Key Facts
Liver cancer and hepatic cancer are different terms for the same condition.
Cancers that develop from liver cells (primary liver cancers) are rare, however, the number of cases is increasing.
In tropical Africa and parts of Asia, liver cancer is much more common.
In the West, liver cancer is a disease of middle aged and older people and is more common in men than women.
The incidence of liver cancer varies across Europe:
- In men, the highest incidence is in Southern Europe
- In women, the highest incidence is in Northern Europe and the lowest is in Eastern Europe
In addition to the cancer that develops from liver cells (primary liver cancer), cancers from other parts of the body frequently spread to the liver, forming secondary cancers or metastases.
The most common cancers to spread to the liver are bowel, stomach, pancreas, breast and ovarian cancers.
Any form of cancer pressing on the normal parts of the liver and interfering with its essential functions can have severe adverse effects on the rest of the body.
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Key Figures
| Total number of new cancer cases in Europe (2006) |
3.2 million |
| Total number of cancer deaths in Europe (2006) |
1.7 million |
| Number of new primary liver cancer cases (2006) |
50,000 |
|
48,700 (EEA) |
|
38,000 (EU25) |
| Number of liver cancer deaths (2006) |
43,300 (EEA) |
|
42,700 (EU25) |
7 men and 2 women per 100,000 develop liver cancer each year. Overall liver cancer accounts for about 2% of all cancers or 50,000 new cases a year across Europe.
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Cancer Types
There are several types of primary liver cancer:
- HepatoCellular Carcinoma (HCC) spreads to form secondary tumours within the liver and the surrounding lymph nodes.
- Fibrolamellar hepatoma is rare, typically occurring in younger people and is not linked to cirrhosis of the liver or other liver disease.
- Bile duct cancer (or cholangiocarcinoma) starts in the cells of the bile ducts and is more common in women.
- Childhood liver tumours are very rare. However, they are more common in boys than girls and may be hepatoblastomas (in younger children) or HepatoCellular Carcinoma (in older children).
This fact sheet dos not include any details about childhood liver cancers. For information on this topic see the Childhood Cancers section of the Media Centre.
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Causes of Liver Cancer
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Prevention of Liver Cancer
The two main ways of protecting against liver cancer are:
- moderating alcohol intake
- taking precautions to prevent contracting hepatitis
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Common Symptoms
Often there are no symptoms in the early stages of liver cancer.
However, symptoms when they do occur include:
- pain or discomfort in the upper part of the abdomen - especially on the right side
- poor appetite
- weight loss
- nausea and sometimes vomiting
- jaundice
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Screening for Liver Cancer
Patients at particular risk (such as those who have had hepatitis B and C) can be screened on a regular (6 monthly) basis using ultrasound examinations. Earlier diagnosis results in more effective treatment.
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Diagnostic Tests
Ultrasound, CT and MRI (Magnetic Resonance Imaging) scans are all used to show whether a tumour is present and what its precise location is.
However, to confirm the type of tumour in the liver, a biopsy is required.
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Treatment
Treatment for primary liver cancer depends on the size and type of the cancer.
Surgery
For hepatoma, surgical removal of the tumour is the best treatment. A healthy liver is able to regrow even after a large part of it has been removed.
However, if cirrhosis has seriously affected the liver, a liver transplant may be the only available surgical option.
Stereotactic Radiotherapy
Stereotactic radiotherapy is a sophisticated form of radiotherapy which allows treatment to be given from a large number of different angles. This means that large doses of radiotherapy can be delivered to a precise area of the liver with minimal effect on the surrounding normal tissue.
By using imaging equipment during this radiotherapy any change in the tumour position due to breathing can be detected. The machine then compensates by re-targeting the linear accelerator before administering the radiation beam. Continuously checking and correcting ensures accurate radiation targeting throughout treatment.
Chemotherapy
Chemotherapy may also be used in the treatment of primary liver cancer. It can be given either before or after surgery or, alternatively, to relieve symptoms caused by a tumour pressing on the rest of the liver.
Chemoembolisation
Chemoembolisation is a type of treatment that combines giving chemotherapy directly to the cancer in the liver with a gel or small particles that block the blood vessels feeding the area containing the cancer. The drugs are introduced through a tube (catheter) which is placed in the artery in the groin and fed up to the blood vessels in the liver.
Biological Therapies – Monoclonal Antibodies
Monoclonal antibodies are used in the treatment of many forms of cancer. They target the specific proteins that are necessary for the progression of the cancer, and cause very few side effects. In liver cancer, proteins in the cancer cells can be targeted by monoclonal antibodies. Treatment with monoclonal antibodies can be combined with radiotherapy.
Cholangiocarcinomas can be difficult to treat. Both surgery and radiotherapy can be used to treat this form of cancer. However, the first priority is usually to treat the associated jaundice by bypassing the blockage to the bile duct.
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Key Trends
- The incidence of liver cancer is increasing.
- Non surgical treatments are increasingly important in treatment - 10 years ago the only treatment was surgery. Now radiotherapy and biological agents are available, giving patients an improved life expectancy.
- Treatment is now available for primary and secondary liver tumours.
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Important Research Areas
- Improving treatments by developing new treatment options and refining and researching the combination of existing types of treatment.
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