In the United States, liver cancer occurs more often in people over age 60 than in younger people. Men are twice as likely as women to get liver cancer. People who have family members with liver cancer may be more likely to get the disease. There is no consensus regarding the optimal treatment of patients with liver tumors. This contributes to the pessimistic attitude that many have regarding the treatment of liver cancer. Aggressive treatment strategies can cure or significantly prolong the life of many patients with liver cancer.
The liver is a common site of metastases from a variety of organs such as lung, breast, colon and rectum. When liver metastases occur at the time of initial diagnosis of the primary tumor, they are described as synchronous. If detected after the initial diagnosis, they are described as metachronous. The liver is frequently involved since it receives blood from the abdominal organs via the portal vein. Malignant cells detach from the primary cancer, enter the bloodstream or lymphatic channels, travel to the liver, and grow independently. We do not understand the mechanism of how a tumor cell can leave the primary site and grow in specific organs. Potentially, the environment of the liver is suitable to the growth of certain tumor cells. Once a tumor begins to grow in the liver, it receives its blood supply from the hepatic artery.
Early stages of cancer can be asymptomatic and may go undetected for months or even years. When symptoms do develop, they are most pronounced as pain.Pain associated with cancer is a result of several possibilities: invasion or destruction of normal tissue with cancer cells; stretching of internal tissue by tumor (an abnormal growth of cells in a lump or mass) growth; pressure of tumor on an organ; blockage of a vital passageway by the tumor; and infection caused by cancer.
Other symptoms may include loss of appetite, loss of weight, fever of unknown origin, limb weakness, sensory loss, or an absence of tendon reflexes in the limb.
Liver cancer, both 
primary
and metastatic, often exhibits symptoms of general malaise (vague
feeling of discomfort like the onset of an illness) as well as
pain and tenderness. The discomfort is usually of a moderate
degree and most often in the upper or upper right part of the
abdomen. In more advanced cases, symptoms of jaundice, a
yellowing of the skin and eyes, may also appear.
At this time, liver cancer can be cured only when it is found at an early stage (before it has spread) and only if the patient is healthy enough to have an operation. However, treatments other than surgery may be able to control the disease and help patients live longer and feel better. When a cure or control of the disease is not possible, some patients and their doctors choose palliative therepy (Treatment given to relieve symptoms caused by advanced cancer. Palliative therapy does not alter the course of a disease but can improve the quality of life. Palliative therapy aims to improve the quality of a person's life by controlling pain and other problems caused by the disease.
Injection of 100% absolute alcohol into tumors can be beneficial as it is highly toxic to liver tumors. It is injected into the center of the tumor through the skin (percutaneously) or at the time of surgery. The alcohol causes cells to dry out and cellular protein to disintegrate, ultimately leading to tumor cell death. This treatment is administered to patients who refuse surgery or who have severe liver disease that prevents them from having liver surgery.
This procedure is often done in a hospital or clinic as the injections are done with the assistance of ultrasound or CT scan. Each treatment consists of one injection, though a series of injections may also be recommended to effectively treat the tumors. Side effects are mild and temporary (5-10 minutes) and include localized pain and an overall feeling of alcohol intoxication.
Alcohol injection is a safe and easy procedure that has been shown to prolong survival (40 - 70% at three years) with small hepatocellular cancers. It provides palliative (the process of relieving the symptoms of disease without curing it; the act of making the patient more comfortable) management of metastatic liver cancer and can, in some cases, extend patient survival rate.
A new experimental therapy for patients with unresectable liver tumors is being tested and is currently underway at the Allegheny General Hospital in Pittsburgh Pennsylvania. Patients undergo an injection with a solution that contains alcohol and a chemotherapy drug called BCNU. This drug combination is called DTI-015.
Sometimes referred to as the great chemical factory of the body, the liver creates, regulates, and stores a variety of substances used by the gastrointestinal system (consists of the esophagus, stomach, liver, small and large intestines), and it serves a number of important digestive functions.
The main digestive chemical synthesized by the liver is bile. During a meal, bile is secreted by liver cells and travels through the hepatic duct system into the small intestine where it is used to break down fat molecules.
Between meals, bile is stored in the gall bladder. Bile further serves as a waste disposal system for toxins removed from the blood by the liver.
The liver also plays a major role in the
regulation of blood glucose (blood sugar). The liver synthesizes,
dissolves, and stores amino acids, protein, and fat. It stores
several important vitamins like B12
and Vitamin A. The liver also disposes of cellular waste and
breaks down harmful substances, like alcohol.
Circulatory Function of the Liver
While the liver is technically part of the gastrointestinal system, it also plays an important role in blood circulation. The liver has been called the antechamber of the heart because it collects and processes all of the gastrointestinal blood through the portal vein and delivers it to the right side of the heart. The liver receives blood through two vascular systems, the portal vein and hepatic artery.
The anterior (at or toward the front) surface of the
liver is triangular in shape, made of two lobes. The right lobe
is the larger of the two, measuring 6 to 7 inches in length. The
left lobe is 3 inches in length.Ligaments connect the upper
surface of the liver to the diaphragm and the abdominal wall and
the under surface to the stomach and duodenum. The gall bladder
is located on the under surface of the right lobe of the liver.
Neighboring organs include the colon, the intestines, and the
right kidney.
The liver is the largest gland in the body (approximately 1500 grams) and is located in the right upper quadrant of the abdomen (largest body cavity that contains the stomach, small intestines, colon, rectum, liver, spleen, pancreas, gall bladder, bladder, kidneys and appendix) . It is glossy in appearance and dark red in color from the rich supply of blood flowing through it. Approximately 25% of the cardiac output flows to the liver. It performs many important functions:
1) the uptake, storage, and disposal of nutrients (protein,
carbohydrates and fat), drugs, toxins and 2) the production of
synthetic proteins (critical for blood clotting) and metabolism
of substances produced by the body
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