Liver Cancer

The liver sits under the ribs on the right side of your abdomen. It’s responsible for many bodily functions, including:

• Filtering chemicals and waste

• Producing bile, a substance that aids digestion

• Storing nutrients

There are several types of liver cancer. Some of these start in the liver, and others start elsewhere in the body and travel to the liver.

Primary liver cancer starts in the liver is known as primary liver cancer. Hepatocellular carcinoma is the most common type of primary liver cancer. Other types include:

• Angiosarcoma — cancer of the blood vessel and lymph vessel lining

• Cholangiocarcinoma — bile duct cancer

• Hepatoblastoma — the most common type of liver cancer in children

Secondary liver cancer starts somewhere else in the body and spreads to the liver. This type is also called metastatic liver cancer. You may hear your care team refer to it based on where it started, for example, colorectal cancer with spread to the liver.

Secondary liver cancer is more common in the United States than primary liver cancer. Several types of cancers may metastasize, or spread, to the liver, including:

• Breast cancer

• Colorectal cancer

• Lung cancer

• Kidney cancer

• Neuroendocrine tumors

• Pancreatic cancer

• Stomach cancer

Benign liver lesions are noncancerous, but they may require treatment because they can cause problems as they grow. Types of benign liver lesions include:

• Focal nodular hyperplasia — a mass in the liver, usually with a central scar

• Hemangioma — a mass made of blood vessels

• Hepatic adenoma — a solid mass that develops in a healthy liver

Many people with liver cancer don’t have any signs or symptoms until the cancer is advanced. If symptoms of liver cancer do appear, they may include:

• Chalky, pale stools

• Itchy skin

• Nausea or vomiting

• Pain near the right shoulder or upper abdomen

• Poor appetite

• Swelling in the abdomen

• Weight loss for no known reason

• Yellowing in the skin or the white of the eyes, known as jaundice

Your Ochsner care team will work together to determine a treatment based on the type and stage of liver cancer and your personal and family medical history.

Liver cancer treatment may include:

• Interventional radiology procedures. These are minimally invasive procedures done with the assistance of real-time imaging technology, such as X-rays or CT scans. One example is a procedure called radioembolization, in which tiny radioactive beads are injected into blood vessels to cut off the blood supply to the liver tumor.

• Minimally invasive surgery. During minimally invasive surgeries, small incisions, or cuts, are made in the skin, then thin instruments with a tiny camera are inserted to reach the target area. When done by hand, this is called laparoscopic surgery. These surgeries may also be done using advanced robotic surgery technology.

• Radiation. Multiple types of radiation therapy are available, including stereotactic body radiation therapy. This type delivers focused radiation over fewer sessions than traditional radiation.

• Systemic therapies. These treatments can affect the whole body. Types include chemotherapy, which uses medications to kill cancer cells; immunotherapy to train your immune system to fight cancer cells; and targeted therapy, a form of precision medicine that uses medications to target cancer cells instead of healthy cells

• Traditional open surgery. This procedure involves a larger incision to allow the surgeon to access the liver directly to perform a complex liver resection, a surgery to remove part of the liver.

Clinical trials may offer additional treatment options to those who are a good match for the studies.

Your oncologist may recommend genetic testing to help determine the best treatment options for you, including:

• Next-generation sequencing, or somatic testing. Somatic testing uses a tissue sample to look at the DNA of the tumor.

• Pharmacogenomics testing. This blood test looks at your genes to determine which medications may work best for you and which are likely to cause side effects.

Most patients with liver cancer will not have a liver transplant. However, if you do need a liver transplant, you’re in good hands at Ochsner.

Ochsner surgeons performed Louisiana’s first liver transplant in 1984. Our liver transplant program is consistently ranked among the best in the country by the Scientific Registry of Transplant Recipients.

At Ochsner, we know that diagnosis and treatment are only a part of the cancer journey. We offer integrative oncology services to support your overall health and wellness during and after cancer treatment.

A nurse navigator will be with you at every step to help you schedule appointments and address the complexities and questions that come with a liver cancer diagnosis.

Your care team will connect you to additional services based on your unique needs, including:

• Housing during liver cancer treatment

• Nutrition support

• Occupational therapy and physical therapy

• Oncology social workers

• Palliative medicine and supportive care

• Support groups

• Survivorship care

Once the care plan is established, the Ochsner liver cancer team works with patients and other providers to ensure care is as convenient and close to home as possible.

Follow-up appointments can often be done through virtual visits. Many patients can also receive chemotherapy and other ongoing treatment at partner facilities near their homes, while remaining under the expert care of the Ochsner liver cancer team.

Ochsner takes a multidisciplinary approach to liver cancer care. Our medical team includes:

• Interventional radiologists

• Hepatologists

• Medical oncologists

• Oncology nurses

• Radiation oncologists

• Surgical oncologists

Even if you see only one doctor, the entire team is involved in your care. The team meets weekly to discuss current patients and their treatment plans to ensure the best possible care.

We also work closely with other Ochsner providers and facilities across the Gulf South to provide high-quality, holistic care that works for you.

Ochsner offers comprehensive liver cancer care at several locations in Louisiana, including in Baton Rouge, Covington and Kenner. Find a location near you.

Our Colorectal Liver Cancer Metastases Program, dedicated precision medicine program and pediatric liver cancer program are the only ones of their kind in Louisiana. Additionally, the Scientific Registry of Transplant Recipients ranked the Ochsner liver transplant program as one of the nation’s top programs.