Liver, Pancreas and Biliary Cancer

Cancers of the liver, pancreas and biliary tracts are often grouped together as ‘Hepatobiliary Cancers’.

Types of Hepatobiliary cancers:

• Liver cancer
• Pancreatic cancer
• Biliary tract – gallbladder cancer and cholangiocarcinoma

Diagnosis of these cancers can be difficult and may require a stay in hospital while undergoing investigations. Treatment of these cancers takes place in Belfast, under a team of specialists.

Our Cancer Services team are here to support you through every step of the way.

Liver Cancer

The liver is your body’s largest internal organ. It weighs around 1.3-1.8kg and is roughly the size of a football. It is separated into two main lobes, the larger left and smaller right lobe. Each lobe has its own main blood supply.

The liver is vital to control most chemicals in the body by performing functions including:

• Filtration
• Digestion
• Metabolism and detoxification
• Protein synthesis
• Storage of vitamins and minerals

What is liver cancer?

Primary liver cancer is a cancer which develops in the liver.  If a cancer develops elsewhere in the body and spreads to the liver, it is known as a secondary liver cancer.  Primary liver cancer is rare in the UK but the number of people diagnosed with it is increasing. More than 6,000 new cases are diagnosed each year.

Types of primary liver cancer

Hepatocellular carcinoma – also known as HCC or Hepatoma. This is the most common type of primary liver cancer. This cancer develops from the main liver cells called ‘hepatocytes’.  It is most common in people with cirrhosis – scarring of the liver from previous damage.

Fibrolamellar carcinoma – a rare cancer of the liver that usually grows in teens and adults under 40 years old. This type of cancer is different than other types of liver cancer because it happens in people who have healthy livers. Fibrolamellar carcinoma may be called by many different names, including eosinophilic glassy cell hepatoma, fibrolamellar oncocytic hepatoma, fibrolamellar hepatocellular carcinoma (FLHCC) or FHCC.

Angiosarcoma – starts in the blood or lymph vessels of the liver. It is a soft tissue sarcoma. Angiosarcomas that develop from blood vessels are called haemangiosarcomas.

Hepatoblastoma – a very rare type of primary liver cancer that usually affects young children. It is most often diagnosed in children under 2 years old.

Benign liver growths

Most tumours in the liver are benign. They aren’t cancerous and won’t become cancerous (malignant) in the future. Benign tumours don’t usually need treatment. This can depend on the size of the tumour and if it is causing symptoms.

The most common types of benign liver tumours:

• Haemangioma
• Hepatic adenoma
• Focal nodular hyperplasia

Pancreatic Cancer

The pancreas is a leaf shaped organ tucked under the liver and behind the stomach. It is about 15cm (6inches) long. It is part of your digestive system and has two glands within it for two separate functions.

Functions of the pancreas:

Endocrine – secretes hormones into the bloodstream:

• Insulin to lower blood sugar
• Glucagon to raise blood sugar

Exocrine digestive enzymes into the GI tract:

• Enzymes including proteases, lipase and amylase
• Bicarbonate which neutralises stomach acid and maintains a perfect pH for enzyme function

What is pancreatic cancer?

Pancreatic cancer is the 10th most common cancer in the UK. Over 10,000 people are diagnosed in the UK each year. The pancreas can be divided in to the head, neck, body and tail. A tumour can develop in any of these areas.

Risk factors for pancreatic cancer:

• Smoking
• age (>75)
• obesity
• alcohol
• family history
• pancreatitis
• gallstones
• diabetes
• metabolic syndrome

Biliary Cancer

Cancers of the biliary tract:

• Gallbladder cancer
• Cholangiocarcinoma – cancer of the bile ducts

Gallbladder cancer

Gallbladder cancer is a rare cancer of the digestive system.

The gall bladder is a small pouch that stores bile- a fluid that helps us digest food by helping to break down fats in food.

1 in 5 gallbladder cancers are found during routine surgery to remove gallstones. Often they exist with no symptoms.

Cholangiocarcinoma – cancer of the bile ducts

The bile ducts connect the liver and gallbladder to the small bowel and transport bile.  Bile duct cancer is rare. Around 1,600 people are diagnosed with it each year in the UK.

Bile duct cancer can affect any part of the bile ducts:

• Intra-hepatic – the bile ducts inside the liver
• Extra-hepatic – the bile ducts outside the liver
• Hilar – this is where the left and right hepatic ducts meet
• Distal – the lower part of the bile ducts, nearest to the bowel.