Hello. I'm Dr. Sean Cleary, a liver
surgeon at Mayo Clinic.
In this video, we'll cover
the basics of liver cancer:
What is it?
Who gets it? What are
the symptoms, diagnosis and treatment?
Whether you're looking for answers
for yourself or someone you love,
we're here to give you
the best information available.
First, before we get into liver cancer,
let's talk about what
your liver actually does.
Your liver is a football-sized organ
that sits under the right
portion of your abdomen,
beneath your diaphragm
and beside your stomach.
The liver has over 500 known functions.
But the most common way the liver works is
by: Balancing the chemicals in your blood.
Making bile, which is
a crucial part of the digestive process.
Clearing toxins from the blood
and regulating blood clotting.
Each year, about 24,500 men and
10,000 women are
diagnosed with liver cancer
in the United States.
Most people who have cancer
in the liver have cancer that
spreads, or metastasizes, to
the liver from another site,
such as the colon,
breast, stomach or other organs.
It is important to differentiate this type of
cancer from liver cancer
that begins in the liver cells.
The treatment of cancer
that spreads to the liver,
rather than starting in the liver,
is determined by the original organ
in the body where the cancer started.
So for example, if the cancer
started in your colon
and then spread to the liver,
it would be called metastatic colon cancer.
Today we'll be focusing on
liver cancer that starts in the liver.
As with all cancers,
liver cancer start when changes or
mutations accumulate in the DNA
of those liver cells.
The cells DNA is the material that provides
instructions for every chemical
and structural process in your body.
DNA mutations cause
changes in these instructions.
And when enough of these mutations
accumulate and affect important genes to
cells can begin to grow out of control and
eventually form a tumor
or a mass of cancerous cells.
Most liver cancers occur in
people with an underlying liver disease.
But sometimes liver cancer happens
in people with
no underlying liver disease and
it's not exactly clear
why. Liver disease can cause
longstanding inflammation in the liver and
accumulate mutations that can lead to cancer.
One of the big problems is that
many people can have liver disease and
not be aware of it until their liver is quite
damaged or a cancer forms.
Here are some things that we know increase
your risk of developing liver cancer:
If you have chronic infections
of hepatitis B or C, cirrhosis,
certain inherited liver diseases such as
hemochromatosis and
Wilson's disease, diabetes,
non-alcoholic fatty liver disease,
or an exposure to aflatoxins,
you have a greater chance
of developing liver cancer.
Excessive alcohol consumption over
many years can also
lead to irreversible liver damage
and lead to liver cancer.
Most people don't have signs and symptoms
in the early stages of primary liver cancer.
When signs and symptoms do appear,
they may include unintentional weight loss,
loss of appetite, upper abdominal pain,
nausea and vomiting,
general weakness and fatigue,
abdominal swelling,
jaundice where your eyes and
skin turn yellow, and white, chalky stools.
Other symptoms can include fever,
enlarged veins on the abdomen
that can be seen through the skin,
an abnormal bruising or bleeding.
Screening programs using ultrasound are very
effective at finding liver cancer
before symptoms develop.
And we encourage everyone
with known liver problems to
talk to their doctor about
whether screening is right for you.
Tests and procedures used to diagnose
liver cancer include blood tests.
These may reveal liver
function abnormalities.
Imaging tests such as
an ultrasound, CT, and MRI.
And if you are diagnosed,
the next step is determining
the extent of liver cancer, or stage.
Your doctor will then ask for
staging tests to help determine
the size and location of
cancer and whether it has spread.
Imaging tests used to stage
liver cancer include CT scans,
MRI, and bone scans.
There are different methods
of staging liver cancer.
For example, one method uses
Roman numerals one through four,
and another uses letters A through D.
Your doctor evaluates your cancer stage
to determine your treatment options
and your prognosis.
There are a number of ways
your doctor can help you
develop a strategy to combat liver cancer.
Surgery may be scheduled to remove
the tumor or remove the entire liver to
perform a liver transplant.
Your treatment may include radiation therapy,
which uses high-powered energy
from sources such as X-rays
and protons, to destroy
cancer cells and shrink tumors.
Doctors carefully direct the energy to
liver while sparing
the healthy surrounding tissue.
Chemotherapy is a common
treatment and is the use of
powerful chemicals to combat
and hopefully kill the cancer.
Targeted drug therapy focuses on
specific abnormalities
present within cancer cells.
By blocking these abnormalities,
targeted drug treatments can
cause cancer cells to die.
Liver cancer is a frightening diagnosis,
but finding a team of experts
to work together can help
you sort out your best options for
treatment using the latest technology,
most advanced research and
specialized care techniques. With
new therapies worked on every day.
We have lots of hope for positive outcomes.
If you'd like to learn even more
about liver cancer,
here are related videos, or visit
MayoClinic.org. We wish you well.