Liver cancer can originate from the liver tissue (primary liver cancer), or cancers of other organs can spread to the liver through blood (metastatic liver cancer). The most common primary liver cancers are hepatocellular carcinoma (HCC) and cholangiocarcinoma. The most common cancers that metastasize to the liver are large bowel cancer, stomach cancer, breast cancer, lung cancer, kidney cancer and prostate cancer.
You can click on the links below to learn more about the primary and metastatic cancers of the liver and new treatment methods.
How is it diagnosed?
Liver cancers can give symptoms such as abdominal pain, jaundice, sweating, weight loss, fatigue and anemia. Blood tests may show signs of impaired liver function, decreased blood values, and biliary obstruction. However, in many patients, the tumor in the liver can be detected by chance during ultrasound, tomography or MRI examinations performed for another purpose. Not all tumors in the liver are cancer; benign masses such as cyst, adenoma and hemangioma are common in the liver.
When a mass in the liver is seen, if a mass is suspected for cancer, a biopsy is usually required. The standard biopsy method in liver is ultrasound-guided trucut (core) needle biopsy. This procedure is done under local anesthesia, practically painless and can be completed in about 10 minutes. After the biopsy, the patient is kept under observation for several hours and then sent home. The pathology result will usually be available in 3-4 days.
Are there new treatment methods?
Classical treatment methods in liver cancers are surgery and chemotherapy. However, percutaneous ablation, chemoembolization, radioembolization and many other new treatment methods are widely used in liver cancers. So much so that the liver is the organ where these innovative treatments are most commonly applied in our body, and there are two important reasons for this:
1. Unlike other organs, the liver has two feeder vessels called "portal vein" and "hepatic artery". The portal vein is the larger of these vessels, and most (about 90%) of the normal liver tissue isfed by this vessel. The hepatic artery is thinner but more important because approximately 90% liver tumors are fed by this vessel. So, practically, cancer cells in the liver are fed by the hepatic artery and normal liver cells are fed from the portal vein. Thanks to this very special condition, it is possible to give "transarterial" therapies such as intraarterial chemotherapy, chemoembolization and radioembolization almost exclusively into tumor cells while causing minimal damage to normal cells in the liver.
2. The liver is the largest organ in our body and is one of the most easily examined organs by ultrasound. Percutaneous ablation methods, such as radiofrequency and microwave, are used more easily in large volume organs because it is easier to destroy 1 cm of normal tissue around the tumor. In addition, since percutaneous ablation is mostly performed with ultrasound guidance, easy examination of the liver by ultrasound allows the procedure to be performed more accurately and safely.
Interventional oncology in cancer management
Prof Saim Yilmaz, MD