How can liver cancer be diagnosed? What are the treatments for liver cancer?

Liver cancer is the third most common cancer worldwide. Primary liver cancer means the tumor begins in the liver. The most common type of primary liver cancer is called hepatocellular carcinoma. Patients with underlying chronic liver disease and who have developed cirrhosis are most likely to develop this type of cancer.

How is liver cancer diagnosed?

1. Clinical diagnosis

Often, liver tumors are discovered during routine screening or when they cause symptoms due to their size or location. Common symptoms include weakness, fatigue, weight loss, and loss of appetite. Other possible symptoms are fever, night sweats, and abdominal pain, but these occur less frequently.

Patients with chronic liver disease often have symptoms of cirrhosis, such as jaundice, itching, an enlarged spleen, severe weight loss and weakness, as well as upper gastrointestinal bleeding, which is caused when blood drains back through the blood vessels in the stomach and esophagus, which then swell and split.

2. Imaging test

Doctors can use a variety of techniques to diagnose liver cancer and determine its severity, also known as the stage of liver cancer, including imaging procedures such as ultrasound, CT, and MRI. Other specific options depend on the exact type of liver cancer involved, such as testing for tumor markers in the blood or using imaging techniques.

3. Biopsy

In most cases, a biopsy is needed to determine the exact type of cancer and judge its aggressiveness. These are now usually performed using image-guided, minimally invasive techniques that involve inserting a needle through the abdominal wall in the stomach area directly into the liver.

What are the treatments for liver cancer?

1. Traditional surgery

Both traditional surgery and interventional techniques play a role in treating liver cancer. If you have hepatocellular carcinoma, surgical options include removal of all or part of the liver and a liver transplant. However, many patients are not eligible for this treatment for a variety of reasons.

2. Interventional techniques

Interventional alternatives include several percutaneous thermal ablation techniques, which means a needle is inserted into the liver tumor under imaging guidance through which extreme temperatures are delivered to destroy the tumor. Types of percutaneous thermal ablation techniques include radiofrequency ablation, microwave ablation, cryoablation, or electroporation.

In some cases, liver tumors have an unusually large number of blood vessels attached to them. This increases the risk of bleeding, making it harder to remove the tumor. A treatment called transarterial chemoembolization can relieve the pain and distress caused by these tumors. In this procedure, an interventional radiologist delivers high doses of cancer-killing drugs directly into the tumor.

3. Radioembolization

Another possible treatment is radioembolization, a technique similar to transarterial chemoembolization that is used to extend and improve a patient's quality of life. During this procedure, interventional radiologists inject radioactive microspheres directly into the tumor, a targeted approach that can destroy liver cancer cells or slow their growth.