Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be going through liver cancer.

And you can find written notes on this topic at zero to finals.com slash liver cancer or in the

gastroenterology section of the second edition of the zero to finals medicine book.

So let's get straight into it.

Primary liver cancer is cancer that originates in the liver.

The main type of primary liver cancer is hepatocelular carcinoma.

Secondary liver cancer originates outside the liver and metastasizes to the liver. Metastasis to the liver can occur in almost any type of

cancer that spreads. It's common to have liver metastases of unknown primary, meaning the original cancer that spread

to the liver is never found. Cancer with metastases to the liver carries a poor prognosis.

Let's talk about the risk factors. The main risk factors for hepatocelular carcinoma is liver

cirrhosis, which may be due to alcohol-related liver disease, non-alcoholic fatty liver disease,

hepatitis B, hepatitis C, or rarer causes such as primary sclerosing colangitis.

Patients with liver cirrhosis are offered screening for hepatocelular carcinoma every six months with ultrasound and an alpha-feetor protein level.

Let's talk about the presentation. Liver cancer often remains asymptomatic for a long time,

then presents late and this makes the prognosis poor. There are non-specific presenting features

associated with liver cancer, such as weight loss, abdominal pain,

anorexia or a loss of appetite, nausea and vomiting, jaundice, pruritus, which is itching,

and an upper abdominal mass on palpation of the abdomen.

So what are the investigations?

The relevant investigations in assessing liver cancer are an alpha-pheto protein,

which is the tumor marker for hepatocelular carcinoma.

Liver ultrasound is the first-line imaging investigation.

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