Primary liver cancer is one of the most aggressive cancers of the digestive system. However, it is also one of the cancers for which treatments have advanced the most over the past few years.
Liver cancer tends to develop following a disease such as infection with hepatitis viruses (B and C), iron overload and chronic hepatitis linked to obesity. Its incidence is rising in France. Every year, close to 9,000 new cases are reported and 6,700 people die of liver cancer. This is one of the highest cancer death rates and is explained by the fact that liver cancer is ‘silent’ because the symptoms only appear when the disease is already at an advanced stage. Liver cancer is often diagnosed late and in 75% of cases, the tumor is already at an advanced stage. Sometimes care is solely palliative and it is estimated that only 10% of patients will survive their cancer for five years or more.
Liver cancer most frequently develops in a liver already damaged by a disease such as cirrhosis or Hepatitis B or C and only rarely in a healthy liver. The most common type is hepatocellular carcinoma, which is sometimes called a hepatoma. This type of liver cancer develops from the main liver cells called hepatocytes. Men account for almost 80% of new cases. Symptoms are major weight loss, loss of appetite, nausea, pain in the upper right-hand section of the abdomen and even swelling which can be detected by palpation.
The symptoms of liver cancer are quite nonspecific. A series of tests therefore need to be conducted to establish a diagnosis and evaluate the state of the liver.
A six monthly liver ultrasound scan of people who are at risk (people with hepatitis or at risk of cirrhosis or with cirrhosis) helps to detect small tumors. Unfortunately, this international recommendation is not widely followed.
There are four types of treatment for liver cancer: liver resection, liver transplant, radiofrequency ablation and chemotherapy.
If the liver is still functioning, the part of the liver where the tumor has grown can be removed. When the liver is no longer functioning normally, it is replaced by transplanting a healthy liver.
Radiofrequency ablation is an alternative to surgery, depending on the size and location of the tumor in the liver. This relatively recent technique involves putting a probe into the tumor and using an electrical current to kill cancer cells.
Chemotherapy slows down the development of cancer when the tumor cannot be removed. It is administered in two ways: chemoembolization and chemotherapy into the liver’s blood supply (known as transarterial infusion chemotherapy).
Institut National du Cancer, Le cancer du foie : les points clés
Bayer, Le cancer du foie : l’espoir d’un dépistage précoce
Institut Curie, Le cancer du foie