Liver Cancer – Symptoms and Causes
Overview
Liver cancer begins in the liver cells rather than spreading from another body part.
The liver, a football-sized organ located under the right side of the abdomen beneath the diaphragm, performs over 500 functions including balancing blood chemicals, producing bile for digestion, removing toxins, and regulating blood clotting.
Each year in the United States, approximately 24,500 men and 10,000 women receive a liver cancer diagnosis.
It’s important to distinguish primary liver cancer (starting in the liver) from metastatic cancer that spreads to the liver from elsewhere, such as the colon or breast. These metastatic cancers are treated according to their origin.
What Causes Liver Cancer?
Like all cancers, liver cancer develops when DNA mutations accumulate in liver cells, causing them to grow uncontrollably and form tumors. Most cases occur in people with underlying liver disease, though sometimes it happens without clear cause.
Risk factors include:
- Chronic hepatitis B or C infections
- Cirrhosis
- Inherited conditions like hemochromatosis and Wilson’s disease
- Diabetes
- Non-alcoholic fatty liver disease
- Exposure to aflatoxins
- Long-term excessive alcohol consumption
Symptoms
Early-stage liver cancer often produces no symptoms. When signs do appear, they may include:
- Unintended weight loss
- Loss of appetite
- Upper abdominal pain
- Nausea and vomiting
- Weakness and fatigue
- Abdominal swelling
- Jaundice (yellowing of skin and eyes)
- White, chalky stools
- Fever
- Visible enlarged veins on the abdomen
- Unusual bruising or bleeding
Screening programs using ultrasound can effectively detect liver cancer before symptoms develop. People with known liver problems should discuss screening options with their doctor.
Diagnosis and Staging
Doctors use several methods to diagnose liver cancer:
- Blood tests to check liver function
- Imaging tests including:
- Ultrasound
- CT scans
- MRI
After diagnosis, staging tests determine the cancer’s extent—its size, location, and whether it has spread. Staging systems use either Roman numerals (I–IV) or letters (A–D). This staging helps doctors determine treatment options and prognosis.
Treatment Options
Several approaches may be used to treat liver cancer:
| Treatment | Description |
|---|---|
| Surgery | Removal of the tumor or entire liver (transplant) |
| Radiation Therapy | High-powered energy (X-rays, protons) to destroy cancer cells |
| Chemotherapy | Powerful chemicals to kill cancer cells |
| Targeted Drug Therapy | Medications focusing on specific abnormalities in cancer cells |
The most common form of primary liver cancer is hepatocellular carcinoma. Less common types include intrahepatic cholangiocarcinoma and hepatoblastoma.
Types
Hepatocellular carcinoma (HCC) develops from the main liver cells called hepatocytes. This type of cancer can grow in different patterns within the liver.
HCC can appear as a single tumor or multiple tumors throughout the liver. Sometimes it can grow as a diffuse cancer, spreading across the liver without forming distinct tumors.
The classification of HCC may be based on:
- Size of tumors
- Number of tumors
- Growth pattern
- Vascular invasion (whether it has grown into blood vessels)
Signs to Watch For
Primary liver cancer often goes unnoticed in early stages. When symptoms do develop, they may include:
- Unexplained weight loss
- Decreased appetite
- Pain in the upper abdomen
- Feeling sick and throwing up
- Weakness and tiredness
- Swelling in the belly area
- Yellowing of skin and eyes (jaundice)
- Pale, clay-colored bowel movements
When Medical Help Is Needed
If you notice any of these symptoms, especially yellowing skin, unexplained weight loss, or persistent abdominal pain, contact your healthcare provider promptly. Early detection gives you the best chance for effective treatment.
Causes
Liver cancer begins when healthy cells in the liver develop DNA mutations. These genetic changes affect normal cell functions, causing uncontrolled growth that forms tumors.
Several factors can trigger these mutations:
- Chronic viral infections like hepatitis B and C damage liver cells over time.
- Cirrhosis (scarring of the liver) creates an environment where cancer cells can develop.
- Excessive alcohol consumption causes liver inflammation and damage.
- Fatty liver disease is related to obesity and diabetes.
- Exposure to toxins such as aflatoxins (found in moldy foods) and certain chemicals.
In some cases, liver cancer develops without any clear risk factors or underlying liver conditions. Researchers continue to study why some people with healthy livers develop this cancer.
Risk Factors
Several factors can raise your chances of developing primary liver cancer:
- Viral Infections: Long-term infection with hepatitis B or hepatitis C viruses significantly increases liver cancer risk.
- Liver Scarring: Cirrhosis, a condition where healthy liver tissue is replaced by scar tissue, greatly raises cancer risk.
- Genetic Liver Conditions: Inherited diseases like hemochromatosis and Wilson’s disease can damage the liver over time.
- Blood Sugar Problems: People with diabetes face a higher risk of developing liver cancer.
- Fatty Liver Disease: The buildup of fat in liver cells (not caused by alcohol) increases cancer risk.
- Toxin Exposure: Foods contaminated with aflatoxins (mold poisons found on improperly stored crops) can harm the liver.
- Heavy Alcohol Use: Drinking large amounts of alcohol regularly over many years damages liver cells and may lead to cancer.
The risk increases when multiple factors are present. For example, someone with both hepatitis and cirrhosis faces greater danger than someone with just one condition.
Ways to Prevent Liver Cancer
Liver scarring, or cirrhosis, makes liver cancer more likely. You can take steps to protect your liver:
Limit alcohol consumption. Women should have no more than one drink daily. Men should have no more than two drinks daily.
Keep a healthy weight. If your weight is already healthy, stay active and eat well to maintain it. If you need to lose weight, cut calories and exercise more. Try to lose 1-2 pounds per week.
Get Hepatitis B Shots
The hepatitis B vaccine helps protect you from this liver disease. Almost everyone can safely receive this vaccine, including:
- Babies
- Older adults
- People with weakened immune systems
Getting vaccinated is a simple step that significantly reduces your risk.
Protect Yourself from Hepatitis C
While no vaccine exists for hepatitis C, you can lower your chances of infection:
Know your partner’s health status. Use protection during sex unless you’re certain your partner doesn’t have hepatitis B, hepatitis C, or other sexually transmitted infections.
Avoid injectable drugs. If you do use them, never share needles and only use clean equipment. Many communities offer needle exchange programs that can help reduce risk.
Choose reputable tattoo and piercing shops. Before getting work done, ask about their cleaning procedures and equipment sterilization. Good shops welcome these questions and follow strict safety rules.
Treat Existing Hepatitis Infections
If you have hepatitis B or C, getting proper treatment is crucial. Research shows that treating these infections can lower your liver cancer risk.
Medical advances have made these infections more manageable than ever before. Talk to your doctor about current treatment options.
Consider Liver Cancer Screening
For most people, routine screening for liver cancer isn’t recommended. However, screening might help if you have:
- Hepatitis B
- Hepatitis C
- Cirrhosis of the liver
Typical screening includes:
| Test Type | Frequency |
|---|---|
| Blood test | Every 6 months |
| Abdominal ultrasound | Every 6 months |
