Liver Cancer

Symptoms and risk factors

Yellowing of skin or pain in the abdomen could be signs of liver cancer.

Most often, people are asymptomatic in the early stages of this kind of cancer. However, if you have the following symptoms, this can be an early indicator or another related condition:

• Pain or swelling on the right side of the abdomen
• Yellowing of the skin and whites of the eyes (jaundice)
• A hard lump on the right side of the abdomen below the rib cage
• Nausea or vomiting
• Loss of appetite or sudden weight loss
• Unusual bowel movements that are chalky or pale

If you notice any of these symptoms, talk to your doctor.

People with Hepatitis B or Hepatitis C have an increased risk of developing cancer.

The hepatitis B and hepatitis C viruses significantly increase your risk of developing cancer in the liver. Other factors that may increase your risk are:

• Having liver scarring (cirrhosis) caused by:
  • Hepatitis
  • Excessive alcohol use
  • A long-term liver injury
• Having nonalcoholic fatty liver disease (NAFLD), which commonly occurs in people who have metabolic syndrome (group of conditions involving extra fat around the abdomen, high blood sugar and blood pressure, and abnormal cholesterol)
• Having hemochromatosis, a hereditary condition that causes the body to absorb too much iron

Having a risk factor doesn't mean you will develop the disease, but you should talk to your doctor about your risk so they can help determine if you would benefit from screening.

Screening and prevention

Screening can help patients with a high risk of liver cancer detect it early while it's treatable.

Unlike breast cancer or colon cancer, there are no universal guidelines for undergoing regular screening for the entire population. However, patients who know they have one or more risk factors may benefit from a screening to identify the disease while it is more easily treated.

At MedStar Health, we offer a High-Risk Gastrointestinal Cancer Prevention program for patients with a high risk. Through the prevention program, we take a proactive and personalized approach to helping you understand and mitigate your risk of the disease through screening, genetic counseling, and other strategies. Screening tests are typically performed every six months and may include:

• Liver MRI
• Alpha-fetoprotein (AFP) blood test

Adequate imaging is the best way to ensure we can accurately see what's happening in the liver. That's why it's so important to seek screening at a facility that offers the latest technology and highly-trained radiologists who specialize in reading these types of test results. Because we have a team that focuses exclusively on abdominal imaging, we know the nuances of these tests and are at the forefront of advanced techniques for screening for and diagnosing.

Ways to minimize your chances of developing liver cancer

This cancer may not be preventable but you can significantly decrease your likelihood of the disease by:

• Living a healthy lifestyle through exercise and a nutritious diet
• Limiting alcohol use
• Protecting yourself against hepatitis B and C infections by:
  • Getting the hepatitis B vaccine
  • Avoiding sharing unsterilized needles
  • Using protection during sex

Diagnosis

Diagnostic tests give us information about the location, size, and extent of your cancer.

There are several diagnostic tests that help us detect and stage this cancer, including:

• Blood tests: We may use a serum tumor marker test to measure the amounts of alphafetoprotein (AFP) in the blood. A high AFP level may indicate cancer, although other conditions can also elevate AFP.
• Diagnostic imaging: Advanced imaging tests help us view your tumor and help us understand its exact size and location. Unlike other types of cancers who rely on biopsies for diagnosis, diagnostic imaging is often the best way to diagnose, if you have the right equipment used under the guidance of experienced radiologists. We may use a combination of computed tomography (CT scan), positron emission tomography (PET), magnetic resonance imaging (MRI), or ultrasound tests to accurately evaluate any abnormalities in the liver.
• Biopsies: If we need a biopsy to diagnose, we'll take tissue samples from the liver. There are different procedures that we use to collect samples, including fine-needle and core needle biopsies and a minimally-invasive procedure called laparoscopy. We can also analyze these tissue samples to better understand the genetic or molecular characteristics (biomarkers) of the tumor which can help us predict how a tumor will respond to certain treatments.

Treatments

Advances in surgery and therapies are helping more and more patients survive.

Your liver treatment will include input from several specialists, including surgeons, medical oncologists, radiation oncologists, interventional radiologists, and others. This collaborative approach ensures we think through the least invasive and most effective way to remove your cancer and give you the best chance at living a healthier, longer life.

No two treatments are the same, and your treatment will consider:

• The size of your liver tumor
• How far the cancer has spread
• How well your liver is functioning
• Your overall health

Why choose us

Our team has decades of combined experience across a variety of specialties. Research proves that multidisciplinary cancer care leads to better clinical outcomes and experiences for patients. Through our Pancreas and Liver Disease program, patients have access to an integrated and collaborative team of doctors and surgeons who have specialty training in certain areas. Our team approach ensures we deliver comprehensive care with input from world-class specialists in:

• Gastrointestinal surgical oncology

• Liver transplant surgery

• Medical oncology

• Radiation oncology

• Interventional radiology

• Diagnostic radiology

• Hepatology

• Gastroenterology

• Pathology

• Rehabilitation

• Nutrition

• Genetic counseling

• and others

Our surgical program is the only one of its kind in the region specializing in minimally invasive, open, and hybrid approaches to liver surgery. Our board-certified, fellowship-trained surgeons are pioneers in new techniques that lead to better outcomes, fewer complications, and faster recoveries for patients who may benefit from surgery.

And because our Center for Liver and Pancreas Surgery is part of the region's largest transplant center, the MedStar Georgetown Transplant Institute, patients benefit from seamless, coordinated care with one of the best transplant teams in the area. This is important because many patients with this cancer also have underlying liver disease that must be addressed to minimize recurrence of cancer. A liver transplant may offer the best option for restoring a patient with liver disease or cancer to a healthy life.

We offer and lead state-of-the-art therapies approved by the FDA and under discovery in clinical trials. Cancer is changing all the time. That's why it's important to get care from a place that has nationally-recognized leaders who are conducting the latest research, rather than reading it in a textbook or journal months or years after it's discovered. Our clinical trials have led to FDA-approved therapies for treating this sort of cancer, which translates into better outcomes for our patients and others seeking treatment around the world.

We deliver patient-centered care and help you navigate your treatment with compassion. Our patients are mothers, fathers, sisters, brothers, aunts, uncles, and grandparents, and we treat them with the same empathy and respect that we'd want for our own family members. From your nurses and care coordinators to your doctors and surgeons, your entire care team is here to support you, encourage you, and help you achieve the highest quality of life throughout your journey.