Liver Cancer Symptoms – Liver Cancer is the condition in which liver cells grow uncontrollably and may also spread to other body sites through the bloodstream. Liver cancer may arise due to chronic liver injury. This life-threatening condition is categorised into primary liver cancer and secondary liver cancer.

Primary liver cancers are tumours that start in the liver and bile ducts present within the liver.

Types of primary liver cancers include:

  • 1. Hepatocellular carcinoma (HCC)
  • 2. Intrahepatic cholangiocarcinoma (bile duct cancer)
  • 3. Hepatic adenoma
  • 4. Focal nodular hyperplasia
  • 5. Hepatoblastoma
  • 6. Hemangiosarcoma and Angiosarcoma
  • 7. Hemangioma

Hepatocellular carcinoma is the most prevalent liver cancer, mainly in patients with chronic liver conditions like hepatitis B, hepatitis C, alcoholism and biliary cholangitis. One of the several subtypes of HCC is fibrolamellar, which is most prevalent in women below 35 years of age.

Hepatocellular cancers can have different growth patterns:

  1. 1. Single tumor enlarged tumor: hepatocellular cancer begins as a single tumor that enlarges within the liver and rarely spreads to other body parts at later stages.
  2.  2. Malignant nodules: These liver cells become cancerous and spread as small cancer nodules throughout the liver, not just a single tumor.

Hepatoblastoma tumor is the uncontrolled growth of liver cells initiating mainly from the right lobe of the liver and can also metastasize towards the lungs. Undifferentiated embryonal sarcoma is vanishingly rare.

It is more prevalent in children than adults. The success rate for surgery or chemotherapy in children with hepatoblastoma is more than 6 percent.

Intrahepatic cholangiocarcinoma (bile duct cancer)

When cells lining the bile ducts of the liver become cancerous, this condition is termed intrahepatic cholangiocarcinoma. Around 15% of liver cancers are intrahepatic cholangiocarcinomas.

Angiosarcoma and hemangiosarcoma

The endothelial cells of blood vessels, when they start growing uncontrollably, may result in highly aggressive malignant neoplasms; this condition is called hemangiosarcoma (HSA) or angiosarcoma. These rare cancers may develop due to vinyl chloride or thorium dioxide exposure. Individuals exposed to arsenic or radium are likely to develop these carcinomas or hereditary hemochromatosis. In more than half of the cases, the cause is unidentifiable.

Secondary liver cancer (metastatic liver cancer)

Secondary (metastatic) liver cancer develops when the cancerous cells, which originated in other parts of the body (primary sites), metastasize or move to the liver through the bloodstream, such as from the colon, breast, stomach, or lungs, these cancers. These tumors are treated based on their original site. For example, breast cancer that starts in the breast and moves to the liver is considered breast cancer.

Benign liver tumors

Benign tumors are cancerous cells that do not evade other sites and slowly enlarge in their particular region. These tumors are easy to treat with simple surgical procedures.


Hemangiomas are the most prevalent type of benign liver tumor originating in the blood vessels. Most liver hemangiomas are asymptomatic and do not require treatment. However, in some cases, bleeding may start, which requires surgical removal of the tumor.

Hepatic adenoma

Hepatic adenoma occurs when the primary liver cells (hepatocytes) become cancerous, but these tumors develop inside the liver and do not move to other body parts. Most individuals with hepatic adenoma do not show any symptoms and do not need any treatment. However, a few adenoma patients might exhibit pain, blood loss or a lump in the stomach. Because there is a risk that the tumor could rupture (leading to severe blood loss) and a small risk that it could eventually develop into liver cancer, most experts will usually advise surgery to remove the tumor if possible.

Focal nodular hyperplasia

Focal nodular hyperplasia (FNH) tumors come under the category of benign tumors. When hepatocytes (major liver cells), bile duct cells, and connective tissue cells start growing uncontrollably, they become cancerous. This condition is termed focal nodular hyperplasia. FNH often shows mild symptoms. At times, the diagnosis is unclear.

The prevalence rate for hepatic adenomas and focal nodular hyperplasia tumors is higher in women than men.

Liver Cancer Symptoms

Most individuals are asymptomatic at an early stage of liver cancer; however, as the disease progress, prominent symptoms may include the following:

  • 1. Loss of appetite or poor appetite: a condition where persons experience a reduced desire for eating food
  • 2. Weight loss: liver plays a crucial part in the digestive system, and tumors in cancer will disrupt digestion, which can lead to a reduced urge to eat, resulting in unexpected weight loss
  • 3. Vomiting or nausea
  • 4. Abdominal swelling
  • 5. Upper abdominal pain
  • 6. Fatigue and weakness
  • 7. White, chalky stools
  • 8. Yellow coloration or paleness of your skin and eyes (jaundice)

Liver Cancer Stages

Staging is the process of categorizing a diagnosed cancer of an individual into a particular stage by determining the amount of spread. Survival statistics are also calculated according to the stage. Some doctors prefer the TNM staging system of AJCC (American Joint Committee on Cancer), which is based on

  • 1. Tumor (T): the size of the tumor,
  • 2. Lymph nodes (N): cancer moves to nearby lymph nodes
  • 3. Metastasis (M):cancer metastasize (invade) to distant locations.

There are 4 stages of liver cancer (stage I is the earliest stage, the milder one with no or least spread cancer and stage IV is the last stage of cancer in which lymph nodes metastasize to distant locations, such as bones).

Stage 4 Liver Cancer Symptoms

  • 1. Loss of Appetite
  • 2. Abdominal pain.
  • 3. Generalized itching
  • 4. Ascites (Abdominal swelling)
  • 5. Fluid in the abdomen
  • 6. Early satiety
  • 7. Skin and eyes becoming pale or yellowish (jaundice)
  • 8. Liver swelling

Liver Cancer Diagnosis

There are several blood tests and liver tests to diagnose liver cancer, which include,

  • 1. Physical examination: Examine the body for overall health; a physical exam is carried out to check a person’s health, including signs of disease, such as lumps or anything else that seems unusual.
  • 2. LFT – Liver function tests is the blood test to quantify the amount of substances released by the liver in the bloodstream.
  • 3. CAT scan or CT scan: computed tomography scan uses X-rays to scan different body parts like the abdomen in different angles. In triple-phase CT, images are recorded three different time lapses after the dye has been injected into the liver. Another type of CT scan, helical or spiral CT scan, provides a detailed series of pictures using a spiral X-ray machine. The doctor then observes these computer-generated images for lumps, swellings, or nodules.
  • 4. AFP Tumor marker test: Alpha-fetoprotein (AFP) tumor markers are released into the blood by organs (like the liver), tissues, or cancerous cells (like tumor hepatocytes) in the body. AFP marker test measures the amount of AFP present in the blood. An abnormally high level of AFP is indicative of liver cancer. Increased levels of AFP may occur due to certain noncancerous infections, like hepatitis and cirrhosis. At times, a perfectly diagnosed liver cancer also shows normal AFP levels.
  • 5. Magnetic resonance imaging (MRI): This procedure involves the use of magnetic and radio waves to scan the internal organs of the body. This information is then transmitted to a computer to convert into readable images. In magnetic resonance angiography, a dye is injected into a vein, and detailed pictures of hepatic ducts and blood vessels are obtained. For triple-phase MRI, images are taken at three intervals after the dye is injected.
  • 6. Ultrasound exam: Ultrasonic waves or high-energy sound waves are used in ultrasound examination. These waves are bounced off the liver and form echoes, this information forms images (sonogram).
  • 7. Biopsy: In a biopsy, a small number of cells or tissues are taken from the body and observed under a microscope for signs of cancer.

The above diagnostic procedures can tell the existence of primary liver cancer; a PET scan is usually preferred for diagnosing secondary liver cancer.

PETscan: A positron emission tomography (PET) scan can detect malignant tumor cells in the body. Radioactive glucose is injected into a vein. Malignant tumor cells are more active and require more glucose intake. Hence, these cells are visibly brighter in the picture.

Liver Cancer Drugs

Several drugs have been approved for the treatment of liver cancer:

  • 1. Atezolizumab.
  • 2. Cabometyx
  • 3. Cabozantinib-S-Malate
  • 4. Avastin
  • 5. Bevacizumab
  • 6. Keytruda
  • 7. Cyramza (Ramucirumab)
  • 8. Infigratinib Phosphate.

Frequently Asked Questions

What is the survival rate of liver cancer?

According to the research published in the American Cancer Society journal,

35% of people with localized liver cancer can have a relative survival rate of 5 years.

12 % of individuals diagnosed with regional liver cancer can survive till 5 years

3% of individuals with distant liver cancer can manage their survival till 5 years.

  • 1. Localized liver cancer: There is no sign that cancer has spread outside of the liver.
  • 2. Regional liver cancer has spread outside the liver to nearby structures or lymph nodes.
  • 3. Distant liver cancer: Cancer has spread to distant body parts, such as the lungs or bones.

However, survival rates for liver carcinoma are considerably higher for patients who can undergo surgery to remove liver cancer, regardless of the stage.

What are the early warning signs of liver cancer?

Check out if you are at risk of liver cancer by analyzing below given conditions in the body:

  • 1. Loss of appetite
  • 2. Weight loss with a normal diet
  • 3. Vomiting or nausea
  • 4. Abdominal swelling
  • 5. Upper abdominal pain
  • 6. Fatigue and weakness
  • 7. White, chalky stools
  • 8. Yellow coloration or paleness of your skin and eyes (jaundice)

What is the main cause of liver cancer?

The most common risk factor for liver cancer is long-term liver cirrhosis with hepatitis B (HBV) or hepatitis C (HCV).

Can liver cancer be cured?

Through partial hepatectomy surgery, liver cancer is curable in the initial stages.

It is strictly dependent on factors such as the size of the tumor and the extent of metastasis to nearby blood vessels.

Is liver cancer a painful death?

In most cases, liver cancer is diagnosed in later stages, as people often neglect liver pain. Liver cancer patients might experience pain from their primary tumor in the liver and pain from other areas if their cancer has spread.

Does liver cancer spread quickly?

Depending on the type of liver cancer, the time the cancer cells take to spread is variable. It is faster in hemangiosarcoma and angiosarcoma as the cells move through the bloodstream. In the case of hepatocellular carcinoma, cancerous cells might take some time to spread to other body parts.

Where is the first place liver cancer spreads?

Metastasis of liver cancer can affect the lungs, bones, and other surrounding tissues.

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