Types of Liver Cancer
When we here the terms "lung cancer," "breast cancer," and "liver cancer," we instantly get scared — and for good reason. However, for all of these cancers (and most others), there are actually several types of cancers
If you’ve recently become diagnosed with liver cancer, your specific type of cancer is diagnosed based on the type of cancerous cells. There are five main types of liver cancers.
Hepatocellular Carcinoma (HCC)
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It accounts for up to 75 percent of all liver cancers.
HCC is called hepatocellular carcinoma because it originates in the hepatocellular cells of the liver, which are the main cells of the liver. This type of cancer typically occurs due to infections of the liver, such as hepatitis B or C, or alcoholism with subsequent cirrhosis.
Some people have no symptoms of liver cancer. However, if symptoms are noted, they commonly include:
- Blood in the stool
- Weight loss without trying
- Ascites (fluid in the abdomen)
Prognosis for HCC is excellent if it is caught early. If caught early, it can be treated with surgery and/or transplant. In more advanced cases when cure is not the goal, the treatment will be aimed at increasing life expectancy and quality of life.
There are a variety of surgical options for HCC. A partial hepatectomy can be performed; this removes the part of the liver that as cancer. If this is not feasible, a liver transplant may be recommended, which is a much larger surgery. This surgery has a longer hospitalization time and requires long-term anti-rejection medications post-transplant. It also requires a donor from someone who has recently passed away; you could be on a donor list for a long time before it is your turn.
Radiation may be recommended. This uses high-energy rays to kill cancer cells. Two types may be used:
- Internal radiation: Tiny radioactive particles are injected into the artery that supplies the liver with blood. These particles destroy the tumor in the liver. A doctor injects the radiation.
- External radiation: a machine is aimed at the liver and the rays penetrate through the skin.
Chemotherapy may be prescribed. For HCC, chemoembolization is often the prescribed type of chemotherapy. Chemoembolization is when a doctor places the chemotherapy drugs directly into the liver.
Percutaneous ethanol injection, also known as “alcohol injection," uses an ultrasound machine to allow a physician to inject alcohol into the liver. This injection of alcohol destroys the cancer.
This type of liver cancer is rare. However, it is more responsive to cancer treatments than other types of liver cancer, IF it is caught in the early stages.
Fibrolamellar HCC is so rare that it is considered “ultra-rare” — it affects one in 5,000,000 people, which equates to about 1,000 people annually. It most commonly occurs in adolescents and young adults who have no history of any type of liver disease.
Symptoms of fibrolamellar HCC include:
- Abdominal pain
- Shoulder pain
- Back pain
- Loss of appetite with weight loss
- Palpable liver mass
- Occasionally, gynecomastia in boys and men (there may be a hormonal influence of the fibrolamellar cells that causes gynecomastia)
Treatment is aimed at cure of the cancer. This is not always possible, and if cure is not possible, the goal then is to slow the progression of the cancer.
If possible, surgical intervention is performed to remove the tumor. Transplant of the liver is also ideal. Because the cancer is so rare, there is no standard of care when it comes to treatment plans so all patients are treated differently. Therapies that have been utilized for fibrolamellar HCC include chemotherapy, immunotherapy, cryoablation, radiofrequency ablation, external beam ablation, embolization, nanoknife, and percutaneous hepatic perfusion.
This type of liver cancer occurs in the bile ducts of the liver. These bile ducts connect the liver to the gallbladder.
This type of cancer occurs in about 10 percent to 20 percent of all liver cancers. It can be further broken down in to intrahepatic bile duct cancer (within the bile ducts) or extrahepatic bile duct cancer (outside of the bile ducts).
The symptoms of cholangiocarcinoma can mimic other conditions, such as gallstones and hepatitis. Some of these symptoms overlap other types of liver cancers, but others are unique to cholangiocarcinoma:
- Stools that are pale in color and have a greasy-looking consistency
- Dark urine