-help group for liver cancer patients or also for cancer patients. The exchange with other affected persons leads to emotional relief. The patient learns to deal with his situation and at the same time has several contacts with whom he can exchange ideas.