Liver Cancer Awareness and Prevention

Liver cancer is treatable and sometimes even curable when it’s caught early. That’s why it’s important to be aware of the risk and recognize any symptoms that could be associated with the disease.

For people who have a high risk for liver cancer because of cirrhosis, UT Southwestern Medical Center offers regular screenings to catch any signs of cancer as early as possible. We also are involved in national projects to improve screening through early detection biomarkers.

“If liver cancer is detected early, then curative therapies – surgical resection, transplant – allow excellent long-term survival,” says Dr. Amit G. Singal, Medical Director of the Liver Tumor Program at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center. However, not enough people who are at risk are screened regularly. Dr. Singal published findings highlighting that liver cancer survival rates could be significantly improved if more people with cirrhosis were screened for tumors using readily available, inexpensive, and noninvasive abdominal ultrasound scans and blood tests.

Risk Factors for Most Common Forms of Liver Cancer

Several factors raise a person’s risk for liver cancer:

• Cirrhosis: This condition causes scar tissue to form in the liver, which significantly increases the chances of developing liver cancer, including hepatocellular carcinoma (HCC) and cholangiocarcinoma. More than 80 percent of patients with hepatocellular carcinoma (HCC) in the United States have cirrhosis, and HCC is a leading cause of death in patients with cirrhosis.
• Chronic hepatitis B and hepatitis C infections: These infections increase the risk of liver cancer (hepatocellular carcinoma and cholangiocarcinoma) because they often lead to cirrhosis of the liver, although hepatitis B can lead to liver cancer without cirrhosis. They are the most common causes of hepatocellular carcinoma. Hepatitis B or C are both treatable conditions and treatment of these conditions significantly reduces the risk of developing HCC. 
• Excessive alcohol use: Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase the risk of liver cancer.
• Nonalcoholic fatty liver disease (NAFLD), obesity, and diabetes: These conditions are all related to fat accumulating in the liver, increasing the risk of liver cancer. NAFLD is now the most common liver disease in the United States, with nearly one-third of Americans having a component of NAFLD.
• Certain inherited liver diseases: Genetic hemochromatosis, tyrosinemia, alpha-1 antitrypsin deficiency, porphyria cutanea tarda, glycogen storage disease, and Wilson’s disease are rare diseases that can damage the liver and increase a person’s liver cancer risk.
• Primary sclerosing cholangitis (PSC): PSC, a chronic disease causing narrowing of the bile ducts, is one of the major causes of cholangiocarcinoma and gallbladder cancer in the United States. Because liver cancer is a major cause of death in patients with PSC, screening for cholangiocarcinoma using MRI and blood tests is encouraged by some experts. 
• Choledochal cyst: A congenital abnormality of the bile duct that is often asymptomatic, a choledochal cyst increases the risk of cholangiocarcinoma. 

Liver Cancer Symptoms

Like many cancers, primary liver cancer seldom produces symptoms in its early stages. That’s why it’s often diagnosed once it has already advanced. If symptoms do occur, they might include:

• Fatigue
• Bloating
• Pain on the right side in the upper abdomen
• Nausea
• Loss of appetite
• Feeling full
• Unexplained weight loss
• Weakness
• Fever
• Jaundice
• White, chalky stool