What is the liver?
The liver is the largest solid organ of the body. It is located on the right side of the abdomen just beneath the right diaphragm. Surrounding organs include the gall bladder (located just behind the liver), the small intestine, part of the colon (large intestine), the right kidney, and the head of the pancreas.
The liver is triangular in shape and is divided into a right and left lobe, the right lobe being the larger of the two. It provides several important functions to the body including:
- Filtering the blood to remove and process toxins.
- Synthesizing and excreting bile, which is important in processing fat from our diet.
- Helping regulate blood sugar (glucose) levels.
- Producing factors that play an important role in blood clotting.
The liver is a very vascular structure, containing a large number of blood vessels, and receives blood through two separate systems: the hepatic artery and the portal vein.
Blood from the abdomen and lower body flows through the liver where it is processed. It then proceeds to the inferior vena cava and ultimately empties into the heart. In large part, due the vascular nature of the liver, it is a very common site to which cancers from other areas of the body spread (also known as metastasis).
What Causes Liver Cancer?
Many liver cancer cases are related to hepatitis B virus or hepatitis C virus infections. Most people don’t know they have the virus.
Other behaviors and conditions that increase risk for getting liver cancer are:
- Excessive alcohol use
- Cirrhosis (scarring of the liver, which can also be caused by hepatitis and alcohol use).
- Having hemochromatosis, a condition where the body takes up and stores more iron than it needs.
- Eating foods that have aflatoxin (a fungus that can grow on foods, such as grains and nuts that have not been stored properly).
What are the signs of liver cancer?
Liver cancer usually does not cause a lot of symptoms until the cancer is quite advanced. Because of this, early stage liver cancers are rarely detected. When patients do develop symptoms, they may have:
- Abdominal pain
- Feelings of abdominal fullness or bloating.This can bedue to ascites which is a collection of fluid within the abdominal cavity.
- Loss of appetite
- Nausea and vomiting
- Yellowing of the skin/eyes (jaundice)
- Weight loss
How is liver cancer diagnosed?
When liver cancer is suspected, the healthcare provider will perform a thorough history and physical examination. If a liver tumor is suspected or a patient is at high risk for developing a liver cancer, a number of diagnostic tests may be performed:
- An ultrasound is a test that uses sound waves to produce an image of the internal body. Ultrasounds are often used to screen for and diagnose liver cancers because they are very easy to perform and have little to no risk to the patient.
- CT/CAT scan is often used to diagnose liver cancers. CT scans are very useful in diagnosing liver tumors; however, many benign tumors are often difficult to distinguish from malignant tumors on CT scan. CT scans often give more detailed images than ultrasounds and are often used to help diagnose liver cancers.
- An MRI may be used if there is difficulty seeing a tumor on CT or ultrasound, or if there is a question about whether a tumor is benign or malignant.
- Angiography is a procedure in which a small tube (called a catheter) is threaded into a blood vessel, often placed through the groin. Contrast is injected directly into the blood vessels leading to the liver and x-rays are taken that can show highly vascular liver tumors. This procedure is infrequently performed because it is much more invasive in nature than ultrasound, CT, or MRI.