About Liver Tumors
Primary Liver Cancer
Incidence
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. Although 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 group.
Possible causes of primary liver cancer
Primary 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.
The consumption 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.
Symptoms
Abdominal 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 mass.
Disease progression/prognosis
The International
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.
Stage II 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.
Stage III 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.
Stage IV 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.
This Web site
presents some treatment options that might prolong survival and even cure
HCC if it is detected at an early stage.
