Liver cancer: diagnosis, treatment options, and more
Understanding Liver Cancer
Liver cancer is defined as when cancer starts in the liver. This is distinct from finding metastatic disease in the liver, which is when other types of cancer like breast or colon cancer spread to the liver. The most common type of liver cancer is called hepatocellular carcinoma; another type called intrahepatic cholangiocarcinoma affects the bile ducts. Certain things increase the risk of liver cancer, like cirrhosis, chronic hepatitis B, alcohol use, fatty liver disease, and more. If you're at risk, your doctor might do regular screening tests like liver ultrasounds and labs for alpha-fetoprotein (AFP).
Diagnosing and Staging Liver Cancer
Doctors use imaging like CT scans or MRIs and lab tests to diagnose liver cancer. They often do a biopsy, which means taking a tiny piece of tissue to confirm the diagnosis and look for specific changes in the cancer.
Just like with other cancers, doctors try to figure out how the extent of spread of liver cancer, or "stage". This depends on the tumor's size (T), whether cancer is in the lymph nodes (N), and if it has spread to other parts of the body (M). The stages go from 1 to 4, with stage 4 representing metastatic disease or when the cancer has left the liver and traveled to other parts of the body. Doctors also calculate a fibrosis score and Child-Pugh class, which tell them about the liver's health and how the disease affects you. This helps them decide if surgery or a transplant is an option.
Treating Liver Cancer
Early Stage:
If liver cancer is caught early, some people can have surgery or a liver transplant. But not everyone can do this. Some patients get treatments before surgery or transplant to control the cancer. These can include procedures like ablation or embolization.
Advanced Stage:
If surgery isn't an option, there are still treatments. Patients might get local treatments like ablation or embolization, which come in different forms. There are also several systemic therapies. Lately, new targeted therapies and immunotherapies have been approved for liver cancer. Doctors will check your Child-Pugh class to see if these treatments can be used.
Remember to discuss your specific diagnosis and treatment options with your doctor.
