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Liver cancer Q&As

Published by Bupa's health information team, October 2008.

Answers to questions about liver cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Why are people with hepatitis B or hepatitis C more at risk of developing liver cancer, even if they don't have cirrhosis?

Hepatitis B and hepatitis C are both diseases that can cause a type of liver cancer called a hepatocellular carcinoma (HCC). This is usually as a result of cirrhosis. However, it's possible for liver cancer to develop without cirrhosis being present. It's thought that both types of hepatitis may trigger changes in liver cells that cause cancerous growths.

Explanation

Hepatitis is a disease that causes inflammation of your liver. It can be caused by an infection (commonly a virus), alcoholism, auto-immune disorders or metabolic diseases. There are several different types of hepatitis virus, including A, B and C. These viruses differ in the way they are passed from person to person and the effect they have on your health.

Both hepatitis B and hepatitis C cause the liver to become inflamed and damaged. This often results in cirrhosis of the liver. Cirrhosis is when healthy liver tissue is replaced by scarring making the liver unable to function as well as it should. Cirrhosis can cause changes in your liver cells, making them grow in an abnormal and uncontrolled way leading to the development of HCC.

However, cirrhosis is not always present in the livers of those with HCC and hepatitis B or hepatitis C. This has led doctors to believe that within both types of hepatitis there is a trigger that alters liver cells causing them to grow into cancerous tumours (HCC). Exactly what the trigger is or how this happens isn't fully understood at present.

If you have any concerns or questions about liver cancer, hepatitis B or hepatitis C, talk to your GP.

Further information

Sources

  • Cassidy J, Bissett D, Spence RAJ. Oxford Handbook of Oncology. Oxford: Oxford University Press, 2002:51-52
  • Souhami R, Tobias J. Cancer and its management. 5th ed. Oxford: Blackwell Publishing, 2005
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What is haemochromatosis and how does it increase the risk of developing liver cancer?

Haemochromatosis is a condition that causes your body to absorb too much iron. This extra iron is deposited in your liver often causing long-term damage in the form of cirrhosis. The cirrhosis in turn can develop into liver cancer, specifically hepatocellular carcinoma (HCC).

Explanation

Haemochromatosis is a chronic condition that you can be born with, genetic haemochromatosis (GH), or you can acquire later in life, usually the result of long-term blood transfusions for a blood disorder (anaemia).

In haemochromatosis, your body absorbs more iron than it needs. Normally you have about three to four grams of iron in your body which is stored in small amounts in your liver and bone marrow. When your body absorbs more than five grams of iron, it starts depositing it in larger amounts than usual in your organs. This happens mainly in the liver, but iron may also be deposited in other organs such as your pancreas, heart, endocrine glands and your joints. This can result in damage that causes long-term health conditions.

One of the main complications of haemochromatosis is cirrhosis of the liver. The damage caused by absorbing too much iron can mean that scar tissue replaces normal healthy liver tissue. Over time this can prevent your liver from working properly and may develop into liver cancer (HCC).

However, simply having haemochromatosis doesn't increase you risk of HCC. Your risk is only increased if you develop cirrhosis of the liver. Treatment for haemochromatosis is very simple and effective. It involves regularly removing blood from the body to help rid it of excess iron - this is called venesection. If you're diagnosed and receive treatment early, damage to your liver and other organs can be prevented. This reduces your risk of developing serious health conditions like liver cancer.

This also highlights the importance of genetic testing for genetic haemochromatosis. Knowing that you have the disease or are a carrier of it will ensure that you and your family are diagnosed and treated early.

If you have any questions about haemochromatosis or liver cancer, talk to your GP or doctor.

Further information

Sources

  • Cassidy J, Bissett D, Spence RAJ. Oxford Handbook of Oncology. Oxford: Oxford University Press, 2002:51-52
  • Haemochromatosis. The British Liver Trust. www.britishlivertrust.org.uk, accessed 3 March 2008
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How is a liver biopsy carried out? Are there any risks involved?

A liver biopsy is carried out using a needle which is inserted into your skin and directly into your liver. This is usually done with an ultrasound or CT scan to guide your doctor. With all procedures there are some risks involved. For a liver biopsy, the main complication is internal bleeding, although this is rare.

Explanation

A liver biopsy is when a small sample of tissue is taken from your liver to be sent to a laboratory for testing. It's done using a hollow needle which is inserted into your skin directly into your liver. It's normally done using an ultrasound or CT scan so your doctor can locate the precise area he or she wants to take the sample from.

The procedure is usually carried out as a day case in the hospital. Occasionally, you may need to stay overnight for monitoring.

A blood test is usually taken and tested before the procedure to make sure that your blood is clotting properly.

You will be asked to lie down on your back or side. Your doctor will inject some local anaesthetic where he or she intends to insert the needle. This completely blocks feeling from the area and you will stay awake during the procedure. You will be asked to hold your breath for five to 10 seconds while the needle is quickly pushed in and out of your skin. This is because your liver moves slightly when you breathe, so you will need to remain very still for the biopsy to be taken.

A liver biopsy is commonly performed and generally safe. Complications are when problems happen during or after the procedure. In liver biopsy, they are rare. Occasionally, internal bleeding can occur. This is more likely if you have cirrhosis or liver cancer. You will be monitored closely for several hours after the procedure to check for any signs of bleeding. Very rarely, bile can leak from your liver as a result of the procedure. There is also a small chance of infection.

You may be in some discomfort after the procedure. If necessary, your doctor or nurse will give you painkillers to ease this.

If you have any questions or concerns about liver biopsy, talk to your GP or doctor before the procedure is carried out.

Further information

Sources

  • Guidelines on the use of Liver Biopsy in Clinical Practice. British Society of Gastroenterology, 2004. www.bsg.org.uk
  • Biopsy (liver). GP Notebook. www.gpnotebook.co.uk, accessed 24 July 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: October 2008

 

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