In 2013, it is estimated that there will be over 30,000 new cases of liver cancer and over 20,000 deaths from liver cancer in the United States. The liver is one of the body’s largest and most essential organs. Weighing roughly 3 pounds, this football-sized organ sits below the lungs and above the stomach on the right side of the body. Its primary functions are to remove toxins from blood, break down nutrients for the body to use, and to make clotting factors. The liver also produces enzymes and bile necessary for digestion. Its primary blood supply comes from the hepatic portal vein, which carries nutrient rich blood, and its secondary blood supply comes from the hepatic artery, which carries oxygenated blood.

Symptoms
Generally, symptoms of liver cancer do not arise until later stages of the disease. Some signs and symptoms may include:

• Fullness after a small meal
• Abdominal pain
• Severe weight loss
• Fluid buildup in the abdomen
• Loss of appetite
• Itching
• Nausea/Vomiting
• Jaundice
• Enlarged liver
• Enlarged spleen

Additionally, some tumors cause hormones to react abnormally on other organs. Signs may include:

• High blood calcium levels
• High red blood cell count
• Low blood sugar
• High cholesterol
• Breast enlargement
• Shrinking testicles

Types
There are several different types of liver cancer. The most common include:

Hepatocellular Carcinoma
This type of liver cancer is most common in adults. It can begin as a localized tumor and eventually spread throughout the liver as it progresses. Hepatocellular carcinomas can also develop as many small cancerous nodules throughout the liver. This is the most common form of cancer in the United States and is often seen in patients with cirrhosis.

Hepatocellular Cholangiocarcinoma
Liver cancer can also originate within cells that make up the lining of the small bile ducts. This type of cancer makes up 10-20% of cancers that originate in the liver.

Angiosarcoma and Hemangiosarcoma
These cancers are rare and begin within the cells lining the blood vessels of the liver. The tumors grow rapidly and are usually too widespread to be surgically removed. These cancers can be managed with chemotherapy and radiation therapy to stop their progression. Typically, people who have been exposed to vinyl chloride, thorium, arsenic, or radium are at risk for developing liver cancer of this nature.

Hepatoblastoma
This is another rare form of liver cancer that develops in children under the age of four. It can typically be treated, and successfully eliminated, when the cancer stays contained within the liver.

Risk Factors
There are several factors that can lead to liver cancer. Males are more likely to develop this type of cancer than females. Race, family history, obesity and lifestyle choices, such as smoking and drinking alcohol can also increase a person’s risk of developing liver cancer. Obesity is the leading cause of liver cancer in the United States.

Cirrhosis:
Liver cirrhosis occurs when cells are damaged and replaced with scar tissue. This scar tissue does not function the same way normal liver cells do, so extensive cirrhosis can decrease liver function. Additionally, cirrhosis can lead to cancer, because cells are being damaged and regenerated. With rapid regeneration, the odds of developing cell mutations, and consequently, cancer, increase.

Cirrhosis generally develops as a result of alcohol abuse, chronic hepatitis B or chronic hepatitis C infections. Patients with non-alcoholic fatty liver disease are also at risk of developing cirrhosis. Additionally, certain autoimmune disorders can cause damage to the liver and bile ducts, leading to cirrhosis.

Chronic Viral Hepatitis Infections:
Chronic hepatitis B and C infections are the number one risk factor for developing liver cancer, worldwide. Since hepatitis B is widely prevented by vaccinations, hepatitis C is more common in the United States, bacause there is no vaccine available. Most hepatitis infections occur as a result of contaminated needle sticks, unprotected sex or childbirth. Infections resulting from contaminated blood transfusions are extremely rare in America.

Hepatitis B typically causes flu-like symptoms and, with treatment, patients usually recover within a few months. Hepatitis C is less likely to cause any symptoms, so those infected may harbor a chronic, long-term infection without knowing it. Because most patients with hepatitis C are unaware of their condition, they suffer the most liver damage and are at a higher risk for developing liver cancer.

Prevention
Receiving the hepatitis B vaccine is one of the most effective ways to lower your risk factors. It is also important to receive treatment if you suspect you have been exposed to hepatitis B or C to avoid transmitting the virus to someone else, and also to lower your chances of developing liver cancer. Additionally, limiting alcohol consumption and not smoking can significantly reduce your risk factors.

Other ways to prevent liver cancer can include:

• Using protection during intercourse
• Avoiding contact with contaminated needles, including recreational drug use, and on the job exposures
• Maintaining a healthy weight
• Avoiding exposure to carcinogenic chemicals
• Treating diseases known to elevate risk factors

Liver cancer can be easily prevented, simply by taking precautions to eliminate risk factors, such as hepatitis infections, alcohol abuse, and obesity. However, if you are experiencing any of these symptoms, or feel that you are at an elevated risk for developing liver cancer, consult your physician.