Risk Factors/Signs and Symptoms

Research is increasing regarding what we know about liver cancer. Scientists are learning more about its causes. Following are common risk factors for the disease:

Viral Hepatitis - Viral hepatitis is one of the largest risk factors for this type of cancer. Hepatitis viruses are viruses that infect the liver. Two common types are Chronic Hepatitis B (HBV) and Chronic Hepatitis C (HCV.) Carriers of Hepatitis B virus face up to a 100-fold increased risk of developing adult primary liver cancer.

Cirrhosis - Cirrhosis is a disease in which liver cells become damaged and are replaced by scar tissue. People with cirrhosis have an increased risk of liver cancer. Most (but not all) people who develop liver cancer already have some evidence of cirrhosis.

There are several possible causes of cirrhosis. Most cases in the United States occur in people who abuse alcohol or have chronic HBV or HCV infections.

Age and Gender - Liver cancer is much more common in males than in females. The fibrolamellar subtype of HCC occurs in about equal numbers in both sexes. In the United States, adult primary liver cancer occurs most often in people over age 60

Race/Ethnicity - In the United States, Asian Americans and Pacific Islanders have the highest rates of liver cancer, followed by American Indians/Alaska Natives and Hispanics/Latinos, African Americans, and whites.

Inherited Metabolic Diseases - Certain inherited metabolic diseases can lead to cirrhosis. People with hemochromatosis absorb too much iron from their food. They are more likely to develop cirrhosis because of the high levels of iron in their liver. Other rare diseases that increase the risk of liver cancer include tyrosinemia, alpha1-antitrypsin deficiency, porphyria cutanea tarda, glycogen storage diseases, and Wilson disease.

Diabetes and Obesity - Diabetes can also increase the risk of liver cancer, usually in patients who have other risk factors such as heavy alcohol consumption and/or chronic viral hepatitis. Obesity may increase the risk of developing liver cancer, probably because it can result in fatty liver disease and cirrhosis.

Anabolic Steroids - Anabolic steroids are male hormones used by some athletes to increase their strength. Long-term anabolic steroid use can slightly increase the risk of hepatocellular cancer. Cortisone-like steroids, such as hydrocortisone, prednisone, and dexamethasone, do not carry this same risk.

Arsenic - Chronic exposure to drinking water contaminated with naturally occurring arsenic, such as that from some wells, increases the risk of some types of liver cancer. This is more common in parts of East Asia but may be a concern in some areas of the United States.

Signs and Symptoms

Because signs and symptoms of liver cancer do not usually appear until it is in its later stages, it is seldom diagnosed early.

Many patients who develop liver cancer have long-standing cirrhosis. If a patient with cirrhosis becomes worse without any known reason, doctors will probably suspect that liver cancer is the cause and do appropriate tests.

The increasing size of the liver and its inability to perform its functions as cancer cells multiply can cause warning signs in people with liver cancer. Following are the most common health problems experienced by people with liver cancer or liver disease:

A hard lump or swelling found on the right side of the abdomen, just below the ribs

Pain or discomfort on the upper side of the abdomen or by the right side of the shoulder blade

Jaundice, or the yellowing of the skin or the whites of the eyes or dark-colored urine

Nausea, loss of appetite or feeling full shortly after you begin to eat

Unexplained weight loss

Fatigue

Swollen abdomen, bleeding (the symptoms of cirrhosis)

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