What Are the Symptoms of Stage I Liver Cancer?

The two main types of liver cancers are:

1. Primary liver cancer, which begins in the cells of the liver.
2. Secondary liver cancer, which develops when cancer cells from another organ spread to the liver. This type is also called metastatic liver cancer. Metastatic cancer has the same type of cancer cells, and it is named the same as original cancer. Often, cancers found in the liver are secondary liver cancers.

• Hepatocellular carcinoma (HCC): Also known as hepatoma, this is the most common primary liver cancer in adults that accounts for about 75 percent of cases. It develops in the main liver cells known as hepatocytes. It either begins as a single tumor or as many small cancer nodules throughout the liver.
• Intrahepatic cholangiocarcinoma (bile duct cancer): About 10 to 20 percent of primary liver cancers are intrahepatic cholangiocarcinomas. These cancers start in the cells that line bile ducts. When cancer begins in bile ducts inside the liver, it’s called intrahepatic cholangiocarcinoma. When cancer begins in bile ducts outside the liver, it’s called extrahepatic cholangiocarcinoma.
• Liver angiosarcoma and hemangiosarcoma: These are rare cancers that begin in the inner lining of blood vessels in the liver.
• Hepatoblastoma: This is a rare type of cancer that develops in children younger than four years of age. The cells of hepatoblastoma are similar to fetal liver cells.

Primary liver cancer is staged as follows based on the size of cancer and its spread:

• Stage I: Tumor remains in the primary site, which is the liver.
• Stage II: There are many small tumors in the liver, or one tumor has reached a blood vessel.
• Stage III: There are several large tumors in the liver or one tumor that has reached a main, large blood vessel.
• Stage IV: Liver cancer has metastasized. It has spread to other parts of the body.

Symptoms are not common in the early stages of liver cancer. Later stage symptoms include

• Weight loss
• Abdominal swelling, pain and tenderness
• Pain close to right shoulder blade
• Enlarged liver, spleen or both
• Jaundice (yellowing of the skin and eyes)
• White, chalky stools
• Dark-colored urine
• Nausea
• Vomiting
• Loss of appetite
• Feeling full after a small meal
• Back pain
• Itching
• Fever
• Bruising or bleeding easily
• Weakness and fatigue
• Swollen veins, which are visible under the abdominal skin.

The exact causes of liver cancer are unknown. Liver cancer occurs when liver cells develop changes (mutations) in their deoxyribonucleic acid (DNA). DNA mutations cause the liver cells to become cancerous and grow out of control, forming a tumor.

Risk factors of primary liver cancer

Factors that increase the risk of primary liver cancer include

• Chronic infection with hepatitis B virus or hepatitis C virus
• Liver cirrhosis
• Family history of liver cancer
• Type 2 diabetes
• Obesity
• Fatty liver disease
• Exposure to aflatoxins
• Excessive alcohol consumption
• Weakened immune system (human immunodeficiency virus infection and acquired immune deficiency syndrome or HIV/AIDS)
• Male gender
• Smoking
• Aged 50 years and older
• Inherited liver diseases, such as hemochromatosis and Wilson disease
• Rare diseases, such as tyrosinemia, alpha1-antitrypsin deficiency, porphyria cutanea tarda and glycogen storage diseases
• Exposure to vinyl chloride and thorium dioxide
• Use of anabolic steroids

Tests and procedures used to diagnose liver cancer include

• Medical history
• Physical examination
• Blood tests
• Liver function test
• Viral hepatitis tests for hepatitis B and C
• Ultrasound
• Imaging scans: X-ray, magnetic resonance imaging (MRI) scan or computed tomography (CT) scan help to determine the size and spread of cancer.
• Liver biopsy: A tissue sample of the tumor is examined under a microscope.
• Laparoscopy: A long, flexible tube with a camera is inserted through a cut in the abdomen to examine the liver and the surrounding area.

Treatments for liver cancer depend on the stage of the disease as well as age, health condition and personal preferences of the patient. Treatment options are

• Partial hepatectomy: Part of the liver with cancer is removed surgically. Over time, healthy tissues will grow to replace the missing part.
• Liver transplant surgery: The diseased liver is removed and replaced with a healthy liver from a donor.
• Ablation therapy: Radio waves, electromagnetic waves, laser, heat or ethanol injections are used to shrink or prevent the growth of the tumor.
• Cryoablation: Tumor is destroyed by freezing it with liquid nitrogen.
• Radiation therapy: High energy radiation beams are directed at the tumor to destroy cancer cells.
• Chemotherapy: Anticancer drugs are injected into the bloodstream or given orally to kill cancer cells.
• Embolization: The blood supply to the cancer is blocked to destroy it.
• Chemoembolization: Chemotherapy drugs are injected and the blood supply is blocked to trap the drug in the tumor.
• Targeted therapy: Targeted therapy uses medications designed to destroy cancer cells by targeting properties specific to cancer cells.
• Immunotherapy: The body’s immune system is triggered to fight cancer.