The difference between primary liver cancer and secondary liver cancer

Written by Sun Wei
Surgical Oncology
Updated on September 09, 2024
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Primary liver cancer, also commonly referred to as liver cancer, originates in the liver itself and is not transferred from other parts of the body. Secondary liver cancer occurs when the primary tumor originates in another location and then metastasizes to the liver, causing hepatic space-occupying lesions; this is referred to as secondary liver cancer. The main difference between the two types is their origin. Additionally, primary liver cancer is often solitary but may develop intrahepatic or distant metastases as the disease progresses. In cases of secondary liver cancer, multiple intrahepatic metastatic lesions may be discovered at the onset. Moreover, primary liver cancer may often display an elevated alpha-fetoprotein tumor marker, whereas this marker might be normal in secondary liver cancer.

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Can a cystic lesion in the liver be liver cancer?

Clinically, cystic lesions in the liver are mostly not liver cancer lesions, because liver cancer is a malignant tumor occurring in the liver. Clinically, on imaging, it is mainly manifested as occupying lesions in the liver, appearing as multiple hepatic nodules fused into a mass, or as a huge single nodular lesion. These lesions generally appear as solid lesions. When the tumor is large, ischemic necrosis can occur due to insufficient blood supply to the central area, resulting in cystic changes in the central region of the solid lesion. Therefore, some patients with large liver cancer may have cystic and solid lesions on imaging, but in most cases, liver cancer lesions are solid.

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Is primary liver cancer contagious?

Primary liver cancer refers to malignant tumors that occur in the liver and are not metastasized from other parts of the body. Such liver cancer itself is not contagious. However, if liver cancer patients have other infectious diseases, transmission may be possible. Most primary liver cancers are related to liver cirrhosis following hepatitis, with hepatitis B being the most common. If accompanied by hepatitis B, it can be contagious, but it usually doesn't spread through regular daily contact. The main transmission routes for hepatitis B are through blood, mother-to-child transmission, and sexual transmission. This means that as long as the patient's blood does not injure someone else, contagion is generally unlikely, so there is no need for excessive worry.

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How to reduce fever in late-stage liver cancer

For late-stage liver cancer patients experiencing fever, antipyretic treatment should be based on different circumstances. If the fever is due to an infection, it often exceeds 39℃ and is accompanied by symptoms and signs related to the infection, such as cough and yellow sputum, abdominal pain, diarrhea, frequent urination, urgency, and painful urination. In such cases, antibiotics should be used for anti-infective treatment, along with antipyretic analgesics for fever reduction. If the fever is due to tumor fever or interventions like liver procedures, there are no infection-related factors, usually the temperature does not exceed 38.5℃, and there are no symptoms or signs related to infection. The treatment primarily involves the use of antipyretic analgesics for fever reduction.

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Why can't people with liver cancer drink milk?

Liver cancer patients are generally advised not to drink milk, particularly in cases of advanced liver cancer where there is a potential for hepatic encephalopathy. This is because, for patients in the late stages of liver cancer, liver function is compromised, and some may already exhibit symptoms indicative of pre-hepatic encephalopathy. Consuming a diet rich in protein can easily trigger hepatic encephalopathy, and since milk is high in protein, its consumption is usually limited or avoided in such patients. However, for the majority of liver cancer patients, drinking milk is permissible as it not only contains abundant protein but also rich calcium, which is beneficial for the recovery of liver cancer patients. Most liver cancer patients have hypoalbuminemia (low levels of protein in the blood) and some also have hypocalcemia (low levels of calcium in the blood), thus the intake of calcium and protein-rich foods can be very beneficial for their recovery.

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Can early-stage liver cancer be cured by resection?

Liver cancer is one of the common malignant tumors of the digestive system. For patients with early-stage liver cancer, clinical cure is possible after curative surgery. This clinical cure refers to instances where liver cancer patients, after undergoing curative surgery, do not show signs of recurrence or metastasis over a period exceeding five years. This means there is no invasion of surrounding tissues and no metastasis to distant organs – effectively, the patients have achieved clinical cure. Patients' survival time exceeds five years, or even longer. Therefore, for patients with early-stage liver cancer, because their lesions are relatively limited, achieving clinical cure is possible following curative surgery. However, as the disease progresses to the mid and late stages, even with aggressive surgery and postoperative adjuvant radiotherapy or chemotherapy, most patients cannot achieve clinical cure.