Liver cancer is a disease characterized by the appearance of cancerous tumors, resulting from an uncontrolled multiplication of cells in the liver. It can be localized in the liver or spread. It is the second most common digestive cancer in men, just after colon cancer.
What are the types of liver cancer?
There are several types of liver cancer:
- Hepatocellular carcinoma, also known as hepatocarcinoma, is a type of primary liver cancer. It accounts for more than 90% of annual liver cancer diagnoses. This form of cancer is characterized by the proliferation of cancerous cells at the expense of hepatocytes, which are the healthy cells of the liver. Hepatocytes perform the majority of the liver's metabolic functions, such as glucose management or the processing of toxic substances. Thus, the replacement of hepatocytes by cancer cells disrupts the normal functioning of the hepatic system, endangering the life of the patient suffering from the disease.
- Rare cancers such as epithelioid hemangioendothelioma or cholangiocarcinoma. Unlike hepatocellular carcinoma, these two less common forms of tumors originate in the cells of blood vessels and bile ducts.
- Secondary liver cancers. As the liver is supplied by numerous blood vessels, cancerous cells from other primary cancers can reach it and develop there, forming new tumors called metastases. These tumors, even if located in the liver, did not originally develop from hepatocytes, hence the term secondary liver cancer.
Liver metastases are very common in most cases of advanced cancers, and their management differs completely from that of primary liver cancer.
What are the stages of liver cancer?
There are 4 stages of liver cancer progression (TNM classification), notably:
- Stage I: corresponding to multiple tumors (less than 3 cm), asymptomatic.
- Stage II: more than 3 asymptomatic tumors are located (larger than 3 cm),
- Stage III: liver cancer has spread to the major blood vessels and/or other organs (metastases) and remains asymptomatic.
- Stage IV: corresponding to an advanced stage of cancer. This is classified as end-stage liver cancer. This has reached the major blood vessels of the liver, or even other parts of the body, and presents symptoms
What are the origins and risk factors associated with liver cancer? Liver pathologies, liver metastases
Maladies chroniques hépatiques
Chronic liver diseases are involved in approximately 90% of liver cancer cases.
Liver cirrhosis: Liver cirrhosis is recognized as a significant risk factor for the development of liver cancer, particularly hepatocellular carcinoma (HCC), which is the most common type of primary liver cancer. Cirrhosis involves a change in the liver's structure due to chronic inflammation and the formation of scar tissue, which hinders the liver's ability to function normally. This transformation of liver tissue creates an environment conducive to the appearance and growth of cancerous cells. The causes of cirrhosis that can lead to liver cancer include chronic hepatitis (particularly hepatitis B and C), long-term alcohol abuse, and non-alcoholic steatohepatitis (NASH), among others. Regular monitoring of individuals with cirrhosis is crucial for the early detection of hepatocellular carcinoma, which can significantly improve the patient's chances of survival.
Hepatitis B and C: Hepatitis B and C, caused respectively by the hepatitis B virus (HBV) and the hepatitis C virus (HCV), are major viral infections affecting the liver and playing a crucial role in the development of hepatocellular carcinoma (HCC), the most common type of liver cancer. Chronic infection by these viruses leads to persistent inflammation and liver damage, promoting fibrosis, cirrhosis, and ultimately the development of cancer. The hepatitis B virus has the unique ability to integrate its genetic material into that of liver cells, directly altering the control of cell growth, while the chronic inflammation associated with HCV stimulates an environment conducive to cancerous mutations. Prevention thru vaccination against hepatitis B, early screening, and treatment of these infections are essential to reduce the risk of progression to HCC.
Other risk factors for liver cancer
To a lesser extent, smoking, abnormal fat accumulation in the liver (known as hepatic steatosis), and excess iron in the body (hemochromatosis) are recognized as secondary contributors to the risk of cirrhosis, which can indirectly increase the risk of developing liver cancer.
To date, there is no systematic screening program for liver cancer in France, making knowledge and prevention of risk factors essential to protect against this disease.
Among all the factors mentioned, alcohol abuse tops the list. Anyone struggling with an alcohol problem, regardless of its severity, is strongly encouraged to consult a doctor for appropriate support.
What are the first symptoms of liver cancer?
Liver cancer is asymptomatic at the beginning. Then symptoms of liver cancer appear: increase in liver volume (mass under the ribs on the right side), nodule formation, abdominal pain, nausea, fatigue, loss of appetite, weight loss, or even ascites (abdominal fluid buildup). We can also observe signs of liver failure (jaundice, light-colored stools, dark urine).