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Liver Cancer


What is Liver Cancer?


Cancers of the liver can be primary (originate in the liver), or secondary (originates from another site in the body). Primary liver and bile duct cancer incidence has been increasing in all races and genders within the past several decades. The American Cancer Society estimates that nearly 23,000 new cases of primary liver cancer will be diagnosed in 2009. More common in men than women, mortality rates remain twice as high in men, with nearly 90% of cases occurring in men. It is also commonly linked with hepatitis virus infections, including hepatitis B and C. As with many gastrointestinal cancers, symptoms often develop in later stages, making detection difficult. One of the largest organs in the human body, the liver is situated in the upper right side of the abdomen, directly inside the rib cage. While primary liver cancer forms in the tissues of the liver and can include the bile duct and gallbladder, the most common form of liver cancer is secondary, coming from other cancers such as the colon.



Causes and Symptoms


Most liver cancer occurs in individuals over the age of 45, with a history of cirrhosis, hepatitis, or a history of a previous cancer such as colon cancer. Symptoms include weight loss, fatigue, yellowing of the skin (jaundice) or a lump under the ribcage. Many patients have no symptoms at all. Early screening and detection can prevent liver cancer from advancing to later stages making curative resection more likely.




Blood tests: liver function tests to evaluate whether the liver is working adequately; also Hepatitis serologies.

Tumor markers: blood tests for Alpha Feta protein levels can be elevated in primary liver cancer and CEA/CA19-9 in metastatic colon cancer.

CT and MRI scans: x-rays that are sensitive for providing anatomic detail and detail the extent of the cancer.

PET scan: evaluates glucose activity within cancer cells and can sometimes find cancers that are not seen using other radiographic techniques.




The eradication of the tumor by resection, ablation, or transplantation are considered the only curative options. Transplantation is only considered for patients with primary liver tumors and poor liver function.

Great strides have been made in prolonging survival in patients with liver cancer originating from the colon. The combination of chemotherapy and new surgical techniques has prolonged survival by years.

Dr. Bichik is considered one of the leading international experts in the management of liver cancer. He performs major liver resections each week, and has been at the forefront of minimally invasive liver surgery. He has published numerous articles and presented his findings at national and international meetings. Dr. Bilchik regularly collaborates with surgeons at MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, Duke University, and Johns Hopkins. Frequently, he’s participated in consensus panels providing important guidelines for the management of patients with liver tumors. As part of a clinical care pathway, patients are rarely transfused, eat the day following surgery, and with many discharged from the hospital 3 to 4 days after surgery. Dr. Bilchik has published several articles describing how surgery and novel chemotherapy drugs have improved survival considerably transforming liver cancer into a “chronic,” manageable illness rather than a terminal event. Patients visit and consult with Dr. Bilchik from all over the world.

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