Primary Liver Cancer

Liver cancer is the fifth-most-common cancer in men and the ninth-most-common cancer in women.10 If the cancer originates in the liver, it is referred to as 'primary' liver cancer. If the cancer has metastasized (spread) to the liver from elsewhere in the body, it is referred to as 'secondary' liver cancer. Hepatocellular carcinoma or HCC is the most common form of primary liver cancer, and accounts for 5.6% of all cancers.4,11 Many patients with HCC develop PVT, a blockage or narrowing of the portal vein due to blood clotting.12 This section will discuss the risk factors for HCC, how HCC develops and spreads, the signs and symptoms of HCC, and testing for HCC.

Risk Factors for HCC
  • Cirrhosis11
  • Long-term use of anabolic steroids13
  • Smoking14
  • Diabetes14
  • Family history of HCC14

How HCC Develops and Spreads

The liver is comprised mainly of cells called hepatocytes.4 Normally, these cells grow and divide to replace old or damaged cells. HCC occurs when there is an error in the regulation of liver cell growth, resulting in uncontrolled cell division and the formation of tumors. These tumors can create their own blood vessels to promote further growth; if not detected or contained, cancerous cells are likely to invade these vessels and metastasize (spread) to other parts of the liver or elsewhere in the body.4,15

Signs and Symptoms of HCC
  • Unexplained weight loss (over 10% of normal body weight)4,16
  • Loss of appetite4,16
  • Abdominal swelling/bloating4,16
  • Abdominal pain4
  • Jaundice4,16
  • Nausea and/or vomiting4
  • Fever16
  • Weakness and/or fatigue17
  • Sudden worsening of health in someone with a liver condition (e.g., cirrhosis, hepatitis C)16

Testing for HCC

When patients show symptoms of HCC, doctors look to the following areas to aid in evaluating the possibility of the disease:
  • Medical history and physical examination4,18
  • Ultrasound scan4,18
  • Blood tests4,18

If results from the above are inconclusive, more thorough scans will be performed using other imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI), which provide more detailed images of the liver and any tumors that may be present.4 If subsequent imaging techniques do not give a clear result, a biopsy may be required to determine if HCC is present.4