Liver cancer is a type of malignant tumor that begins in the liver and can spread to the bile ducts or blood vessels. It can cause symptoms such as abdominal pain, yellowing of the eyes, nausea, loss of appetite, and weight loss.

People with fatty liver disease, cirrhosis, or who use anabolic steroids have a higher risk of developing liver cancer. It is usually diagnosed with abdominal imaging tests, such as ultrasound or CT scan, which can detect one or more nodules in the liver.

Treatment for liver cancer depends on the size and number of tumors and the stage of the disease. Doctors may recommend surgery, chemotherapy, radiation therapy, immunotherapy, or a liver transplant.

Symptoms of liver cancer

The most common symptoms of liver cancer include:

Abdominal pain, especially on the right side
Swelling in the abdomen
Yellowing of the skin and eyes
Unexplained weight loss
Loss of appetite or feeling full after eating small amounts
Hard lump on the right side of the abdomen, below the ribs
Pale or whitish stools

Other possible symptoms of liver cancer include itchy skin, general discomfort, fever, nausea or vomiting, extreme fatigue, and dark urine.

In most cases, liver cancer symptoms only appear in more advanced stages of the disease.

How to confirm a diagnosis

Diagnosis is made by a hepatologist, based on symptoms, medical history, and family health history.

To confirm liver cancer, the doctor may order blood tests and imaging exams such as ultrasound, CT scan, MRI, or laparoscopy.

If suspicious changes are found, a liver biopsy may be recommended to confirm in the lab whether cancer cells are present.

In less concerning cases, doctors may suggest repeating tests every 1 to 3 years to monitor growth or new changes that could indicate liver cancer.

What causes liver cancer?

The main causes and risk factors for liver cancer include:

Chronic hepatitis B or C infection
Type 2 diabetes
Cirrhosis
Fatty liver disease (hepatic steatosis)
Excessive alcohol consumption
Obesity
Smoking

Exposure to aflatoxins, substances produced by certain fungi found in cereals, peanuts, walnuts, almonds, and spices, can also increase the risk of liver cancer.

Types of liver cancer

Liver cancer can be classified as primary or secondary:

Hepatocellular carcinoma (hepatoma): the most common type of primary liver cancer, starting in the main liver cells (hepatocytes)
Cholangiocarcinoma: a type of primary liver cancer that begins in the cells lining the bile ducts
Angiosarcoma: a rare type of primary liver cancer that starts in blood vessels, usually affecting people over 70 years old
Fibrolamellar carcinoma: a type of primary liver cancer that tends to occur in people between 20 and 30 years old

Secondary liver cancer develops from metastasis, when cancer spreads from other organs such as the lungs, stomach, intestines, pancreas, or breasts.

Treatment options

Treatment for liver cancer depends on the severity of the disease and the person’s overall health. The main options include:

1. Chemotherapy

Chemotherapy may be recommended for people whose liver cancer cannot be treated with surgery and who did not respond to other therapies such as ablation or embolization.

The most commonly used chemotherapy drugs for liver cancer include gemcitabine, oxaliplatin, and capecitabine. These can be given through a vein or directly into the artery, in a procedure called chemoembolization.

2. Surgery

Surgery, usually performed by resection (removal of part of the liver), is generally recommended for primary liver tumors.

The surgeon may remove a small section or up to three-quarters of the liver, since the liver is capable of regenerating and growing back.

3. Radiation therapy

Radiation therapy is less commonly used for liver cancer but may be recommended to destroy cancer cells or control metastasis with targeted radiation.

4. Liver transplant

For people with cirrhosis, a liver transplant may be advised. This procedure involves replacing the diseased liver with part or all of a healthy donor liver.

5. Immunotherapy

Immunotherapy uses medications given intravenously to stimulate the immune system so it can recognize and attack cancer cells.

6. Radiofrequency ablation

Radiofrequency ablation uses electrical currents or waves to heat the tumor from the inside, destroying cancer cells.

This treatment is usually recommended when surgery or a liver transplant is not possible.

Can liver cancer be cured?

Liver cancer can be cured, especially when it is diagnosed and treated early. The best chances of cure are with surgery or liver transplant.

Liver Cancer: Symptoms, Diagnosis, Causes, Types & Treatment