2024 - Cancer of the liver and bile ducts

What is it about ?

This patient guide talks about liver cancer. He is not talking about metastases in the liver from other cancers.

the liver cancer is more common in humans. Out of 10 people who develop liver cancer, 9 people already had chronic liver disease, such as liver cirrhosis or chronic hepatitis.

the bile duct cancer occurs in the bile ducts and in the gallbladder. This cancer usually affects the elderly as well as those who suffer from chronic inflammation of the bile ducts (primary sclerosing cholangitis). People with primary sclerosing cholangitis have a higher risk of developing bile duct cancer at a younger age.

What is its frequency?

In Belgium, there are around 600 new cases of liver cancer every year. Two-thirds of people with liver cancer are men, usually 55 years of age or older when the disease starts. The highest peak is observed in people over the age of 70.

Each year, approximately 400 new cases of gallbladder cancer. This cancer is 1.5 times more common in women than in men. Most people with the disease are over 64 years of age at the onset of the disease. The presence of gallstones increases the risk of developing gallbladder cancer.

How to recognize it?

The possible symptoms are as follows: weightloss, tired, jaundice, sometimes accompanied by fever. It happens to feel a lump in the upper right belly. Symptoms of an underlying liver or gallbladder disease may also develop, such as swelling of the stomach from a buildup of fluids, confusion, and an increased tendency to bleed. These are signs of already advanced cancer. Often there are no symptoms yet at the time of diagnosis.

How is the diagnosis made?

Liver tumors larger than 2 cm are recognizable on the CT-scan. NMR imaging can also be performed. The value of alpha-fetoprotein (AFP) is determined in the blood. A greatly increased value may support the diagnosis. Sometimes a piece of liver tissue will need to be taken (a biopsy) to confirm the diagnosis.

A CT scan and magnetic resonance imaging (MRI) can also be used to diagnose cancer of the bile ducts and gallbladder. The doctor may also take samples of the bile ducts, both through the small intestine and through the skin.

What can you do ?

Reduce the risk of developing these cancers by adopting a healthy lifestyle and in particular limit the alcohol consumption.

What can your doctor do?

Liver cancer

Treatment depends on the extent of the tumor and the condition of the liver. If possible, the tumor should be surgically removed or a liver transplant performed. If surgery is not possible, you can opt for radiofrequency ablation (RFA). This procedure destroys the tumor by heating it from the inside with sound waves. Another technique is transarterial chemoembolization (CETA): blood flow to the tumor is blocked by means of a catheter placed in an artery or very localized chemotherapy is administered.

Strict follow-up after treatment is necessary through regular ultrasound examination and blood work.

Cancer of the bile ducts and gallbladder

Surgery is the treatment of first choice. Usually, parts of the liver or even the entire liver have to be removed. Only 1 in 3 cancer can be operated on. Otherwise, a stent may be placed or chemotherapy may be considered.

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