What is liver cancer and why do we need more research?

• Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It can grow as a single tumour, or many tumours can spread through liver. Most people diagnosed with HCC are older adults, but fibrolamellar HCC is a rare form of HCC which is more common in younger adults under 40.
• Bile duct cancer is a type of cancer that starts in the bile duct. These are small tubes which connect different organs involved in digestion, and are partly embedded in the liver.
• Hepatoblastoma is a very rare type of childhood liver cancer that is most common in children under two years old.
• Angiosarcoma is another very rare type of cancer that grows in the blood vessels or lymph vessels. This cancer sometimes grows in blood vessels which feed the liver.

Liver cancer in the early stages may not have any symptoms, and any that do appear may be quite non-specific, like feeling sick or tired and run-down. Other symptoms of liver cancer might include:

• Jaundice- yellowing of the whites of the eyes, and skin
• Appetite changes, like feeling full quickly
• Weight loss
• Itching
• Feeling bloated and swollen around tummy
• Right shoulder pain (as swelling around the liver irritates nerves to the shoulder)

As with many cancers, a combination of different factors can influence a person’s individual risk of developing liver cancer. These can include genetics, age, or the presence of certain health conditions.

The risk of developing primary liver cancer is increased if the liver becomes severely damaged (cirrhosis).

Severe liver damage can take a long time to develop. It can be caused by having a long-term condition which affects the health of the liver, such as non-alcoholic fatty liver disease, long-term exposure to alcohol or chemicals, or certain immune or inherited conditions.

Ongoing infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) can also cause cirrhosis, and are major risk factors for liver cancer. Worldwide, around 8 in 10 cases of primary liver cancer are linked to HBV and HCV infection.

However, not all cases of liver cancer are linked to cirrhosis, and not everyone with cirrhosis will develop liver cancer. Researchers are still trying to understand why some cases of liver cancer develop. Understanding in detail how liver cancer develops will ultimately give more options for new and effective treatments.

Treatment options for liver cancer can include surgery, chemotherapy or radiotherapy. Sometimes a liver transplant may be needed.

Surgery involves removing part of the liver. It is usually only an option if the cancer is in early stages, and the liver is healthy enough to regrow and repair over time.

If surgery is not possible, other types of treatment might be used. These can include:

• Embolization: This involves injecting tiny beads into blood vessels that feed the liver to block the tumour’s blood supply. Sometimes chemotherapy is also delivered locally to the liver alongside embolization. Or radioactive beads might be used, which can deliver radiation directly to the tumour.
• Thermal ablation: Targeted microwaves or radiowaves are used to generate heat and destroy liver cancer cells.
• Radiation therapy: External stereotactic radiation is a very accurate form of radiation. It might sometimes be used if surgery is not possible.
• Targeted therapies: If the cancer has spread outside of liver cells to blood vessels or lymph nodes, doctors might also use targeted therapies. These aim to kill the cancer cell by exploiting specific molecular vulnerabilities.
  
  

Worldwide Cancer Research supporter Sam was diagnosed with advanced liver cancer and needed a liver transplant when he was just 11 years old. Read Sam’s inspiring story here.