Liver cancer is a malignant tumour in the liver that may be primary (originating in the liver tissue itself) or secondary (having spread from another part of the body). The liver's role is to filter toxins and other wastes from the blood, and convert nutrients into ready-to-use chemicals. However, when cancer strikes here the liver does not have the ability to cleanse itself of it.

Men are twice as likely to be affected by liver cancer than women.

There are two main types of primary liver cancer.

• Hepatoma, which develops in the liver cells
• Cholangiocarcinoma, which develops in the cells lining the bile ducts within the liver.

Hepatomas are the most common liver cancers worldwide and are closely linked to infection with hepatitis B. These tumours are much more common in Africa, the Middle East and the Far East than in Europe and America. Hepatoma is quite rare in Ireland.

Secondary liver cancers are about twenty times more common in Ireland than primary liver cancers. Secondary liver cancers may arise from primary cancers in many different organs but the most likely sources are the stomach, pancreas, colon and rectum.

Hepatomas (primary liver cancers) are likely to arise when viral infections (particularly hepatitis B) have already affected the liver.

The causes of secondary liver cancers depend on the cause of the primary tumour.

In the early stages, liver cancer often has no symptoms. However when symptoms emerge, they usually include:

• Weight loss and loss of appetite, nausea.
• Pain in the upper abdomen.
• Jaundice (yellowing of the skin and whites of the eyes).
• Irritated and itching skin.
• Malaise (the general feeling of being unwell)
• Oedema, (fluid swelling) in the legs
• Fever, vomiting, fatigue and weakness.

In diagnosing liver cancer, your doctor must rule out other symptoms, which mimic those of liver cancer.

• He/she will require your medical and family medical history. Illnesses such as hepatitis, haemochromatosis, cirrhosis and alcoholism should be reported.
• Blood tests and scans (ultrasound, CT or MRI scans) will help in making the diagnosis.
• The doctor may require a needle biopsy of the liver, where tissue from the organ is taken for examination. This is the only way to differentiate a benign (non-cancerous) tumour from a malignant (cancerous) one.

A primary liver tumour, hepatoma, usually remains confined to the liver for a considerable time and removing the tumour may be possible and is usually curative. If complete removal of the tumour is not possible, chemotherapy (anticancer drugs) can help the patient survive for longer. Sometimes a liver transplant may be considered.

Where the liver cancer is a secondary tumour, chemotherapy (anticancer drugs) will usually improve the patient’s quality of life and prolong survival. In some cases, a single secondary tumour in the liver may be surgically removed.

You can follow a few simple guidelines, to reduce the risk of liver cancer:

• Avoid excessive alcohol consumption.
• Ensure that you work in a safe environment, compliant with safety regulations.
• If you work in a high risk area, immunise against hepatitis B.