Liver cancer: symptoms
Cancer of the liver is a serious form of cancer. A cancer or tumour of the liver can either start within the liver (called primary liver cancer) or be caused by cancer cells that have come from other parts of the body and spread to the liver (called secondary liver cancer). Secondary liver cancer is the more common type in Australia.
Many secondary liver cancers start in organs of the digestive system (bowel, pancreas, stomach). Other primary cancers that can spread to the liver include breast and lung cancer. However, most cancers can spread to the liver.
Symptoms of liver cancer
The symptoms for both primary and secondary liver cancer are similar. Liver cancers often do not produce symptoms for some time during their growth. However, symptoms, when they do appear, may include:
- jaundice — a yellowing of the skin and eyes;
- dark-coloured urine and pale stools;
- swelling in the abdomen caused by fluid build-up (called ascites);
- abdominal pain that may vary in intensity, especially pain over the liver;
- loss of appetite;
- weight loss;
- weakness and tiredness;
- nausea and occasional vomiting;
- pain around the right shoulder blade; and
Examination and diagnosis
Your doctor will want to make a careful evaluation by taking a complete history of your symptoms and conducting a physical examination.
Your doctor will also ask about any risk factors for primary liver cancer, including:
- hepatitis B or C infection;
- cirrhosis (liver scarring) that may have been caused by disease or heavy use of alcohol;
- haemochromatosis (an inherited condition causing progressive iron accumulation in the body, leading to excess iron in the liver cells) and certain other inherited metabolic diseases;
- diabetes; and
- being overweight.
Your doctor will check your abdomen for any signs that your liver is enlarged. They may be able to feel a hard mass on the right hand side below the ribs if it is enlarged.
Your doctor may recommend that you have a sample of blood taken to check the levels of enzymes in your liver. These tests are known as liver function tests. Blood tests to check for tumour markers (chemicals that are produced by certain cancers) may also be recommended.
Your doctor may send you for some investigations including CT scanning, MRI (magnetic resonance imaging), liver ultrasound or needle biopsy (where cells from the liver are obtained through a very thin needle inserted into the liver and then studied under a microscope).
Treatment will depend on the type of liver cancer that is present and how advanced the cancer is. Your doctor is the best person to advise you about the best management options for your particular condition.
2. National Cancer Institute. What you need to know about liver cancer (updated 29 April 2009). http://www.cancer.gov/cancertopics/wyntk/liver/page1 (accessed Feb 2013).
3. American Cancer Society. Liver cancer (reviewed 21 June 2012). http://www.cancer.org/cancer/livercancer/detailedguide/index (accessed Feb 2013).