Primary liver cancer is a malignancy that originates in the liver. Most liver cancers are secondary; they start in an organ elsewhere and reach the liver through the circulation. In developed nations, rates of primary liver cancer can be as low as 2% of all cancers, in contrast with the developing world, where there are more risk factors for this type of cancer and it can occur in 50% or more of all cancer cases. Treatment options for primary liver cancer are limited, and patients typically survive between six and 20 months after diagnosis.
In many cases of primary liver cancer, the patient has a history of cirrhosis because of alcoholism or hepatitis infection. Some patients have fatty liver disease. The cancer may take the form of a growth like cholangiosarcoma, which arises in the liver's bile ducts, or hepatoceullar carcinoma, growing in the liver cells themselves. As it grows, it will consume more of the liver's area, and may spread to other regions of the body.
Patients with primary liver cancer may notice a mass in the abdomen along with symptoms like fatigue, nausea, swelling in the abdomen, and jaundice, if the tumor progresses far enough to impair liver function. A doctor can identify the growth on a medical imaging study and may also be able to feel it with palpation of the abdomen. She may recommend some blood tests to determine how well the liver is functioning and to collect other useful information. A biopsy of the cancer is also part of the diagnostic process to determine its origins.
In the early stages, primary liver cancer may be treatable with surgery. Other patients may have inoperable tumors and must rely on chemotherapy and radiation to address the growth. The best treatment depends on the type of tumor and the location. Some doctors may also be willing to work with complementary medicine like acupuncture for pain management. Patient comfort is an important consideration, as this cancer is often not survivable and the doctor may place a priority on keeping the patient in minimal pain, rather than on trying to cure the cancer.
Rates of primary liver cancer drop dramatically when the population has access to vaccinations to prevent some forms of hepatitis, good hygiene to limit food-borne hepatitis A, and appropriate treatments for alcoholism and fatty liver disease. In these regions, patients rarely develop the cellular changes necessary to lead to liver cancer. For them, secondary cancers are the primary source of concern.