Primary liver cancer

Primary liver cancer

What is primary liver cancer?

Primary liver cancer is a tumour that starts in the liver and grows in an uncontrolled way.

The main type of primary liver cancer that can affect adults is hepatocellular carcinoma (HCC). HCC starts in the hepatocytes, the liver’s main cell type, and is also known as hepatoma. Here we focus on HCC.

A less common type of liver cancer can start in the bile ducts that connect the liver to the bowel and gall bladder. This is known as cholangiocarcinoma or bile duct cancer.

A very rare type of liver cancer that starts in the blood vessels is known as angiosarcoma. Hepatoblastoma is a form of liver cancer that affects only young children and is also very rare.

Cancer that starts in another part of the body and spreads to the liver is known as secondary cancer in the liver.

Learn more about:

The liver

The liver is the largest organ inside the body. It is part of the digestive system and is found next to the stomach on the right side of the abdomen under the ribs. The gall bladder sits under the liver, and the pancreas sits under the stomach. These organs work together to help the body process food.

The digestive system

The digestive system

How the liver works

The two main sections of the liver are the right and left lobes. Blood flows into the liver from the hepatic artery and the portal vein. Blood in the hepatic artery comes from the heart and carries oxygen, while blood in the portal vein comes from the stomach and carries nutrients and substances such as medicines or alcohol to the liver.

The liver does many important jobs. These include:

  • breaking down drugs and alcohol, and getting rid of toxins
  • producing bile to help dissolve fat so it can be easily digested
  • storing and releasing sugars (glucose) as needed
  • storing nutrients
  • making proteins to help blood clot and to balance fluid in the body.

Unlike other internal organs, a healthy liver can usually repair itself if injured. It can continue to function even when only a small part is working and may grow back to its normal size in 6–8 weeks.

Bile is made in the liver and stored in the gall bladder. A series of tubes called bile ducts carry bile between the liver and gall bladder. The common bile duct carries bile from the liver and gall bladder to the bowel, where it helps to break down fats.

Who gets primary liver cancer?

In Australia, about 1900 people are diagnosed with primary liver cancer each year, with almost three times as many men as women affected.

HCC most often develops in people with underlying liver disease caused by obesity, drinking too much alcohol or infection with hepatitis B or C. It is common in Asia, the Pacific Islands and Africa due to high rates of hepatitis B infection.

In Australia, HCC is more common in migrants from Vietnam, China, Taiwan, Hong Kong and Korea – countries where there is a higher rate of hepatitis B infection.

What causes primary liver cancer?

The main type of primary liver cancer, HCC, is most often related to long-term (chronic) infection caused by the hepatitis B or C virus. See the next section below for more information. Talk to your doctor if you are concerned about the link between hepatitis and liver cancer.

Liver scarring (cirrhosis) can also increase a person’s risk of developing HCC. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs and naturally produced toxins. It also slows the liver’s production of proteins and other substances.

Cirrhosis may develop slowly over months or years. It can be caused by a number of factors, including:

  • hepatitis B or C
  • fatty liver disease – often related to a high-carbohydrate diet, being overweight or obese, drinking too much alcohol, or having type 2 diabetes
  • alcohol consumption (with or without fatty liver disease)
  • type 2 diabetes (with or without fatty liver disease)
  • genetic disorders such as iron overload (haemochromatosis) or low levels of a particular protein that can cause tissue in the lungs and liver to break down (alpha-1 antitrypsin deficiency).

Smoking tobacco also increases a person’s risk of developing HCC.

People with more than one risk factor for HCC have an increased risk of developing the disease.

Link between hepatitis and liver cancer

Worldwide, about 8 in 10 cases of HCC can be linked to infection with the hepatitis B or C virus.

Hepatitis B and C spread through contact with infected blood, semen or other body fluids. This can occur during sex with an infected partner, or by sharing personal items, such as razors, toothbrushes or needles, with an infected person. The most common way hepatitis B spreads is from mother to baby during birth.

When a person has hepatitis, the virus attaches to the liver cells (hepatocytes) and starts multiplying. The body’s immune system then attacks the virus, causing liver inflammation. If the hepatitis infection lasts more than six months (chronic infection), this inflammation may lead to liver scarring (cirrhosis) that can increase the risk of developing liver cancer.

To limit the spread of hepatitis B and the rate of primary liver cancer, all at-risk people should be vaccinated against the virus.

At-risk people include:

  • migrants from South-East Asia, Africa and the Pacific Islands
  • sexually active partners of individuals with hepatitis B
  • people living in a household with someone with hepatitis B
  • recipients of blood products
  • infants and children (these are vaccinated as part of Australia’s National Immunisation Program).

If you are already infected with hepatitis B, vaccination won’t help but you will have regular tests to ensure you don’t develop liver problems. If you do have signs of liver damage from hepatitis B, you will be offered antiviral medicines to help manage the effects of the infection and prevent further liver damage.

New antiviral medicines can cure hepatitis C in most people. This lowers the risk of developing liver cancer but does not eliminate it. Even after successful hepatitis treatment, people with cirrhosis need long-term monitoring.

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EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
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This information was last reviewed in May 2018
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