Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about liver cancer.

If you want to follow along with written notes on this topic, you can follow along at zero definals.com slash liver cancer or in the gastroenterology section of the zero definals medicine book.

So let's get straight into it.

Liver cancer can either be primary or secondary.

And primary liver cancer is cancer that originates in the liver,

and there's two main types of primary liver cancer.

A patocellular carcinoma, which accounts for about 80% of liver cancers,

and something called calangiocarcinoma. And calangio carcinoma is a cancer of the bile ducts,

which accounts for about 20% of liver cancers. Secondary liver cancer is cancer that originates

outside the liver and metastasizes to the liver.

And metastasis to the liver can occur with pretty much any cancer that spreads,

and there's quite a poor prognosis when there's a cancer that's spread to the liver and you have liver metastases.

The first step if you find a secondary liver cancer is to investigate for the primary,

with things like a full body CT scan, a thorough history, an examination of the skin and the breasts.

It's not uncommon to have liver metastases with an unknown primary. So you search for the primary source of the

cancer and never find it. Let's talk about the risk factors. The main risk factor for

hepatocelular carcinoma is liver cirrhosis. And liver cirrhosis could be due to viral hepatitis,

like hepatitis B or C, alcoholic liver disease, non-alcoholic fatty liver disease,

or any other chronic liver disease that usually progresses to cirrhosis.

And patients with chronic liver disease and cirrhosis are screened regularly

to check for hepatocelular carcinoma because it's such a well-known complication.

Kalangiocarsinoma is associated with primary sclerosin colangitis.

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