Liver Cancer

The liver is located in the upper right side of the abdomen. One of the largest organs in the body, the liver performs several vital functions:

• Helps your body process and absorb nutrients in food
• Produces proteins to help the blood clot
• Stores glycogen (sugar) that the body uses for energy
• Helps your body filter and remove harmful substances

Liver cancer happens when cancer cells form in the liver and create tumors. Liver cancer can either start in the liver (primary liver cancer) or spread to the liver from elsewhere in the body (secondary liver cancer). Liver cancer is treated based on the location where it began.

Liver cancer symptoms aren’t common in the early stages of the disease. Signs of liver cancer that may appear later include:

• Unusual weight loss
• Loss of appetite
• Nausea or vomiting
• Pain in the upper abdomen
• Swelling in the abdomen
• Feeling weak and tired
• Jaundice (the skin and the whites of your eyes look yellow)
• White or chalky stool

We don’t know the exact cause of liver cancer. We do know that there are some factors that increase your risk:

• Drinking excessive amounts of alcohol
• Eating foods contaminated with aflatoxin (poison from a fungus that grows on grains and nuts that have not been stored properly)
• Having a close relative with both hepatitis and liver cancer
• Having cirrhosis of the liver
• Having hepatitis B or hepatitis C

There are several different methods we can use to determine a liver cancer diagnosis:

• Liver biopsy uses a long needle inserted between 2 of the right lower ribs to remove a sample of liver tissue. The tissue sample goes to the lab, where a pathologist will look at the cells under a microscope.
• Computed tomography scan is another tool for detecting liver cancer. A CT scan uses X-rays and contrast dye to make soft tissue visible in images.
• Endoscopic ultrasound combines the technologies of endoscopy and ultrasound and greatly improves our ability to diagnose liver cancer. We are one of the few providers in the Kansas City region offering EUS.
• Positron emission tomography scanning uses a special camera to see organs in the body. The camera records a tracer (radioactive sugar) in your vein. Cancer cells use more sugar than normal cells, so the tracer shows up in the cancer cells.

These tests help your liver cancer care team:

• Detect cancer
• Pinpoint its location
• Decide what kind of cancer it is
• Learn how far it has spread (also called staging)
• Develop a liver cancer treatment plan

This information helps the liver cancer care team determine the best way to treat you after a liver cancer prognosis.

There are several different treatment options for liver cancer. You’ll work closely with your cancer care team to decide which liver cancer treatment may work best for you.

Chemotherapy uses medicines to destroy cancer cells. You may receive chemo by IV or take medicine by mouth. Our doctors have helped develop new chemotherapy drugs, based on clinical studies. These drugs treat specific cells or the way cells grow. They include:

• Targeted therapies that kill cancer cells without affecting healthy cells
• Drugs that prevent the formation of blood vessels that feed tumors

These can be used with regular chemotherapy and surgery, when needed.

In some cases, your doctor may recommend a liver transplant as part of your treatment for liver cancer. The liver transplant program at The University of Kansas Health System is one of the regional leaders. We have performed more than 1,100 liver transplants since the program began in 1990.

Radiation therapy uses high-dose X-rays to kill cancer cells and shrink tumors. It can be internal or external. You may receive radiation, like an X-ray, from outside the body. Or, the doctor may place radioactive material inside your body, near the cancer site. External-beam radiation is not always useful in liver cancer because liver cells are very sensitive to radiation. Radiation therapy is used to relieve pain by shrinking the tumor.

Proton therapy is the leading-edge form of radiation treatment currently available. Proton therapy is a form of external beam radiation that uses energized protons to deliver radiation to a tumor.

Interventional radiology uses several advanced techniques, such as:

• Embolization: Cuts off the blood supply to the tumor
• Radiofrequency ablation: Destroys tumor tissue with heat
• Chemoembolization: Injects anticancer drugs directly into the blood vessel feeding a cancerous tumor
• Microwave ablation: Injects microwave energy, similar to your microwave at home, through a fine needle to destroy cancer cells
• Calypso^® 4D Localization System™: Uses leading-edge technology to track the movement of targeted tissue for more accurate delivery of energy
• Radioembolization: Uses radioactive TheraSpheres®, glass beads, to treat primary liver cancer, and SIR-Spheres uses beads of biocompatible resin to treat metastatic liver cancer. Radioembolization is usually combined with chemotherapy.

Sometimes people with liver cancer take part in clinical trials. Clinical trials are research studies to help find better ways of preventing, diagnosing and treating liver cancer.

If you have liver cancer, you will find the leading specialists you need at The University of Kansas Cancer Center. We have an interdisciplinary team of fellowship-trained doctors who specialize in:

• Liver disease (hepatologists)
• Liver surgery (hepatobiliary surgeons)
• Cancer (medical oncologists)
• Radiation therapy (radiation oncologists)
• Using imaging to deliver treatment for liver cancer (interventional radiologists)

They have years of experience treating hundreds of patients with a liver cancer diagnosis.

Among the treatment options we incorporate for liver cancer are new-generation targeted chemotherapy, minimally invasive precision surgery, liver transplants, chemoembolization, radiofrequency ablation and TheraSphere therapy.