What Are the Symptoms of Stage I Liver Cancer?

Liver cancer, hepatic cancer or hepatocellular cancer (HCC) is a cancer that begins in the liver. Normal liver cells become abnormal in appearance and behavior and grow out of control.

The liver is one of the most important organs in the body performing various functions, including aiding digestion, removing toxins from the body and producing several proteins (such as blood clotting factors). When cancer develops in the liver, it interferes with the functions of the liver. There are usually no symptoms in the early stages of liver cancer. Liver cancer is difficult to cure. Even when successfully treated, liver cancer may relapse. Hence, regular follow-ups with the doctor are needed.

What are the types of liver cancer?

The two main types of liver cancers are:

Primary liver cancer, which begins in the cells of the liver.
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.

Types of primary liver cancer

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.

Stages of liver cancer

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.

What are the signs and symptoms of liver cancer?

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.

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What causes liver cancer?

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

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How is liver cancer diagnosed?

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.

How is liver cancer treated?

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.