One of the most vital and dare I say underappreciated organs in the human body is this structure that you can see here called the liver. The liver is a tireless workhorse that performs multiple essential functions from metabolizing proteins, carbs, and fats to producing bile that aids in digestion. It also gets involved in regulating blood glucose levels, stores glycogen, as well as stores multiple vitamins such as vitamins's A, B12, D, E, and K. and of course detoxifies the body from harmful substances such as alcohol and certain drugs. So clearly if this organ were affected by say something like cancer, this could potentially be devastating and life-threatening. And we even have a body in this lab that died of a type of cancer that affected the liver, which we are definitely going to take a look at. We'll also discuss the potential causes and risk factors of liver cancer and therefore discuss the things that you can do to reduce your risk of getting liver cancer as well as talk about some of the potential treatment options. I'm Jonathan Beny with the Institute of Human Anatomy and it's time to get into this anatomical awesomeness. So, what exactly is liver cancer? Well, liver cancer can come in two different types, primary or secondary liver cancer. and they're quite different animals. Primary liver cancer is when the cancer originates in the liver itself. The most common type of primary liver cancer is hpatoscellular carcinoma and this affects the apatocytes. Site means cell and aat refers to liver. And so these are the liver cells that perform many of the essential functions that I mentioned in the intro. But with hpatoscellular carcinoma, these cells mutate within the liver, start to divide out of control and form tumors within the liver. Hpaticellular carcinoma accounts for about 75 to 85% of primary liver cancers. Another type of primary liver cancer which starts in the bile ducts within the liver makes up about 10 to 20% of cases. And we're going to talk more about these primary liver cancers especially hpatoscellular carcinoma in just a minute. But we need to address secondary liver cancer because secondary liver cancer, also called metastatic liver cancer, is when cancer from another part of the body spreads to the liver. And that's what metastasis refers to when cancer cells spread from their primary site to another site through the blood vessels or lymphatic vessels. And secondary liver cancer is actually more common than primary liver cancer. But why is that? Well, we have a body in this lab that can help us with this. This body died when cancer cells infiltrated and started growing in the liver. You can actually see some of the rough spots or nodules where the cancer likely spread to. And for comparison, here's what a healthy liver looks like with more of this brown smooth textured surface. And just some additional information, we're really zoomed in here on this body as well as really zoomed in on this body. And so if you've never seen a liver before, the liver is located in the right upper portion of the abdomen draped by this muscle that you can see called the diaphragm. And you might notice that the healthy liver looks a little bit smaller than the cancerous liver. And there are two reasons for this. The healthy liver is in a much smaller body. This body is female and about 5t tall. Whereas the cancerous liver is in a male body that is about 6 feet tall. The second reason is that the diseased cancerous state also likely caused this liver to enlarge to a certain degree. However, that was not the primary cancer of this body. The primary cancer of this body was colloerectyl cancer. And here's part of the rectum and the colon. Rectum being down here coming up to the sigmoid colon here. And this is where those cells forming the tumors were originating. And eventually those cancer cells from the rectum and the colon spread into the bloodstream to get to the actual liver, which caused this secondary liver cancer. And this is what ultimately led to the death of this body over here. And it's actually not that shocking that the first place that these cancer cells went to was the liver. Because if I pull up this mezzent, which is this yellowy tissue that you can see here, there's a whole bunch of blood vessels that are bringing substances from the digestive tract within this mezzent. And all of them eventually funnel into a large vein called the hpatic portal vein. So the first major stop for these cancer cells was the liver. In fact, about 25 to 50% of colurectal cancer patients will develop liver metastasis at some point if left untreated. And colurectal cancer is not the only cancer that can spread to the liver. The liver has this massive blood supply. So in theory, almost any cancer could potentially spread there. But some well-known cancers that have been known to spread to the liver are breast cancer, lung cancer, and pancreatic cancer as well as some others. But the point is that this helps us to understand why secondary liver cancer is more common than primary liver cancer because you have multiple primary cancers from other sites that could potentially spread to the liver. Now before we dive into the risk factors in treatment of liver cancer, let's talk about something that is also critical in the world of health and that is accurate information. Because inaccurate information about diseases like cancer can spread faster than a viral Tik Tok video leading to unnecessary panic, misguided treatments, and missed early warning signs. That's why staying properly informed is essential. And that's exactly where our sponsor, Ground News, comes in. Ground News is an app and website that shows you over 50,000 sources from around the world in one place so you can critically think about the news you read. Think of it as an anatomical dissection of the news. It breaks things down layer by layer so you can get to the truth without those sneaky algorithms pulling the wool over your eyes. Let me give you a quick example. Look at this story. CT scans linked to 103,000 annual cancer cases in the US. Study finds over 100 sources are covering this story from different perspectives across the world. Here it says increased CT scan usage since 2007 exposes more patients to cancer-causing ionizing radiation. To easily get more context on the study, I love that on ground news, you can compare headlines side by side. Here, CBS News informs us that it could be the radiation from the CT scans causing the cancer. From ZME Science, they mentioned how CT scans save lives, but researchers now say they could also be behind 100,000 future cancer cases. And Fox News emphasizes common medical tests linked to 5% of cancer. Studies suggest use them wisely. Having all these perspectives in one place helps me see the full picture of the story without having to dig through dozens of tabs. Plus, ground news shows that nearly 90% of the outlets covering this topic are rated high to very high in reliability of the sources reporting, which gives me confidence in the quality of information I'm relying on, especially when it comes to research. And I found this story because they have a dedicated interest page for health and cancer, so I can stay current on breaking developments in medicine, public health, and beyond. So, if you want to try it, you can subscribe by scanning the QR code or going to ground.news/hum to get 40% off the Vantage plan, giving you unlimited access that only comes out to $5 a month. That information will also be in the description below. And now, let's get back to the liver. Now, I do want to have a little bit of a cancer checkpoint here. I'm not going to move too far away from primary and secondary liver cancer, but I do think it's important to note that cancers like colurectal cancer, breast cancer, lung cancer, yes, they can spread to the liver, but they can also spread to other regions like breast cancer could spread to the brain. It could spread to multiple loes of the lungs. We don't ever know for sure. And this is one of the reasons why cancer treatment can be so difficult. If we could in theory predict exactly where each primary cancer was going to spread to, that would greatly assist in treatment, but we can't fully predict this. We have estimates based on statistics, but again, there's no perfect predictor of where cancer will spread. And this also helps us to understand why most people that die from cancer often die from a secondary cancer, wherever that secondary site is. But often that secondary site is a more vital organ. Let me give you some examples of what I mean by this. With primary breast cancer, we can remove breast tissue and therefore the breast cancer before somebody dies. As long as those cancer cells have not spread to a more vital organ, we can remove segments of the colon for people that detect colon cancer early enough. We can remove a testicle with testicular cancer, an ovary with ovarian cancer. We can remove the mole and skin cancers like malignant melanoma. And again, these individuals can often survive because the removed organ or segment of the organ was not required for survival. again as long as it was removed or treated early enough. Now, I'm not saying that people can't still beat cancers that have spread to other regions and even more vital organs because people definitely do beat metastatic cancers with chemotherapy and various other treatment options. But the reality is that in general, the prognosis becomes less favorable the later you detect cancer. So, if you've watched some of my previous videos on cancer, you're going to hear my broken record statement again. Early detection, early detection. So don't skip out on your annual physicals and do your best to follow the recommended cancer screening guidelines with your health care provider. Now obviously it would be even more ideal to completely prevent cancer rather than just detect it early once we have it. Now there's no guaranteed method to prevent all cancers. Most cancers arise due to multiple factors, some of which are completely beyond your control. However, there still are some things that you can do to reduce your risk of developing cancer. And since we're mainly supposed to be talking about liver cancer today, what are some specific things that you can do to reduce your risk of developing the primary liver cancer, hpatoscellular carcinoma? One of the biggest culprits for hpatoscellular carcinoma is chronic liver damage and there are multiple things that can cause chronic liver damage and therefore potentially lead to hpatoscellular carcinoma such as hepatitis B and C infections. These viruses can irritate the liver for years causing chronic liver damage. So reducing your risk of contracting these viruses through safe sex practices and avoiding IV drug use can reduce your risk of hpatoscellular carcinoma. There's also a vaccine available for hepatitis B. And if someone does contract one of these viruses, there are treatments available. Chronic alcohol consumption is another risk factor that can be controlled. Now the exact dose and duration of alcohol use before it becomes a serious problem is not exact and can vary from person to person. But the main problem is when chronic alcohol consumption leads to cerosis, and more on that in just a second. There's also non-alcoholic fatty liver disease. This is tied to obesity and diabetes and is when the liver becomes infiltrated with fat, which we've actually done another video on if you want to check that out. But non-alcoholic fatty liver disease can also lead to cerosis. So, we should probably just briefly talk about cerosis. Now, cerosis is scarring of the liver. And everything that we just talked about, hepatitis B and C, chronic and excessive alcohol consumption and non-alcoholic fatty liver disease can lead to this scarring of the liver aka cerosis. In fact, 80% of patients that have hpatoscellular carcinoma also have cerosis. So clearly this is a significant risk factor that we want to do our best to avoid. And all of these risk factors, hepatitis infections, excessive alcohol consumption, and non-alcoholic fatty liver disease, we have a lot of control over. Some other risk factors that we need to mention, obesity and type 2 diabetes appear to increase one's risk. Granted, those can both lead to fatty liver disease, but both of those appear to increase the risk of hpatoscellular carcinoma independent of the development of fatty liver disease. Tobacco smoking doesn't just increase your risk of lung cancer. Granted, lung cancer is a greater risk from tobacco smoking, but it can also increase your risk of apatoscellular carcinoma. And obviously, your genetics play a significant role, but that's something that you don't have any control over. But what about reducing your risk of secondary liver cancer? Well, reducing your risk of secondary liver cancer would come from reducing your risk of developing that initial primary cancer and early detection of that primary cancer before it spreads to the liver. So, in other words, reducing your risk of something like colctal cancer or some other cancer that could spread to the liver. And we've already completed some other cancer specific videos where we include how to reduce your risk for that specific cancer. And our goal by the end of the year, depending on when you're watching this video, is to cover almost all the common types of cancer so that you can assess and understand your risk factors for those specific cancers. So, we've created a specific playlist for those videos that I'll link at the end. So now let's talk treatment and survival rates for apatic cellular carcinoma. The overall 5-year survival rate is about 20%. Overall means that this percentage includes all stages of apatic cellular carcinoma. However, if you catch it early while the cancer is still localized in the liver, survival jumps to 35%. If it spreads to nearby lymph nodes, you're looking at about 12 to 13%. And if it jumps to distant sites, it's a tough 3%. Now there's variation within these categories. For example, someone catching it early with tumors confined to one liver segment, no invasion into the liver's blood vessels and say the person is part of that 20% of hpatic cellular carcinoma patients without cerosis. Their 5-year survival rate could be much higher like 50% or more. The point is those percentages are helpful but your unique situation the health of the liver or tumor specifics really dictates the survival odds. Now like treatment for other cancers, treating hpatoscellular carcinoma is nuanced. It depends on whether it's primary or secondary liver cancer, the stage and whether the liver is still holding strong or struggling with severe cerosis. Surgical resection is a big player with liver cancer treatment and potentially curative. And this is where the surgeon removes that cancerous segment of the liver. And the liver is quite the incredible organ as it has the ability to regenerate that lost portion. But again, only if that remaining liver portion is healthy and the cancer hasn't also snuck into the blood vessels within the liver. Some patients might be candidates for a liver transplant, but that's rare and it's reserved for cases that meet very specific criteria. For those who can't go the surgical route, there's still some more tools in the tool box, such as ablation, which zaps small tumors with heat or cold. There's also embleization, which starves tumors by cutting off their blood supply. Now, traditional chemotherapy actually isn't used as much as you might think for hpatoscellular carcinoma because it's rough on the already damaged liver and doesn't actually do a great job shrinking these types of tumors. Instead, targeted drug therapies are used, which are certain drugs that hit specific cancer pathways to slow growth with less collateral damage. And amunotherapy is a somewhat newer option for hpatoscellular carcinoma, which kind of revs up your immune system to attack those rogue cancer cells. So hopefully that gave you some useful information about hpatoscellular carcinoma and some of the differences between primary cancers and secondary cancer. Thanks so much for supporting the channel everyone. Like and subscribe if you got an extra second to click and if you have even more time to click buttons, let us know what you thought of today's video in the comments and of course we'll see you in the next video.