Memorial Sloan Kettering experts discuss advances in our understanding of primary liver cancer and new approaches to treating it.
Experts from Memorial Sloan Kettering explain that liver function is a key factor in selecting treatment for people with liver cancer.
Interventional radiologist Karen Brown outlines techniques she uses to care for patients with liver cancer
The liver is the body’s largest internal organ. It’s located below the right lung and divided into right and left lobes. The liver is made up of cells called hepatocytes that process nutrients in your blood. It’s responsible for breaking down and storing many of these nutrients, and it helps remove waste from the body. The liver also makes bile, which is a fluid that helps you digest food. It makes proteins that help stop bleeding from cuts or wounds too.
It’s more common to develop liver cancer that has spread from somewhere else in the body, which is called liver metastases. However, each year as many as 16,000 to 20,000 Americans receive a diagnosis of primary liver cancer, which means the cancer begins in the liver itself.
The number of people with primary liver cancer is growing as more Americans have conditions that affect the liver and increase the risk for cancer in this organ, such as chronic hepatitis C. Primary liver cancer tends to occur in people in their 60s and 70s, and is more common in men.
Types of Liver Cancer
There are several types of liver cancer. Each type is different in the way it develops and changes over time, as well as in how it should be treated.
The most common type of primary liver cancer is hepatocellular carcinoma. This cancer begins in liver cells called hepatocytes, which process nutrients in the blood. It often develops as a single tumor that spreads to other tissues and organs over time.
Most Americans with hepatocellular carcinoma also engage in behaviors or have a disease of the liver that causes inflammation and scarring in the organ, such as:
- long-term infection with the hepatitis B or C virus
- a metabolic abnormality, such as nonalcoholic fatty liver disease or too much iron in the body
- excessive alcohol consumption
Intrahepatic cholangiocarcinoma is the second most common type of primary liver cancer. It starts in the tubelike structures called bile duct cells that deliver bile, a substance that helps in digesting food. This type of liver cancer tends to develop in people who have:
- been infected with the hepatitis B or C virus
- primary sclerosing cholangitis, a disease that can lead to inflammation and scarring of the bile ducts
- nonalcoholic fatty liver disease, which involves inflammation that’s unrelated to alcohol consumption
Also known as fibrolamellar carcinoma, this rare type of hepatocellular carcinoma is less aggressive than other types of primary liver cancer. It usually develops in people in their 20s and 30s. It’s often misdiagnosed as a type of noncancerous liver tumor called focal nodular hyperplasia.
These tumors develop along the inner linings of blood vessels. They almost only occur in very young children and are considered curable.
This type of primary liver tumor is made up of tissue that looks like fetal liver cells, bile duct cells, or mature liver cells when we examine them under a microscope. Hepatoblastomas are curable.
Sometimes, a tumor forms in the liver that is benign (noncancerous). This type of cancer often doesn’t cause symptoms or discomfort. Doctors usually find benign liver tumors by chance when a person undergoes imaging tests for another health condition.
Common benign tumors of the liver include:
- cysts in the liver
- focal nodular hyperplasias
How We Care for You
Many people with primary liver cancer survive the disease. At Memorial Sloan Kettering, our goal is to cure your cancer and help you have best possible quality of life. At every step, we’ll work with you to determine the best treatment approach. We’ll consider everything from the type and stage of the liver cancer to your overall health and personal needs.
Our doctors have treated more than 5,000 people with liver cancer over the past decade. Experts from different areas care for every patient. This team includes specialists in surgery, medical oncology, and interventional radiology.
Each year, our surgeons perform hundreds of procedures to remove primary liver tumors. Because we’re so experienced, we’re often able to offer treatment to people whose tumors aren’t considered operable at other hospitals.
If surgery isn’t an option for the type or stage of cancer that you have, MSK interventional radiologists may be able to use imaging tests — such as CT, ultrasound, or MRI — to guide treatments directly to where your tumor is located and destroy it with minimally invasive techniques, such as ablation, NanoKnife, and embolization.
We work to ensure that you have access to innovative techniques, new drugs, and clinical trials if appropriate. We also offer comprehensive follow-up care and survivorship programs for each of our patients with primary liver cancer.