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Liver Cancer

When cancer starts in the tissue of the liver it is referred to as primary liver cancer.

When cancer has spread (or metastasized) from another organ into the liver, it is referred to as secondary liver cancer or metastatic liver cancer. In the U.S., metastatic liver cancer is more common than primary liver cancer.

Common types of liver cancer

  • Hepatocellular carcinoma is the most common type of liver cancer, accounting for 80 percent of primary liver cancer cases.
  • Bile duct cancer (also known as intrahepatic cholangiocarcinoma or Klatskin’s tumor) is the second most common type of primary liver cancer.
  • Hepatoblastoma is a rare childhood cancer that can develop in children younger than 4 years old.
  • Metastatic cancer occurs when other cancers spread (or metastasize) from another organ to the liver.

Risk factors for liver cancer

Liver cancer affects more men than women, and typically develops after age 50. Other liver cancer risk factors include the following:

  • Hepatitis B or C
  • Alcohol abuse
  • Cirrhosis from any cause (liver damage that leads to scarring and liver failure)
  • Metabolic syndrome, a set of conditions including excess abdominal fat, high blood sugar, high blood pressure, high levels of triglycerides and low levels of high-density lipoproteins in the blood
  • Fatty liver disease
  • Obesity
  • Primary sclerosing cholangitis (inflammation and narrowing of the bile ducts)

If you have any of these risk factors, your doctor may recommend regular surveillance and screening, which may help detect tumors at an early stage. As with most cancers, liver cancer that is detected early responds more effectively to treatment.

Liver cancer symptoms

Symptoms of liver cancer may not be present until the disease is advanced. Call your primary care physician right away if you experience any of the following symptoms:

A hard lump just under the rib cage on the right side

  • Jaundice (yellowing of the skin or whites of the eyes)
  • Abdominal swelling
  • Pain or discomfort on the upper right side of the abdomen
  • Easy bruising or bleeding

How can I get help for liver cancer?

After examining you and running diagnostic tests, your doctor may refer you to a medical oncologist, hepatologist (liver specialist) or surgeon at Rush for additional tests and exams as needed.

You may need one or more of the following diagnostic tests:

  • Abdominal imaging
  • Blood tests
  • Liver biopsy

Care for liver cancer at Rush

Liver cancer experts at Rush take a multidisciplinary approach to your treatment. Your care team may include medical oncologists, hepatologists, transplant surgeons, interventional radiologists and others. Together, they will create an individualized care plan for you.

Treatment may include some of the following, either in combination or alone:

Drug therapies

Liver cancer does not respond well to medications alone. However, your treatment may include drug therapies used in combination with each other or other liver cancer treatments.

  • Chemotherapy: You may receive chemotherapy directly into the liver via a catheter in the blood stream of the liver to reduce the size of the tumor. You may also have the option of using oral therapy (a pill). Chemotherapy is also sometimes used shrink the cancerous area in the liver before surgery.
  • Targeted therapy: Using drugs that identify and attack cancer cells without harming normal cells, targeted therapy drugs stop cancer cells from dividing; prevent the growth of blood vessels that feed the tumor; and target proteins on cancer cells that help them grow.

Surgery

  • Liver surgery: Your liver surgeon may remove part of the liver, leaving healthy tissue. The remaining liver will take over and may even regenerate itself.
  • Liver transplant: If the tumor cannot be removed surgically, liver transplant may be an option. Your transplant surgeon will remove the entire liver and replace it with a healthy donor liver. The Liver Transplant Program team at Rush will provide expert care before, during and after your transplant.

Minimally invasive procedures

  • Tumor ablation: Ablation therapy destroys liver cancer cells with radiowaves, microwaves or cryoablation (extreme cold). Ablation is typically used when surgery is not an option due to ailing overall health or poor liver function.
  • NanoKnife: The NanoKnife destroys cancer cells by using bursts of electricity administered through needle-like probes, which your interventional radiologist will thread through the skin and guide by ultrasound or CT. This procedure is typically used on small tumors, and it can be used to treat both primary liver cancer and metastatic liver cancer.

Embolization

Embolization uses substances to block or reduce the blood flow to cancer cells in the liver. It is typically used for larger tumors that cannot be removed surgically.

  • Chemoembolization: Your doctor will inject an anticancer drug that gets trapped close to the tumor to help cut off the flow of blood to the tumor from the hepatic artery. The healthy parts of the liver are nourished by the hepatic portal vein.
  • Radioembolization: Your doctor will inject radioactive microbeads through the blood vessels to the tumor, which deliver targeted radiation for several days.

Radiation therapy

  • External beam radiation: High-energy radiation is used to destroy tumor cells. It cannot be used at high doses because it can easily damage normal liver tissue. For this reason, radiation is not used as often as ablation or embolization.
  • Three-dimensional conformal radiation therapy (3D-CRT): Advanced technology precisely maps the tumor in 3D, allowing your doctor to better target the tumor, while sparing healthy surrounding tissue.
  • Stereotactic body radiation: Special equipment delivers focused beams of high-dose radiation directly to the tumor over just a few days, compared to external beam radiation, which is delivered five days a week for several weeks.

Why choose Rush for liver cancer care

  • Team-based approach: A multidisciplinary team of liver cancer specialists in medical oncology, hepatology, liver transplant and interventional radiology will collaborate to create a personalized plan of care for you.
  • Experienced liver transplant program: The liver transplant program at Rush is one of the most active programs of its kind in the U.S., successfully performing liver transplants for more than 30 years.
  • Advanced radiation capabilities: Radiation therapists at Rush have extensive experience and access to advanced radiation technologies. They are able to conform radiation beams to tumors with great precision, sparing as much healthy tissue as possible.
  • Latest technology: Interventional radiologists at Rush use the most advanced technology, such as the NanoKnife and radioactive microbeads, which target liver tumors more precisely and spare surrounding healthy tissue.
  • Accredited care: The Rush University Cancer Center received the Outstanding Achievement Award from the American College of Surgeons’ Commission on Cancer in its most recent survey. Rush has received this triennial award all four times since the award was created in 2004. The prestigious award recognizes programs that excel in providing quality cancer care.

Departments and programs that treat this condition