This is considered a minimally invasive procedure. Ablation uses heat and electric current to destroy tumors by causing the surrounding tissues to heat up and then kills the nearby cells. Used to treat a spot of cancer that is causing problems; not generally used as the primary treatment for most cancers. (Mayo Foundation, 2018)

Aflatoxins are toxins that are produced by a mold (fungus) that grows on nuts, seeds, and legumes. They are considered unavoidable contaminants and are in low amounts, particularly in peanuts, peanut butter, corn and some tree nuts. Always buy from major brands and discard any peanuts that are moldy, shriveled and/or discoloured. Ingested in large amounts, aflatoxins may cause liver damage and an increased risk of liver cancer. (Mount Sinai, 2023; NCI, 2022).

Alagille syndrome is a genetic disorder that results in a build-up of bile in the liver either due to too few bile ducts or narrowed bile ducts to carry the bile away from the liver, leading to liver damage (Medline Plus, 2014).

Alpha one antitrypsin (AAT) is a protein produced by the liver and this protein travels through the blood to help protect the lungs, and other parts of the body. In an inherited condition, called Alpha-1, larger amounts are produced than normal and the protein is in a different shape than normal; the liver cannot break this protein down and so it becomes damaged and scarred (Alpha-1 Foundation, nd).

Fluid collects within the spaces of the abdomen (Johns Hopkins Medicine, 2023).

Substance produced by the liver and travels to the gall bladder via bile ducts (or tubes) for storage. Bile is used in the digestion and absorption of fats.

Biomarkers are made up of the person’s genes, proteins and other substances specific to that tumour. Everyone has their unique pattern of biomarkers or tumour marker. Biomarker testing may assist the physician in determining the treatment plan (NCI, 2021).

Different Biomarkers:

• The following definitions for the tumor marker tests are taken from the Canadian Cancer Society, 2023 https://cancer.ca:
• AFP – Alpha-fetoprotein is usually very low in healthy children and adults. Certain types of cancer cause an increase in the amount of AFP in the blood.
• CEA – carcinoembryonic antigen (CEA) blood test is a tumor marker for some types of cancers.
• CA 19-9 – Carbohydrate antigen 19-9 (CA19-9) is another tumour marker test to evaluate the status of the tumor activity.
• DCP – 1,2-dichloropropane (DCP) is a chemical used in some types of offset printing. If exposed to this at a young age, more likely to develop bile duct cancer at a younger age.

Carbohydrates are the body’s main source for energy (Calories). Along with being important nutrients for health, and include sugars, starch and fiber (Health Canada, 2019).

This therapy is presently being used for blood cancers. It is a form of immunotherapy where the person’s T cells are removed from their body and genetically modified to produce chimeric antigen receptors (CARs); they are infused back into the patient’s blood stream and they target and kill the cancer cells (Mayo Clinic, 2023).

Chemoembolization (also known as TACE) is a cancer treatment that blocks a tumor’s blood supply (Cleveland Clinic 2022).

Drugs are used to kill cancer cells. (CCS, 2023).

Cholesterol is a fat found in the blood. There are two main types (and other subtypes): HDLs (high density lipids) and LDLs (low density lipids). The body produces cholesterol and it is also obtained from diet (HSF, 2023).

Cirrhosis refers to a condition of advanced liver disease (damage to liver function). The normal tissue has been replaced by scar tissue. It can be caused by hepatitis or excessive alcohol intake, NAFLD (MASLD), NASH, PSC, and inherited diseases, among other causes (Canadian Liver Foundation, 2023).

This is an inherited disease that cause ammonia and other toxic substances to accumulate in the blood (Medline Plus, 2017).

A computerized tomography (CT) scan is a series of X-ray images taken from different angles around your body and can be used to visualize nearly all parts of the body to diagnose disease or injury and to plan the medical, surgical or radiation treatment (Mayo Clinic, 2023).

The body naturally rids the body of harmful substances (or detoxifies) through the kidneys, liver, lungs, digestive system and skin (VanDe Walle, 2023).

Diabetes mellitus is a disease in which your body either can't produce insulin (diabetes type 1, DM1) or can't properly use the insulin it produces (diabetes types 2, DM2). Insulin is a hormone produced by your pancreas that regulates the amount of glucose (sugar) in the blood stream. It allows glucose into the cells to be used for energy (Diabetes, 2023).

Embolization procedures stop blood flow to a specific blood vessel. It is considered a minimally invasive procedure (Cleveland Clinic, 2022).

Originating or occurring outside of the liver (Segen’s Medical Dictionary, 2012).

Also known as lipids. They are a source of energy for the body and can be converted to glucose as needed. There are saturated (solid at room temperature) and unsaturated fats (not solid at room temperature) (Youngson, 2005).

Bile duct stones that may become trapped in the bile duct and if the stone lodges in the bile duct, it can be very painful; also known as choledocholithiasis. Cholelithiasis refers to having gallstones, but not symptomatic (Molvar & Glaenzer, 2016).

Genetic testing looks for changes, mutations or variants in your DNA, prior to becoming ill or showing symptoms. This can be done to diagnose a genetic condition (CDC, 2022).

Used interchangeably with biomarker testing.

The main carbohydrate storage molecule of animals. Can be converted to glucose when needed. It is found in the liver and muscles of the body (Youngson, 2005).

One form of a viral hepatitis is Hepatitis A. Hepatitis A is spread from close contact with an infected person or from eating hepatitis A contaminated food or water. Hepatitis is found in the feces (stool) of an infected person and if their hand hygiene after using the washroom is poor, eating food prepared by that person can spread the virus. There is a preventative vaccine against Hepatitis A (Canadian Liver Foundation, 2023).

Hepatitis B is common worldwide. In Asia and Africa, where it is common, one in five may be infected with this virus. Chronic hepatitis B is a silent disease as a lot of times there are no outward symptoms until the liver is severely damaged. Hepatitis B is found mainly in the blood, semen and vaginal fluid of an infected person: because of this, the infection can be spread to other people through blood or other body fluids or by sexual contact. There is a preventative vaccine for Hepatitis B and treatment but no cure to date (Canadian Liver Foundation, 2023).

Hepatitis C is spread through blood-to-blood contact. Hepatitis C can cause liver damage if left untreated. There are tests available to identify the virus and it can be treated and cured. There is no vaccine at this time for Hepatitis C (Canadian Liver Foundation, 2023).

A fetal cell liver tumour that children have; usually diagnosed by age three.

Hilum is an opening that allows structures to pass into and out of the liver. The structures include the blood vessels (portal vein and hepatic artery) and common bile duct (Fletcher, 2022).

Histotripsy is a noninvasive, non-ionizing, non-thermal ablation technique using focused ultrasound delivered from outside the body. Approved only for liver cancer at this time (Xu et al., 2021).

A chemical transmitter substance produced by the cells of the body and transported to their target cells and organs where they exert their functional effects (Farlex, 2012).

Immunotherapy boosts the immune system or helps the immune system to find cancer and attack it. There are different kinds of immunotherapy (Canadian Cancer Society, 2023).

Situated or occurring inside or within the liver (Merriam-Webster Dictionary, 2023).

The yellowing of the skin and whites of the eyes because the blood contains too much bilirubin, the yellow pigment that causes the discolouration. Also called hyperbilirubinemia (Subbiah & West, 2016).

Liquid biopsies are blood tests which can detect cancer associated biomarkers that the tumour is shedding (NCI, 2021).

A liver fluke is a parasitic worm and infections in humans usually occur after eating contaminated raw or undercooked freshwater fish or watercress. After they are ingested, they travel from the intestines to the bile ducts in the liver where they grow and live. The risk of infection increases if travel to parts of the world where parasites are widespread occurs (Healthline, 2023).

Metabolic Associated Steatotic Hepatitis (MASH) replaces NASH. MASH is the presence of excess fat leading to lipotoxicity and inflammatory damage to liver cells (hepatocytes). The use of alcohol has to be ruled out so it is not confused with alcoholic hepatitis (Tholey, 2023).

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). This term replaces NAFLD as it encompasses more risk factors. With MASLD, in addition to liver or hepatic steatosis, there is at least one or more of the metabolic syndrome risk factors (AASLD, 2023).

Metabolic syndrome is a cluster of conditions that occur together and increase the risk of stroke, heart disease, diabetes and other chronic illnesses. These conditions include high blood pressure (greater than 130/85 or receiving medication), high blood sugar (fasting glucose of greater 5.6 mmol/L), large waist circumference (greater than 102 cm in men and 88 cm in women), high triglycerides (greater than 1.7 mmol/L or receiving medication) and low HDL-cholesterol (less than 1.0 mmol/L in men and 1.3 mmol/L in women) (Metabolic Syndrome Canada, 2023).

MRI is a noninvasive way for a medical professional to examine your organs, tissues and skeletal system. It works by using a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body which produce high-resolution images of the inside of the body that help diagnose a variety of conditions (Mayo Clinic, 2023).

Damage to the nerves can cause pain, numbness, tingling, burning sensation, swelling or muscle weakness in the extremities, feet and hands but can affect other parts of the body as well. Some of the causes include diabetes, kidney disease, and chemotherapy. (Mayo Clinic, 2023; NCI, 2020).

NAFLD is a liver disease affecting people who drink little or no alcohol. It is a rather benign condition but affects about 20% of all Canadians. The main characteristic is too much fat stored in liver cells and the most common cause is obesity. It is strongly associated with metabolic syndrome (Canadian Liver Foundation, 2023). See also the more encompassing term Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

More serious form of NAFLD. NASH can cause liver scarring and one out of every five people with NASH will develop cirrhosis. People with NASH are at a greater risk for developing liver cancer or liver failure. In chronic liver failure, a liver transplant may be needed (Canadian Liver Foundation, 2023). See also Metabolic Associated Steatotic Hepatitis (MASH).

Neuropathy is often referred to as peripheral neuropathy. (NCI, 2020).

Also know as serum proteins. They are dissolved proteins of the blood and include albumin and globulins. These plasma proteins hold fluid in the blood vessels by osmosis and include antibodies and blood clotting proteins (Farlex, 2012).

Porphyria, usually inherited, refers to a group of rare disorders that result from a build-up of natural chemicals called porphyrins in the body. There are 8 chemicals needed to make heme, a part of hemoglobin. Hemoglobin carried oxygen to the body tissues and organs. Without enough of these enzymes, porphyrias build up in the blood and can cause major problems (Mayo Clinic, 2023).

PBC is a chronic liver disease where the immune system attacks the liver causing slow progressive damage to the bile ducts: over time causing scarring of the liver (Canadian Liver Foundation, 2023).

PSC is a liver disease in which the bile ducts progressively decrease in size due to inflammation and scarring. This results in the accumulation of bile within the liver, damaging the liver (Canadian Liver Foundation, 2023).

A protein is a naturally occurring complex substance consisting of amino acids residues connected by peptide bonds. Proteins are present in all living organisms and include many essential biological compounds such as enzymes, hormones and antibodies (Koshland & Haurowitz, 2023).

Severe itchiness.

Treatment that uses high-energy rays (x-rays or gamma rays) to damage or destroy cancer cells. May be given externally or internally (implanted near the cancer cells). Also called radiotherapy, irradiation or x-ray therapy (CCS, 2023).

Also called intr-arterial brachytherapy, selective internal radiation therapy or Y-90. Radioembolization delivers radiation directly to the cancerous tumors in the liver. See Yttrium-90. (Northwestern Medicine, 2024).

Steatotic Liver Disease (SLD) is a benign condition where there is a fat buildup in the liver; more than 5-10% of it's weight (Tholey, 2023).

Treatment that uses drugs or other substances to target specific molecules involved in cancer cell growth while minimizing harm to normal cells (CCS, 2023).

TACE is a cancer treatment that blocks s tumor’s blood supply. The tumor gets most of its blood supply from the hepatic artery. After TACE and blocking the hepatic artery, the liver receives its blood supply from the portal vein. Chemoembolization delivers the chemotherapy drugs directly to the tumor. The treatment uses a higher dose of chemotherapy than systemic chemotherapy. Fewer side effects are experienced because the drugs are delivered directly into the tumor. An interventional radiologist performs this procedure.(Cleveland Clinic, 2022).

A liver transplant is a life saving operation where the diseased part of the liver is replaced with healthy donated liver (Canadian Liver Foundation, 2023).

Wilson disease is a hereditary disease in which there is excessive amounts of copper that accumulates in the body, mainly the liver. The liver stores copper and when there is too much, the copper is released into the bloodstream and accumulates in other organs. If untreated, it is fatal (Canadian Liver Foundation, 2023).

Yttrium-90 is a radioisotope of yttrium. It has a wide range of uses in treating cancer. Although not a cure for metastatic liver cancer, Y-90 can help extend and improve the quality of life a person has. Y-90 gives off radiation. Y-90 is embedded in glass beads and inserted into a blood vessel near the tumor by a surgeon. The beads partially block the blood flow to the tumor. Radiation is released for about 2 weeks and after a month or so, there is no more radiation released. (UPMC Hillman Cancer Center, 2024).

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