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Q.

Does smoking cause liver cancer? What else could cause this disease?

A colleague died of liver cancer a few days ago. This was less than 3 months after she had been diagnosed with stage 4 cancer. She was not a drinker and had no history of liver infection or cancer in the family. She used to smoke before, but not heavily, and then she stopped.
 

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A.

Cancer that starts in the liver is called primary liver cancer. Cancer that starts somewhere else in the body and spreads to the liver is called secondary liver cancer. Primary liver cancer is the most common solid tumor worldwide. In North America and Europe, secondary liver cancer occurs much more frequently than primary liver cancer. The liver is the most common organ to which cancer spreads.

The two major risk factors for primary liver cancer are:

  • Persistent hepatitis B and C. People who never completely recover from hepatitis B or C infections have constant liver inflammation.

  • Cirrhosis. In North America and Europe, the most common causes of cirrhosis (scarring of liver cells) are hepatitis C and drinking too much alcohol.

It is more likely that your colleague had secondary liver cancer. Secondary liver cancers are defined by the organ where the cancer began. For example, doctors call cancer that started in the lung and spread to the liver "metastatic lung cancer with liver involvement." Many different types of cancer spread to the liver. So smoking can increase the risk of developing lung, pancreas, bladder, and other tobacco-related cancers.

When a cancer spreads to the liver from somewhere else, the cancer cells are the same in both places. In people with secondary liver cancer, doctors treat them for the original site of the cancer. So, metastatic lung cancer that has spread to the liver would be treated as lung cancer, not liver cancer.

Copyright 3/26/2010 Harvard University. All rights reserved. HHP/HMS content licensing handled by Belvoir Media Group.

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