Liver Cancer

Liver cancer usually doesn’t cause symptoms in its early stages. In fact, many liver cancers do not cause symptoms until they have grown fairly large. When symptoms do appear, they can include:

• Weight loss
• Change in eating habits
• Nausea
• Vomiting
• A lump or mass in the upper-right side of your abdomen
• Constant belly pain
• Abdominal swelling
• Jaundice (Yellowing of the whites of your eyes and skin)
• Persistent itching
• Fever
• Excessive bleeding from small injuries or after activities such as brushing your teeth
• Frequent bruising

If your doctor thinks you might have liver cancer, exams and tests will be required to reach an accurate diagnosis. This begins with your physician asking questions about your health history, symptoms, risk factors and family history of disease, and may continue with more in-depth tests:

• Ultrasound: This is often the first test done if cancer is suspected. An ultrasound uses sound waves to look for abnormalities in the liver. It is very helpful in seeing whether a liver tumor is a fluid-filled sac that’s likely not cancer (cyst) or a solid mass that’s more likely to be cancer.
• Alpha-Fetoprotein (AFP) Blood Test: Elevated AFP levels can be a sign of liver cancer or other conditions, so this test alone can't be used to diagnose liver cancer.
• Liver Function Tests (LFTs): These tests can show liver irritation and inflammation. If they show that your liver has been damaged, your physician may do other tests to see if you have cancer.
• Magnetic Resonance Imaging (MRI): This test creates detailed images of the liver and nearby organs. MRIs can show more detail than other imaging tests.
• Computed Tomography (CT scan): A CT scan uses X-rays taken from many angles. This creates very detailed cross-section pictures of the liver and nearby organs.
• Liver Biopsy: If an imaging test shows something in your liver that looks like it might be cancer, your healthcare provider may take small samples of liver tissue, called a biopsy. This may be done with a needle biopsy, laparoscopic biopsy or surgical biopsy. A doctor who specializes in looking at cells, called a pathologist, looks at the samples under a microscope to tell whether cancer is there.
• Needle Biopsy: For this test, a thin, hollow needle is put through your skin into the liver tumor to get a sample of it.
•  Biopsy: Small cuts are made in your abdomen. The surgeon or physician will put long surgical tools (including one with a tiny video camera on the end) into them. Then he or she looks at the surface of your liver and nearby organs. If your physician sees small pieces of tumors, he or she will remove them.
• Surgical Biopsy: A biopsy taken during surgery to treat the tumor.

Several types of treatment can be used for liver cancer. Which may work best for you? It depends on a number of factors. These include the type, size, location, and stage of your cancer. Other important factors include your age and overall health, how well the rest of your liver is working and what side effects you find acceptable. Your doctor can answer any questions or concerns you have.

• Surgery: Surgery offers the best chance to cure liver cancer. Unfortunately, only a small percentage of people can have surgery. If the cancer is small and in only one part of the liver (and the rest of the liver is healthy enough), the part of the liver with the cancer can be removed. This surgery is called a hepatectomy. Another option might be to remove the entire liver and replace it with a liver transplant.
• Tumor Ablation and Embolization: These techniques can be used to treat some tumors in the liver. Ablation involves using heat, cold or other methods to destroy tumors rather than removing them. Sometimes this is combined with radiation (radioembolization) or chemotherapy (chemoembolization).
• Radiation: Radiation uses high-energy X-rays to kill cancer cells. It’s used mainly when surgery or other treatments aren't good options.
• Targeted Therapy: This type of treatment uses medicines that target proteins or cell functions that help cancer cells grow. It’s used mainly for advanced liver cancers that can't be treated with other methods.
• Chemotherapy: The goal of chemotherapy is to stop cancer from growing or spreading. It does this by using medicines to kill the cells or stop them from dividing. Chemotherapy can be used to treat advanced liver cancer. In most cases it isn’t as helpful as targeted therapy.
• Supportive Care: Your doctor may suggest treatments that help ease your symptoms, but don’t treat the cancer. These can sometimes be used along with other treatments. Or your healthcare provider may suggest supportive care if he or she believes that available treatments are more likely to do you more harm than good.
• Immunotherapy: Researchers are also studying treatments that help the body's immune system fight cancer. These are called immunotherapy techniques.
• Clinical Trials for New Treatments: Researchers use clinical trials to find new ways to treat liver cancer. Talk with your doctor to find out if there are any clinical trials you should consider.
• The Multidisciplinary Cancer Clinic: The INTEGRIS Cancer Institute’s Multidisciplinary Gastrointestinal clinic brings together medical oncologists, gastroenterologists, radiation oncologists and radiologists as a team to provide specific services to the patient with the aim of ensuring that the patient receives optimum care and support.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for liver cancer include:

• Mind, body therapies including acupuncture, massage, and yoga
• Research and clinical trials
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Resource Room
• Clinical social work services
• Counseling
• Patient navigation and survivor care planning
• Multi-disciplinary clinic coordination
• Cancer screenings
• Patient and family support groups
• Integrative Medicine Clinic