Liver cancer is a cancer affecting the cells of your liver – the largest organ in your body. It is the sixteenth most common type of cancer in Australia. While it is among the seventh leading cause of cancer deaths in Australia, it is relatively uncommon in this country. Improved treatments can offer better outcomes for people with liver cancer.
What is liver cancer?
The liver sits just under your ribs, on the right side of your abdomen. It manufactures bile and blood proteins, filters your blood, rids your body of harmful chemicals, and has other vital functions.
There are two main types of liver cancer — ‘primary’, which means the cancer started in the liver, and ‘secondary’, which means the cancer has spread into the liver from another part of the body.
Primary liver cancer
Most people with primary liver cancer have hepatoma or hepatocellular cancer. This begins in the main type of liver cell, known as a hepatocyte.
The cancer can occur as a single tumour and spread through the liver or it can start in many different cells across the liver.
Other types of primary liver cancer include:
- cholangiocarcinoma — or bile duct cancer, which starts in the cells lining the bile ducts
- angiosarcoma — a rare liver cancer that starts in the blood vessels
If primary liver cancer is not found early or treatment is unsuccessful, it can metastasise or spread to other parts of the body.
Secondary cancer in the liver
Most cancers that affect the liver have spread from elsewhere in the body. These are known as secondary cancer in the liver. These secondary cancers are named after the part of the body in which they started. Colon, breast, ovarian and lung cancers, as well as melanomas, are all cancers that can spread to the liver.
What are the symptoms of liver cancer?
Often people don’t realise they have liver cancer until the disease is advanced. Symptoms of liver cancer that you might notice include:
- feeling very weak and tired
- unexplained drop in weight
- loss of appetite
- nausea and vomiting
- pain in your upper right abdomen
- swelling of the abdomen (ascites)
- yellowing of skin and eyes (jaundice)
- pale, chalky bowel motions
What causes liver cancer?
Doctors don’t always know what causes primary liver cancer. Your risk of getting primary liver cancer is greatly increased if you have a chronic hepatitis B or hepatitis C infection which has caused permanent scarring or damage to your liver, known as cirrhosis.
You are also more likely to develop primary liver cancer than other people if you:
- have scarring of, or injury to, the liver
- drink a lot of alcohol
- have certain inherited diseases, such as haemochromatosis or Wilson’s disease
- have autoimmune disorders that damage the liver.
- have type 2 diabetes
- have nonalcoholic fatty liver disease
- are obese
- have been exposed to some chemicals
Can liver cancer be prevented?
One way of preventing liver cancer is not to get hepatitis B or C. You can have a vaccination against hepatitis B. If you are exposed to these infections, for example, if you have sex or share needles with someone who has hepatitis, you should be tested to make sure you are not infected.
If you have hepatitis B or C, then your doctor may prescribe antiviral drugs to suppress the infection and reduce your risk of getting liver cancer. Your doctor may also monitor you regularly to detect problems early.
How is liver cancer diagnosed?
Your doctor will first examine you and ask about your physical symptoms. If there is a possibility of liver cancer you may then need tests including blood tests and imaging (such as magnetic resonance imaging (MRI) or computerised tomography (CT) scans, or a PET-CT scan). You may have a biopsy to remove a sample of liver tissue for testing. This is done with a thin needle under local anaesthetic.
If you have secondary liver cancer, you may have other tests to find out where the primary cancer is.
If you have liver cancer, you are likely to be referred to a gastroenterologist, surgeon or oncologist (cancer specialist). You may need further tests to find out what stage your cancer is at. These could include bone scans and examinations of the bowel, stomach and breasts.
Your doctor may do a laparoscopy, using a small tube with a camera at the end, to look at your liver and surrounding organs while you are under anaesthetic.
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Last reviewed: May 2019