Primary Liver Cancer
Primary liver cancer (cancer that starts in the liver) is one of the
most common malignancies in the world, with approximately 1,000,000
cases reported every year. This ranges from 15,000 cases in the United
States to more than a 250,000 in China. About 80% of people with primary
liver cancer are male.
two-thirds of people have advanced liver disease when they seek medical
help, one third of the patients have cancer that has not progressed
beyond the liver. The most promising treatments apply to this latter
causes of primary liver cancer
liver cancer (Hepatocellular Carcinoma, or HCC) is associated with liver
cirrhosis 60-80% of the time. A strong relationship exists between HCC
and chronic Hepatitis B and chronic Hepatitis C. The unfortunate worldwide
epidemic of Hepatitis C is expected to result in a dramatic increase
in primary liver cancer. There is also a relationship between HCC and
alcoholism, although much less common.
of natural carcinogens (cancer-causing agents) also may cause HCC. Aflatoxin
B is commonly found in grains, including rice, stored under hot humid
conditions. This contributes to the extremely high incidence of HCC
in Asian countries. Similarly, in sub-Saharan Africa the consumption
of plants, fungi and bacteria that synthesize natural carcinogens relates
to widespread incidence of HCC.
pain is generally the initial and most frequent symptom. While severe
in some instances, the pain is more likely to be a persistent dull ache,
which intensifies in later stages. The next two most common universal
symptoms are weakness and weight loss, although symptoms vary in different
parts of the world. Other symptoms that result from HCC include loss
of appetite (anorexia), indigestion (dyspepsia), constipation and abdominal
Union Against Cancer (UICC) System is used to distinguish the stages
of liver cancer. Stage I consists of a single tumor no larger than 2
cm (about ¾ inch) in size, with no progression into the blood
vessels. Patients with Stage I have the best prognosis.
is a more advanced disease with vascular (blood vessel) involvement
and/or tumor(s) larger than 2 cm (3/4 inches) in diameter. Cancer in
the blood vessels provides a route for malignant cells to move to other
sites and has a significant negative effect on prognosis. Large tumors
are also more likely to be associated with vascular involvement.
disease generally indicates disease progression in which the tumors
are large and may include lymph node and vascular involvement. When
patients are initially diagnosed at this stage, prognosis for survival
is usually less than one year.
disease reflects widespread, significant malignant lesions as well as
vascular invasion and lymph node involvement. Prognosis for patients
with this late stage disease is poor. Few patients survive more than
one year after transplantation or surgery.
site presents some treatment options that might prolong survival and
even cure HCC if it is detected at an early stage.
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Last modified: Tuesday, January 06, 2004