Cancer treatments have come a long way in recent years and over the last three decades, survival rates have increased. According to the American Cancer Society, ” The risk of dying from cancer in the United States has decreased over the past 28 years according to annual statistics reported by the American Cancer Society (ACS). The cancer death rate for men and women combined fell 32% from its peak in 1991 to 2019, the most recent year for which data were available.” However, the organization made note that “Some of this drop appears to be related to an increase in the percentage of people with lung cancer who are living longer after diagnosis, partly because more people are being diagnosed at an early stage of the disease.”

While there’s been a lot of progress, cancer is still one of the main causes of death in the United States. The Centers for Disease Control and Prevention says, “Cancer is the second leading cause of death in the United States, but many kinds of cancer can be prevented or caught early,” which is the case with liver cancer. Certain lifestyle choices can greatly increase the risk. The amount of liver cases has been reduced drastically, but people are still dying every year from the disease. The CDC says, “Each year in the United States, about 25,000 men and 11,000 women get liver cancer, and about 19,000 men and 9,000 women die from the disease. The percentage of Americans who get liver cancer rose for several decades, but is now declining. Liver cancer is more common in other parts of the world than in the United States.” 

Knowing the signs of liver cancer, getting early treatment and practicing healthy habits that can reduce the risk. Eat This, Not That! Health spoke with cancer specialists who explain symptoms to be aware of and what to know about liver cancer. As always, please consult your physician for medical advice. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

The liver is one of the most important organs we have. It’s located “in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds,” John Hopkins Medicine states. the liver performs over 500 vital jobs for our body including storing nutrients, breaks down and eliminates waste, regulates blood clotting, removes bacteria from the bloodstream, which helps your body resist infections and much more. Keeping a healthy liver is important for your overall health.  

Afshin Safa, MD, FACR Medical Director of Radiation Oncology at Leavey Cancer Center with Dignity Health Northridge Hospital and Medical Director of Radiation Oncology at Leavey Cancer Center  Associate Professor, Department of Radiation Oncology at David Geffen School of Medicine at UCLA says, “Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths in the world.  Overall, the prognosis of this aggressive tumor remains poor,  However, the  survival rate for patients whose tumors are detected at an early stage and who receive treatment are very good.  Most people who get liver cancer have had  long-term liver disease (also called chronic liver disease). Having long-term liver disease increases a person’s chances of getting liver cancer. The most common and most serious form of long-term liver disease is a condition called “cirrhosis,” which scars the liver.”

Ronald Tang, DO Board certified Hematologist/Oncologist Los Angeles Cancer Network Beverly Hospital and Los Angeles Cancer Network tells us, “Risk factors for liver cancer include individuals who have cirrhosis whether it is due to alcohol abuse, hepatitis infection or fatty liver.  You can lower your risk of liver cancer by abstaining from alcohol along with eating a healthy low fat diet with good weight control.  Hepatitis can be contracted through unsafe sexual contact and use of unclean needles.”

 

Dr. Safa says according to UptoDate, a free service for dignity health doctors,

“Hepatocellular carcinoma (HCC) is a primary tumor of the liver that usually develops in the setting of chronic liver disease, particularly in patients with cirrhosis due to alcohol use, chronic hepatitis B or C virus infections.  if a person’s cirrhosis is due to alcoholism, it’s imperative to get the alcohol use treated and under control. Likewise, if a person’s cirrhosis is caused by an infection, such as hepatitis C, it’s important to treat the infection. Prevention of  hepatitis infections includes practicing safe sex, not sharing needles/syringes, and immunization with vaccines. People who have liver cancer, especially if they have long-term liver disease, should avoid alcohol and any drugs that could be harmful to the liver. Comprehensive care for patients with cirrhosis includes treatment of the underlying liver disease (eg, antiviral therapy for HBV or HCV), immunization against hepatitis A and HBV (if indicated), and cirrhosis management, including endoscopic screening and treatment for varices.”

According to Dr. Tang, “Liver cancer is challenging to screen for due to the fact that symptoms occur when the liver cancer grows to a large size or is too advanced. Individuals may not know they have cirrhosis as early stages are asymptomatic and by the time symptoms occur, the liver is already too weak to recover.  Patients who have cirrhosis need to have abdominal ultrasounds annually to screen for liver cancer.”

Dr. Safa adds, “Liver cancer is frequently diagnosed late in its course for two reasons: the absence of symptoms in patients with early disease, and the limited  surveillance for high-risk patients.   It is estimated  that  fewer than one-third of patients with cirrhosis undergo surveillance for HCC . As a result, many patients have advanced disease at the time of diagnosis.” Dr. Safa adds, UptoDate states, “If your doctor suspects you have liver cancer, they will do 1 or more of the following tests:

–Blood tests

–An MRI scan, CT scan, ultrasound, or other imaging test – Imaging tests create pictures of the inside of the body and can show abnormal growths.

–Biopsy – For this test, a doctor will remove a small sample of tissue from the liver. Another doctor will look at the sample under a microscope to see if it has cancer.”

According to Dr. Tang, “Common signs and symptoms of liver cancer are yellowing of the skin and eyes (jaundice and scleral icterus), abdominal pain. fatigue, you easily bruise, spontaneous bleeding, unintentional weight loss, tea-colored urine and uncontrollable itching without a rash.” Dr. Safa says, “Liver cancer does not usually cause any symptoms of its own. A few patients might have a lump or mild pain in the upper belly, feel full early on when they try to eat, or lose weight. Others might have symptoms that are caused by the liver disease they had before they got cancer. Those symptoms can get worse or come back because of the cancer. They include swelling of the belly or leg , and  the skin or white part of the eyes turning yellow.”   

The CDC says, “In its early stages, liver cancer may not have symptoms that can be seen or felt. However, as the cancer grows larger, people may notice one or more of these common symptoms. It’s important to remember that these symptoms could also be caused by other health conditions. If you have any of these symptoms, talk to your doctor.

Liver cancer symptoms may include—

• Discomfort in the upper abdomen on the right side.
• A swollen abdomen.
• A hard lump on the right side just below the rib cage.
• Pain near the right shoulder blade or in the back.
• Jaundice (yellowing of the skin and whites of the eyes).
• Easy bruising or bleeding.
• Unusual tiredness.
• Nausea and vomiting.
• Loss of appetite.
• Weight loss for no known reason.

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Dr. Tang explains, “Treatment modalities include surgery by removing the whole tumor if possible along with local treatments which include direct injection of chemotherapy into the liver cancer.  There are new systemic therapies that have been FDA approved over the past 2-3 years as well which include medications that target the tumor’s ability to grow blood vessels along with using the patient’s immune system to attack foreign tumor cells. General 5 year survival rate for liver cancer is 20% however early patients who are diagnosed with early stage liver cancer have a 35% survivability at five years. Like most cancers, early detection increases the 5 year overall survivability therefore patients who have risk factors of cirrhosis or hepatitis should have annual imaging of the liver to evaluate for liver cancer.”

Dr. Safa explains, “The goal is to detect small  tumors when they are <1 inch in size so that the entire range of treatment options are available. The  survival rate for patients whose tumors are detected at an early stage and who receive treatment are very good. Getting treated for liver cancer involves making many choices, such as what treatment to have. Treatment depends on the stage of your cancer. It also depends on how healthy your liver is (in other words, how serious your liver disease was before you got cancer).” UptoDate states, “The different treatments include:

• Surgery – Liver cancer can sometimes be treated with surgery to remove the part of the liver with the cancer.
• Liver transplant – A liver transplant is a type of surgery in which a doctor replaces a diseased liver with a healthy liver from another person.
• Ablation therapy – Ablation therapy is a procedure that can kill cancer cells in the liver. It does not involve surgery. Doctors can do ablation therapy in different ways. They can kill the cancer cells using   focused  radiation therapy, aka, stereotactic ablative Radiation therapy (SABR)
• Blocking the cancer’s blood supply – Doctors can do a procedure called “embolization” to block off the blood vessel that sends blood to the cancer. This keeps the cancer from growing by “starving” it of its blood supply. Sometimes, the embolization procedure is combined with chemotherapy (“chemoembolization”) or radiation (“radioembolization”).
• Immunotherapy – This is the term doctors use for medicines that work with the body’s infection-fighting system (the “immune system”) to stop cancer growth.
• Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.”