Liver Cancer

Introduction

The liver lies under the diaphragm in the right upper abdominal cavity. The largest surface is covered with a shiny peritoneum membrane, which has a lot of nerve endings. When the liver enlarges because of a new cancerous growth in it, these nerve endings report pain. The cancerous growth could be from another cancer in the body, called "secondary liver cancer" or metastasis.

However, the cancer could originate in the liver, then the tumor is called "primary liver cancer" or simply liver cancer.

Symptoms:

Weight loss and right upper abdominal pain are the most common symptoms. The physician can feel a mass in the right upper abdomen.

There often is also a fever without any apparent infection. However, in the beginning of this disease it can be a challenge to the doctor to make the diagnosis. Ultrasound, CT and MRI scan help in the diagnosis, as do blood tests, which show elevated liver enzymes. Ultrasound guided liver biopsy allows the pathologist to make the diagnosis. A high percentage of patients with liver cancer had cirrhosis of the liver before and the cancer developed as a result of the chronic irritation in the tissue of the cirrhosis. The cirrhosis can be on the basis of alcohol abuse, due to chronic hepatitis( hepatitis B or C) or due to primary sclerosing cholangitis.

Treatment:

Like with any other cancer tests have to be performed by the oncologist to see which cancer stage the patient is in. Unfortunately, as there are no early warning signs, the patient often is already in a late stage at the time of diagnosis. Treatment consists of chemotherapy and details can be found in the cancer chapter. With leukemia or Hodgkins lymphoma where the liver can be involved secondarily, the primary leukemia or lymphoma has to be treated with appropriate combination chemotherapy.

Further details regarding liver cancer can be found under this link in another chapter.

Disclaimer

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References

1. DM Thompson: The 46th Annual St. Paul's Hospital CME Conference for Primary Physicians, Nov. 14-17, 2000, Vancouver/B.C./Canada

2. C Ritenbaugh Curr Oncol Rep 2000 May 2(3): 225-233.

3. PA Totten et al. J Infect Dis 2001 Jan 183(2): 269-276.

4. M Ohkawa et al. Br J Urol 1993 Dec 72(6):918-921.

5. Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc., pages 976-983: "Chapter 107 - Acute Abdomen and Common Surgical Abdominal Problems".

6. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice, 5th ed., Copyright © 2002 Mosby, Inc. , p. 185:"Abdominal pain".

7. Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., Copyright © 2002 Elsevier, p. 71: "Chapter 4 - Abdominal Pain, Including the Acute Abdomen".

8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Suzanne Somers: "Breakthrough" Eight Steps to Wellness-- Life-altering Secrets from Today's Cutting-edge Doctors", Crown Publishers, 2008

Last Modified:March 1, 2012