Liver cancer happens when liver cells develop mutations (changes) in their DNA. This usually occurs when you have long-term chronic hepatitis B or C infection and other conditions like cirrhosis, fatty liver disease or hereditary liver disorders.
Your doctor may diagnose liver cancer based on the symptoms you have and tests, including blood work and imaging. These tests help determine the stage of your liver cancer, which can affect your prognosis.
The liver is the largest internal organ in the body. It performs many critical functions, including filtering blood and converting nutrients, fats and drugs into usable chemicals. It also stores glucose (a source of energy) and helps the blood clot. Liver cancer develops when cells in the liver grow abnormally and form tumors. These tumors can be non-cancerous (benign) or cancerous. When the cancer is in its early stages, it may not cause any symptoms. However, as it grows, the tumors may cause pain in the upper right side of the abdomen or a feeling of fullness or bloating. They can also lead to jaundice, a condition that causes the skin and whites of the eyes to appear yellow.
The most common type of liver cancer is hepatocellular carcinoma (HCC). It starts in the hepatocytes, which are the main type of cell in the liver. Hepatocellular carcinoma can spread to other parts of the body and can be fatal if it is not treated.
Other types of liver cancer include hepatoblastoma (which affects only young children) and metastasis from other sites in the body, such as colon, lung or breast cancer. Most people who get cancer of the liver have hepatitis B or hepatitis C, or other diseases that damage the liver, such as cirrhosis.
Doctors will check your symptoms and medical history to find out if you might have liver cancer. They will do imaging tests to look for tumors or signs of the disease in your liver and other parts of your body. They will also do a liver function test to see how well your liver is working.
Your doctor might also do a liver biopsy, which involves inserting a needle into the liver to remove a small piece of tissue for examination under a microscope. A liver biopsy can help your doctor find out if you have primary liver cancer or cancer that started in another part of the body and spread to the liver (metastasis). They may also do a computed tomography scan of the abdomen, or CT scan, to make a series of detailed pictures of your liver and surrounding organs. The images can help your doctor find the location of the tumors and determine their size and severity.
The liver is a large organ that sits behind your ribs on the right side of your body. It helps digest food, makes proteins to help your blood clot and removes toxins from the body. Cancer starts in your liver cells and can spread (metastasize) to other parts of the body.
A doctor will ask about your past health, symptoms and risk factors for cancer. Then a physical exam will be done. Your doctor may also do an imaging test such as an ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI). Blood tests including a test for alpha-fetoprotein (AFP) are often done. High levels of AFP are seen in some people with liver cancer. The blood tests can also check your liver function and help find out if you have hepatitis C or B or other conditions that can cause liver cancer.
X-rays and other imaging tests can find tumors or other problems in your liver. To do an ultrasound, a gel will be put on your abdomen and then a small device called a transducer is moved over the area. The device creates sound waves that bounce off the liver and other organs in your abdomen and are detected by a computer to make a picture. You might also have a computed tomography (CT) scan of your abdomen. To get a clearer picture, a dye is often injected into your vein before the scan. The dye highlights blood vessels and other structures in the body.
Other imaging tests you might have include an angiogram. This test uses a dye to highlight blood vessels in the liver and other organs. A special type of MRI scan that can take multiple pictures of your liver at different angles is sometimes used to diagnose cancer or to find out how much it has grown.
If the other tests show that you have a liver cancer, a biopsy is usually needed to confirm the diagnosis. Your doctor will use anesthesia to keep you from feeling pain during the procedure. The biopsy will usually involve removing a sample of liver tissue for examination under a microscope. You may have a fine needle aspiration, where a thin needle is used to collect fluid or tissue; a core needle biopsy, which is more accurate but involves more pain; or laparoscopy, where your doctor inserts a thin, lighted tube, called a laparoscope, into one of the incisions in your abdomen.
The liver is the largest internal organ of the body. It is made of a network of blood vessels, bile ducts and cells called hepatocytes. It processes the nutrients in your blood and removes toxins from your body. Cancer can form in the liver or spread from it to other parts of the body. The main type of primary liver cancer is hepatocellular carcinoma, or HCC. It is also possible to have cholangiocarcinoma, which forms in the bile ducts and represents about 10% of all liver cancer cases.
Your treatment plan will depend on the type and stage of your cancer. In early-stage liver cancer, surgery may be a treatment option. Other treatments include radiation therapy, ablation therapy and chemotherapy.
Liver cancer that has spread to other parts of the body can be treated with a combination of chemotherapy drugs and targeted therapy. Targeted therapy involves using medicines that attack specific molecules that help tumors grow or spread.
Surgical removal of the tumor or liver transplantation may be an option for people with advanced liver cancer. Doctors can often remove a tumor from the liver without damaging healthy tissue around it. This is called a partial hepatectomy. During a liver transplant, the entire liver or part of it is removed and replaced with healthy liver tissue from a donor. Liver transplantation is only an option if your doctor can find a suitable donor and you meet certain criteria, including having fewer than three tumors in your liver that are 3 cm or smaller.
A person with hepatitis B or C or cirrhosis has a greater chance of developing hepatocellular carcinoma. Liver cancer can develop in a liver damaged by birth defects, alcohol abuse or diseases such as hepatitis B and C or hemochromatosis (a hereditary disease that causes too much iron in the body).
Palliative care is an important part of your treatment plan. It is a team of doctors, nurses and other professionals who can manage your symptoms and improve your quality of life. Palliative care is started soon after your diagnosis and continued throughout treatment.
The chance of cancer returning (recurrence) after treatment depends on the type of cancer, where it started and what caused it. You may have a different prognosis if the cancer has spread beyond the liver. Some types of cancer can spread to the bones, lungs and other organs. If recurrent disease occurs, your doctor will create a follow-up schedule to monitor your condition. This might include physical exams, blood tests and imaging tests like CT scans or MRIs.
Liver cancer that starts in the cells of the liver is called hepatocellular carcinoma (HCC). Some kinds of HCC spread quickly and are more likely to recur than others. The chances of recurrence increase with the size of the tumor, the stage of the cancer (how advanced it is) and the degree to which the liver has been damaged. Other important factors are the age of the patient and race and ethnicity. People who are African American, Hispanic or Asian are more likely to get liver cancer than white people. Liver cancer is also more common in men than women and tends to develop more quickly in people who have a history of hepatitis B or C virus infection.
If recurrent HCC has not yet spread to other parts of the body, repeat liver surgery can be curative. However, recurrence usually occurs within 18 months after the initial liver resection. Recurrence is often in the same area of the liver, and the number of recurrent lesions may be higher with the second resection. In addition, the survival benefits of a second resection depend on several other factors, including the extent of the hepatic resection and the volume and function of the remaining liver.
The chances of recurrence are lower if the initial hepatectomy was performed with adequate margins and if no lymph node or bone metastases were found. The chance of recurrence is also lower if the person received systemic therapy before or after hepatectomy.
If recurrent HCC has spread beyond the liver, treatments can include ablation and other surgeries to remove any dead tissue. Other treatments might include targeted therapy drugs that target specific molecules on cancer cells or inside them. These drugs stop the growth of cancer cells without harming normal ones. Examples of targeted therapy drugs for recurrent liver cancer include sorafenib (Nexavar) and lenvatinib (Lenvima).
Many of the symptoms are caused by other health problems, so they don’t necessarily mean that you have cancer. But you should tell your doctor if you have any of them.
They’ll examine you and ask questions about your symptoms. They might also do imaging scans, such as an MRI or CT scan, and a biopsy to get a sample of tissue for testing.
Almost everyone experiences abdominal pain from time to time. Often it’s nothing to worry about, but sometimes it may be a sign of a serious health problem, such as liver cancer. Abdominal pain can be mild, moderate or severe, and it may come and go or occur in only one part of your belly. Pain may be felt in the upper right side of your belly (abdominal hepatic pain), or in the lower part of your stomach and intestines, or in your back and chest.
The type and location of pain can help doctors determine if it’s caused by the liver or another condition. For example, if the pain is localized in only one area, it’s likely a symptom of something like indigestion or a stomach virus and might not be related to your liver. If the pain is generalized over most of your belly, it might be a more serious problem, such as pancreatitis or diverticulitis, which are inflammations in the stomach and large intestine, respectively.
Liver cancer may cause pain in the abdomen, especially as the tumor grows and spreads to other parts of the body. If the cancer is at stage II or early stage III, it may be difficult to pinpoint exactly where the pain comes from because of its gradual onset.
If the cancer has reached later stages, it may cause other symptoms, such as swelling of the abdomen or a feeling of fullness and bloating (hepatomegaly). It may also lead to jaundice, which is a yellowing of the skin and whites of the eyes caused by high levels of bilirubin, a yellow pigment that results from the breakdown of red blood cells.
If cancer spreads from the liver to other organs, it can cause a build-up of fluid in your abdomen. This is called ascites. This build-up is sometimes painless and occurs because the tumor is growing or there is inflammation in the area or because the tumor is pressing against nearby tissue. It is important to tell your doctor if you have this symptom because it could be a sign of liver cancer.
Your doctor will ask you how long you have had these symptoms and when they started. They will also want to know if they are getting worse or staying the same. This information is used to figure out what is causing your symptom and how bad the cancer is. Your doctor may decide to do an ultrasound test or surgical biopsy to look at your liver and other organs in your abdomen for signs of cancer.
In addition to being a symptom of liver cancer, abdominal swelling can be caused by other health conditions such as end-stage liver disease (cirrhosis) and heart failure. It can also be a symptom of secondary liver cancer, which means that the cancer originated in another part of your body, like the colon, stomach or pancreas, and then spread to the liver.
If you have a lot of fluid in your abdomen, your doctor might drain the fluid using a tube placed down the throat (endoscopically). This procedure is called an ascitic tap. You might need to stay in hospital while the fluid is drained and you will need to drink lots of liquids to replace the lost water. You might also need medicine to stop the fluid building up again.
A tumor in the liver can reduce blood flow to the organ, leading to weight loss. This is more common in advanced liver cancers, especially those caused by hepatitis B or C and cirrhosis. If you are experiencing this symptom, see your doctor.
Liver cancer can also cause jaundice, which makes the skin and whites of your eyes look yellow. This symptom is rarer in liver cancers that start in the bile ducts, but can happen with any type of liver cancer. It can also be a sign of other health conditions, including inflammation or infection.
If you are experiencing these symptoms, it’s important to visit your GP. They can carry out tests to find out what’s causing them and whether or not you have cancer. These tests include a liver function test and blood tests.
The most common type of liver cancer is called primary hepatocellular carcinoma (HCC). It starts in the liver cells known as hepatocytes. The tumour may grow into a single tumor or spread from other areas of the liver. It can also begin in the small blood vessels that connect the liver to other parts of the body, such as the bile ducts or gallbladder.
Another type of liver cancer is cholangiocarcinoma, which starts in the bile ducts that drain bile into the gallbladder to help with digestion. This type of cancer is less common than HCC, but it can be more serious.
The liver is a large organ in the upper right side of your abdomen. It collects blood flowing from your intestines, filters it and changes some nutrients into substances the body needs to build tissue, like sugars, starches and fats. It also makes bile, which helps digest food and absorb nutrients. The liver also breaks down medications and helps the body clot. It also stores nutrients, so that the body can remain nourished when you are not eating. Cancer develops when cells in the liver grow and divide uncontrollably. These cells can form lumps or masses called tumors. Some of these tumors are noncancerous (benign). Others are cancerous (malignant) and can spread to other parts of the body. The spread of cancerous cells is called metastasis.
A loss of appetite is a common symptom of liver cancer, especially when the disease advances to stage 4. In this stage, there are multiple large tumors in the liver or one tumor has reached a major blood vessel.
It is important to see your doctor if you experience this symptom. Depending on the cause, your doctor may be able to prescribe medicine to help stimulate your appetite or to treat any other condition that is causing it. You may be able to find foods you enjoy more, or your doctor might suggest high-protein nutritional shakes.
Many cancer treatments can decrease your appetite or make it hard to eat. Your oncologist will know which chemotherapy drugs are more likely to cause this side effect, and can give you anti-nausea medication to help. If you are not able to eat, you may be referred to a dietitian. You can also ask your doctor if there is a clinical trial for an experimental drug that might ease your symptoms and increase your chances of recovery.
A blood test is a simple way to find out how well your liver is working. It checks the levels of certain chemicals in your blood, including red and white blood cells, and platelets. It also measures the levels of a chemical called alpha fetoprotein (AFP), which is produced in the liver. The AFP level is higher in some cancers. The AFP level can also be high in people with hepatitis C, which may need treatment.
Other blood tests can help check your overall health, such as a basic metabolic panel, which looks at some naturally occurring chemicals in the fluid part of the blood. It usually includes a measurement of the proteins albumin and globulin. It also checks the balance of your electrolytes, including calcium, magnesium, potassium, sodium, and chloride, and your BUN (blood urea nitrogen).
An ultrasound scan creates images of structures within the body using sound waves. It’s a safe and painless procedure. It’s done while you lie down and a gel is spread over the area to be examined. A device called a transducer is then moved over the area. It sends sound waves that echo off your internal organs, and a computer creates a picture of them on a screen.
A CT scan is an x-ray imaging technique that uses a computer to combine a series of pictures taken from different angles. This creates detailed, cross-sectional pictures of your body. A contrast dye is sometimes used to highlight the areas being scanned.
At NYU Langone’s Perlmutter Cancer Center, specialists in hepatology, medical oncology and surgery, interventional radiology, radiation oncology, nurse practitioners, and social workers can all provide care to patients with liver cancer or metastases (cancer that has spread from another part of the body). They can also manage symptoms such as abdominal pain and swelling.
When the cancer is found at an early stage and your liver is working well, treatment aims to eliminate the tumor. Other goals include relieving symptoms and improving your quality of life.
A biopsy is when a tissue sample is taken from your liver to check for cancer cells. This can be done with a needle under local anaesthetic or laparoscopy.
Surgery is the most successful disease-directed treatment for some people with liver cancer, especially those in early stages or with a single tumor that takes up a small area of the liver. During surgery, doctors remove the tumor and some surrounding healthy tissue, and they may also repair damage to other organs caused by the cancer. Surgery can be used to treat primary liver cancer, as well as secondary liver cancer that has spread from another part of the body.
Before surgery, your doctor will take your vital signs and answer any questions you or your family have. They’ll also ask you to stop eating or drinking because having food in your stomach can cause vomiting during and after the operation and lead to complications.
During surgery, you’ll be given medicines to help you fall asleep or to numb the area that’s being operated on. You’ll also be given an IV (an intravenous line) so the health care team can give you fluids and medicine through it.
The surgeon can use a laparoscope or robotic surgery to remove the tumor and some surrounding tissue. These techniques may reduce pain, scarring and your time in the hospital.
If the surgeon has to remove a large section of your liver, it’s called hepatectomy. The remaining portion of your liver can usually heal itself and grow back to normal size, although it may change its shape. Before a hepatectomy, the surgeon may perform a procedure called portal vein embolization, which uses small beads that emit radiation to destroy nearby cancer cells or block their growth.
The surgeon may also remove only the part of your liver with a tumor, which is called a segmentectomy. This can be done for hepatocellular carcinoma, cholangiocarcinoma and biliary tract cancer. If you have a segmentectomy, you’ll likely be given medications to help the liver regenerate and repair itself. These medications are called targeted therapies, and they work by blocking the cancer’s ability to make proteins that are needed to grow or spread. You might receive a combination of targeted therapy with other treatments, such as chemotherapy and radiation therapy.
Radiation is often used to treat tumors that cannot be removed surgically or to relieve pain and other symptoms. The radiation dose and location are carefully planned to minimize exposure to nearby normal tissue. Our team has advanced radiation therapy equipment, including computed tomography and magnetic resonance imaging scans to accurately target the site of your cancer. This technology, called image-guided radiation treatment (IGRT), is the safest way to deliver high-dose radiation for liver cancer.
If your doctor thinks you might have liver cancer, they will use a medical history, physical exam, and laboratory tests to find out more about your health. They may also perform a biopsy of your liver to check for cancer cells. This is usually done by inserting a thin needle into the liver or abdominal cavity under local anesthesia, but it can be performed using a laparoscope. A sample of your blood is also sometimes taken during a biopsy. These samples can be tested to see if you have certain genetic mutations that might indicate a higher risk of developing cancer.
In addition to surgery, radiation therapy can be used for primary liver cancers that cannot be removed and secondary cancers in the liver that have spread. Ablation and embolization are minimally invasive techniques that use small tubes and needles to deliver cancer therapy directly to the tumor site. These procedures use an imaging test, such as ultrasound, to guide the needles or tubes into the hepatic artery supplying the cancer cell. The cancer is killed by heating the cells or blocked from receiving oxygen and nutrients (embolization).
Another form of radiation therapy involves delivering radioactive beads to the tumor site. The yttrium-90 or holmium-166 microspheres enter the hepatic artery and attach to the cancer cells, killing them. This is an option if the tumors can’t be treated with surgery or ablation and you are ineligible for a transplant.
Chemotherapy is a drug treatment that works by stopping cancer cell growth or killing the cells that are growing too fast. The type of chemotherapy your doctor uses depends on the kind of cancer you have and whether it is growing in the liver or in other parts of your body.
Ablation and embolization are ways to destroy tumors without removing them surgically. These procedures block a tumor’s blood supply or cut off its oxygen to prevent it from growing and dividing. They are often used in combination with surgery, radiation and chemotherapy.
The most common type of ablation treatment uses heat to destroy cancer cells. Doctors insert a needle through your skin (percutaneous ablation) or make a small cut in your abdomen (ablation with surgery). They use an imaging test, such as ultrasound or a CT scan, to guide the needles into the tumor. They then heat the needles with radio waves or microwaves to kill cancer cells. Other forms of ablation treatments use cold to destroy cancer cells or expose them to chemicals that damage the cell membrane. For example, your doctor might inject ethanol (pure alcohol) directly into a liver tumor to kill it. Other types of chemical ablation treatments involve using a special dye to mark the tumor so it can be destroyed with a laser (fluorescent marking) or freezing it with a very cold gas, called cryotherapy or cryoablation.
During embolization, doctors put a substance into the blood vessel that supplies or feeds a tumor to block blood flow. They may also add a medicine that can kill or shrink tumors, or tiny beads that contain radiation or chemotherapy. Embolization can be done alone or with ablation or other surgeries for liver tumors. It’s usually done when the tumor isn’t large enough for surgery or can’t be removed safely by other methods.
Liver transplantation is the last option if your cancer can’t be treated with ablation or embolization and your health care team thinks you’re healthy enough for a donor liver. To be considered for a transplant, you must meet certain criteria, such as having a liver tumor smaller than 3 cm and meeting other medical conditions. You might receive other treatments, such as ablation or embolization, while waiting for a donor. You might also receive active surveillance, which involves closely watching the tumor and getting tests on a regular basis.
Chemotherapy uses drugs to kill cancer cells and prevent them from growing or spreading. It may be given systemically, through a pill or through an IV drip, which travels throughout the body. It can also be given directly into the liver, either by injection or placing tiny beads containing chemotherapy in the hepatic artery (called chemoembolization). The type of chemotherapy drug used depends on your diagnosis and what other treatments you’ve had. At City of Hope, we specialize in molecular or genetic testing for liver cancer, which can help us select the most effective drugs with fewer side effects. We also offer a number of clinical trials, including some that focus on preventing recurrence of liver cancer after other treatments.
Other local treatment options include a procedure called alcohol injection, in which pure alcohol is injected into tumors to destroy them; and ablation therapy that uses heat from radio waves or microwaves, or by freezing the cancerous tissues with cryotherapy. If the disease has spread to other parts of the body, we can use radiation therapy, a combination of external beams and internal placement of an energy emitting substance that targets and damages cancerous tissue.
Our multidisciplinary team consists of experts from many different fields, including surgery, radiation oncology and medical oncology. They meet weekly to review patient cases and bring a wide range of clinical perspectives to develop your personalized treatment plan.
Depending on the stage of your cancer and other factors, we may recommend that you undergo active surveillance. This involves closely watching your condition and only giving you treatment if the tests show that the cancer is getting worse.
At City of Hope, we use innovative technology to improve the quality of your life and give you a better chance for a longer survival. We have one of the country’s most renowned liver cancer programs and are developing new, promising therapies for this disease, including immunotherapy. We also offer a variety of supportive care services to reduce symptoms and discomfort.
The type of tumor you have affects your chance of recovery. The way doctors describe how a cancer has grown or spread is called staging.
The outlook varies depending on the type of liver cancer you have and other factors, such as your age, whether you have cirrhosis or hepatitis B or C.
Hepatocellular carcinoma (HCC) is a cancer that starts in the liver and grows out of control. It happens more often in men than in women and usually occurs after a person has had chronic hepatitis B or C infection or cirrhosis for many years. It can also start in people who don’t have cirrhosis but who have other risk factors for it, such as drinking alcohol heavily or taking certain drugs. Hepatocellular carcinoma can be found only in the liver or it may spread to other parts of the body.
Hepatitis B virus infection, alcohol consumption and hepatitis C infection increase the chance of developing HCC. Hepatitis B and C can cause scar tissue to build up in the liver, which leads to cirrhosis. HCC can start in the scar tissue, but it can also begin in healthy liver cells.
Symptoms of hepatocellular carcinoma include abdominal pain, weight loss, jaundice and a large mass that can be felt in the upper right part of the abdomen. In cirrhotic patients, HCC can lead to complications such as ascites, variceal bleeding and hepatic encephalopathy.
A biopsy (when a sample of tissue is removed and checked) can confirm the diagnosis of hepatocellular carcinoma. A doctor can do this with a fine needle aspiration, where a small amount of tissue is removed with a thin needle; or by doing a surgical biopsy. During surgery, a doctor removes all or part of the tumor and checks it for cancer cells under a microscope.
Liver cancer can also be diagnosed by a blood test called alpha-fetoprotein (AFP). High levels of AFP are linked with HCC and hepatocellular carcinoma. Some people with other types of liver cancer can have high AFP levels as well.
Liver cancer is staged based on how large it is and whether it has spread to other parts of the body. Staging helps doctors decide what treatment is best for you. Depending on the stage of your cancer, your doctor will give you a prognosis, which is how likely it is that the disease will go away or get worse.
Fibrolamellar Carcinoma (FLC) is a rare, slow-growing type of liver cancer. It usually occurs in young adults and is more common in men than women. It is not known what causes this type of tumor. Like HCC, it does not cause any symptoms early on and can only be diagnosed when a CT-scan or MRI of the abdomen is performed. Symptoms may include abdominal pain, fatigue and weight loss.
When this cancer is diagnosed, it often appears as a solid mass on a radiology image. It is often confused with other types of liver disease or with noncancerous conditions. As a result, it is often misdiagnosed or left undiagnosed until the mass grows large enough to produce symptoms.
On a microscopic level, this tumor is characterized by hepatocyte-like cells that are arranged in fine bands called lamellae. The tumor is named for this appearance. Like conventional hepatocellular carcinoma, it can occur in cirrhotic or noncirrhotic livers and affect both males and females. However, it is rarer than HCC and is less commonly diagnosed in older patients.
Because of its rarity, FLC is difficult to study and understand. In addition, even when a biopsy is obtained and examined by multiple pathologists, the diagnosis can be difficult to make. Immunohistochemical stains such as CK7 and CD68 can help distinguish it from other cancers.
Currently, the only effective treatment for FLC is surgical removal of the tumor. However, due to its location within the liver, this surgery can be challenging. In addition, because of its low survival rate, it is important to make the correct diagnosis and ensure that the entire tumor is removed.
In some cases, chemotherapy or embolization therapy may be used to treat FLC. Embolization therapy is a way to cut off the blood supply to the tumor so that it cannot get oxygen and nutrients. This is an option if the tumor is not completely removed during surgery or if it has spread to other parts of the body. It is not known if these treatments will improve survival in patients with FLC, but they are being explored.
Angiosarcoma develops when cells in the lining of blood vessels or lymph vessels change. These changes, called mutations, cause the cells to grow and keep living when they should die. Over time, the abnormal cells build up to become a tumor that can grow into surrounding tissues and damage them.
An angiosarcoma may appear as a raised area of skin with a purplish color that bruises easily and does not heal. It may also form as a lump beneath the skin or in a tissue such as muscle or bone. Often, these deep-seated tumors go unnoticed until they start to affect nearby organs and tissues.
Our Sarcoma Program offers specialized care for patients with these rare and aggressive cancers. Our team of specialists can perform a range of tests to determine the extent of the disease and how far it has spread, including MRI, CT scan and PET scan.
Most angiosarcomas occur in the liver or near the portal vein, but they can form in other parts of the body. Some are associated with chronic lymphedema (swelling of the arms or legs), radiation therapy and exposure to certain chemicals such as arsenic and vinyl chloride.
Angiosarcoma is one of the most rare forms of cancer, and doctors don’t know what causes it. But it is more common in adults than children, and people of color are more likely to develop it than whites.
Doctors treat angiosarcoma with chemotherapy and radiation. They may also use medicines that block the growth of new blood vessels or kill the cancer cells. They can administer these drugs by mouth or injection into a vein (IV). They can also use high-energy rays (radiation) to destroy cancer cells and shrink tumors, which can be used when surgery isn’t possible.
Some types of angiosarcoma can return after treatment, so follow-up visits are important. Our cancer experts will watch for signs of recurrence and help you manage your care throughout the years to come.
Cholangiocarcinoma happens when cells in the bile ducts develop changes (mutations) that cause them to multiply out of control and form a mass of tumor cells. It’s not known what causes these changes. But having certain risk factors can increase your chance of getting cholangiocarcinoma. These risk factors include a history of chronic liver disease, primary sclerosing cholangitis (hardening and scarring of the bile ducts), and choledochal cysts.
This type of cancer is rare, affecting about 8,000 people in the United States each year. It is usually diagnosed in advanced stages, when the cancer has spread beyond the bile ducts into other parts of the body. Symptoms of bile duct cancer can include itching, loss of appetite, dark-colored urine, unintentional weight loss and abdominal pain. When the bile duct tumor blocks the flow of bile, it can also lead to jaundice, a yellowing of the skin and whites of the eyes.
Bile duct cancer can be hard to diagnose because it often doesn’t produce any symptoms in its early stages. Symptoms occur when the cancer grows and begins to block the flow of bile, which can lead to a buildup of bilirubin in the bloodstream. This can cause the skin, whites of the eyes and the inside of the mouth to look yellow. Other signs of bile duct cancer can include fever, itching and fatigue.
A doctor can find a bile duct tumor with tests that check for abnormalities in the liver, gallbladder and bile ducts. These tests can help diagnose bile duct cancer and determine how far the cancer has spread.
These tests can also help identify conditions that may be causing bile duct cancer, such as inflammation of the liver or gallbladder (hepatitis), high levels of alkaline phosphatase or bilirubin in the blood, and elevated tumor markers like carcinoembryonic antigen (CEA) or CA 19-9.
Another test that may be used is endoscopic retrograde cholangiopancreatography (ERCP). During this procedure, your doctor inserts a thin tube called an endoscope into your mouth and then into your esophagus. Then, he or she injects a substance called contrast into your bile ducts and takes X-ray pictures of the area. Your doctor can also use a special tool called a cholangioscope to see and biopsy the area directly.