Liver Cancer (cont.)
Keith E. Stuart, MD
Dr. Keith E. Stuart is a medical oncologist specializing in the study and treatment of cancers involving the gastrointestinal tract, with a special interest in tumors involving the liver. He was educated at Harvard University (graduating magna cum laude) and Albert Einstein College of Medicine and did his medical training at the New England Deaconess Hospital.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Liver cancer facts
- What is liver cancer (hepatocellular carcinoma, HCC)?
- What is the scope of the liver cancer problem?
- What are the population characteristics (epidemiology) of liver cancer?
- What are liver cancer causes and risk factors?
- What are liver cancer symptoms and signs?
- How is liver cancer diagnosed?
- Blood tests
- Imaging studies
- Liver biopsy or aspiration
- What is the natural history of liver cancer?
- What are the treatment options for liver cancer?
- Chemotherapy and biotherapy
- Chemoembolization (trans-arterial chemoembolization or TACE)
- Ablation techniques
- Stereotactic radiosurgery
- Proton beam therapy
- Is there a role for routine screening for liver cancer?
- What is fibrolamellar carcinoma?
- What's in the future for the prevention and treatment of liver cancer?
- Find a local Oncologist in your town
What are the population characteristics (epidemiology) of liver cancer?
In the U.S., the highest frequency of liver cancer occurs in immigrants from Asian countries, where liver cancer is common. The frequency of liver cancer among Caucasians is the lowest, whereas among African-Americans and Hispanics, it is intermediate. The frequency of liver cancer is high among Asians because liver cancer is closely linked to chronic hepatitis B infection. This is especially so in individuals who have been infected with chronic hepatitis B for most of their lives (it is usually a childhood disease in Asia). If you take a world map depicting the frequency of chronic hepatitis B infection, you can easily superimpose that map on a map showing the frequency of liver cancer. On the other hand, in Japan, North America and Europe, hepatitis C infection is a much more common cause; alcohol abuse is also an important contributing factor. All of these diseases cause continual damage to the liver, which can result in severe scarring (cirrhosis) that then can lead to cancer.
In areas where liver cancer is more common and associated with hepatitis B, the cancer usually develops in people in their 30s and 40s, as opposed to other areas of the world, where they are in their 60s and 70s. This is because it generally takes about 30 years of chronic damage to the liver before the cancer grows large enough to become obvious. Men are much more likely than women to have liver cancer, especially if they have hepatitis and cirrhosis. Regardless of the cause, patients with a history of alcohol abuse as well are much sicker when they initially develop the cancer. In North America, up to one-quarter of people with liver cancer have no obvious risk factors; they are generally healthier and do much better with treatment.
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