Overview
What Is Liver Cancer?
Liver cancer is a disease in which abnormal cells grow uncontrollably in the liver and form a tumor. It can affect people with long-term liver disease, but it may also occur in people without a known risk factor. Primary liver cancer starts in liver cells or nearby bile ducts, while metastatic liver cancer begins in another organ and spreads to the liver. The liver helps process nutrients, filter substances from the blood, and make bile, so a tumor or underlying liver disease can affect several body functions.
Symptoms
Liver Cancer Symptoms
Early liver cancer may cause no noticeable symptoms, or its symptoms may be mild and nonspecific. Some changes come from the liver tumor itself, while others result from cirrhosis, hepatitis, or another underlying liver condition. Symptoms of liver cancer can also vary according to the tumor’s size, location, and effect on liver function.
- Unexplained weight loss may occur without a change in diet or exercise.
- Reduced appetite can make eating less appealing than usual.
- Feeling full quickly may occur after eating only a small amount.
- Pain, discomfort, or fullness in the upper-right abdomen can develop.
- Nausea or a general feeling of being unwell may occur.
- Jaundice can make the skin or whites of the eyes look yellow and may darken the urine.
- Abdominal swelling may result from fluid buildup or an enlarged liver.
- Itching can occur when bile flow or liver function is affected.
- Unusual tiredness may be related to cancer, anemia, or liver disease.
When symptoms need attention
Symptoms can have many causes
Contact a healthcare professional about persistent symptoms, jaundice, a new abdominal lump, or unexplained weight loss. These signs of liver cancer are not specific and do not confirm cancer, but they should be assessed promptly.
Causes
What Causes Liver Cancer?
Liver cancer can develop when repeated inflammation or injury causes scarring and changes in the DNA of liver cells. Over time, abnormal cells may escape normal growth controls, multiply, and form a hepatic tumor in the liver. Chronic liver damage raises the risk, although some people develop liver cancer without a clearly identified cause.
Risk Factors
Liver Cancer Risk Factors
| Risk category | Examples |
|---|---|
| Factors that cannot be changed | Older age, male sex, a family history of liver cancer, and certain inherited conditions. |
| Chronic infections and liver disease | Chronic hepatitis B or C, cirrhosis, fatty liver disease, and other long-term liver conditions. |
| Potentially preventable or treatable factors | Heavy alcohol use, diabetes, obesity, tobacco exposure, and untreated viral hepatitis. |
| Inherited or long-term exposures | Hemochromatosis, alpha-1 antitrypsin deficiency, Wilson disease, and selected environmental or occupational exposures. |
Having one or more liver cancer risk factors does not mean that someone will develop the disease. Conversely, some people develop HCC cancer without a known risk factor. A clinician can help identify which risks apply and address factors that can be treated or reduced.
Complications
Liver Cancer Complications
- Worsening jaundice can occur when liver function or bile flow becomes more impaired.
- Fluid buildup in the abdomen, called ascites, can cause swelling and discomfort.
- Bleeding or easy bruising may result from reduced clotting ability or enlarged blood vessels.
- Confusion or extreme sleepiness can occur when liver dysfunction affects brain function.
- A tumor can block bile flow and cause jaundice, itching, or infection.
- Tumor growth or liver swelling can cause abdominal or referred pain.
- Cancer can spread to distant organs, causing metastatic liver cancer or complications in other parts of the body.
Get urgent help
Some complications need emergency treatment
Seek emergency care for vomiting blood, black or tarry stools, severe or rapidly worsening confusion, or rapidly increasing abdominal swelling. These symptoms may signal serious bleeding, liver failure, or another urgent complication.
Diagnosis & Staging
How Liver Cancer Is Diagnosed and Staged
Evaluation may include a medical history, physical examination, liver function tests, and blood tests such as alpha-fetoprotein or other tumor markers. Ultrasound is often used first, while multiphasic CT or MRI can show the number, size, location, and blood supply of a lesion. A biopsy may be recommended when imaging does not provide enough information or when the tumor type needs confirmation. A liver mass or lesions on the liver are not automatically cancer; cysts, benign tumors, infection, and other conditions can look similar.
What staging considers
| Disease extent | What it generally means |
|---|---|
| Localized or potentially removable disease | One or more tumors may be confined to the liver and potentially treatable with surgery, ablation, or transplant, depending on liver function and overall health. |
| Regionally advanced disease | The tumor may involve major blood vessels, multiple areas of the liver, or nearby structures, making treatment more complex. |
| Metastatic or stage 4 disease | The cancer has spread outside the liver to distant organs or tissues and is generally treated with therapies aimed at controlling disease and symptoms. |
Treatment Options
Liver Cancer Treatment Options
SURGERY AND TRANSPLANT
Liver resection removes the tumor and a margin of healthy tissue when enough well-functioning liver remains. Liver transplant replaces the diseased liver and may be considered for selected people with tumors that meet specific criteria.
LOCAL TUMOR TREATMENTS
Ablation destroys selected tumors with heat, cold, or another technique. Embolization or radioembolization blocks or reduces blood flow to a tumor and may deliver radiation directly to the liver area.
SYSTEMIC MEDICINES
Targeted therapy and immunotherapy travel through the bloodstream to act on cancer cells or help the immune system recognize them. Other medicines may be used according to the tumor type, genetic features, and previous treatment.
SUPPORTIVE AND PALLIATIVE CARE
Radiation, pain relief, nutrition support, and palliative care can reduce symptoms and preserve quality of life. Supportive care can be provided alongside cancer treatment and is not limited to end-of-life care.
Potentially curative treatment is most feasible when the disease is limited and liver function is adequate. For advanced or stage 4 liver cancer, treatment is often intended to control growth, relieve symptoms, extend life, and preserve quality of life. The plan depends on the cancer type, tumor extent, liver function, and overall health.
Making treatment decisions
Treatment is individualized
Discuss treatment goals, clinical trials, possible side effects, liver function, and second opinions with a multidisciplinary liver cancer team. Ask how each option may affect daily life as well as cancer control.
Prevention & Screening
Liver Cancer Prevention and Screening
- Get hepatitis B vaccination when recommended and discuss vaccination with a healthcare professional.
- Ask about hepatitis B and C testing, and complete treatment for chronic infection when appropriate.
- Limit alcohol or avoid it if a clinician advises this because of liver disease.
- Maintain a healthy weight and choose habits that reduce fatty liver disease.
- Manage diabetes, cholesterol, and other metabolic conditions with a healthcare team.
- Avoid tobacco and seek support to stop using it.
- Reduce exposure to unsafe needles by using sterile equipment and reputable medical or tattoo services.
There is no universal liver cancer screening program for average-risk adults. People with cirrhosis, selected chronic hepatitis infections, or other high-risk conditions may need regular liver ultrasound with or without alpha-fetoprotein testing, based on clinician guidance. The timing of surveillance depends on the cause and severity of liver disease.
Outlook and Prognosis
Liver Cancer Outlook and Prognosis
Some localized liver cancers can be removed, destroyed with ablation, or treated with a liver transplant. Advanced or metastatic liver cancer is generally more difficult to cure, but medicines and liver-directed treatments may control disease and relieve symptoms. Liver cancer prognosis depends on stage, tumor biology, liver function, treatment response, age, and overall health rather than on one factor alone.
Varies
Prognosis varies by stage and whether the tumor has spread.
Important
Liver function affects which treatments are possible.
Changeable
Response to treatment can change the outlook over time.
Survivorship & Follow-up
Survivorship and Follow-Up After Liver Cancer
Follow-up commonly includes scheduled visits, liver function and tumor-marker blood tests, and imaging. The timing is determined by the tumor type, treatment received, risk of recurrence, and the presence of cirrhosis or another liver disease. Regular follow-up helps clinicians monitor for recurrence and manage ongoing liver health.
- Attend surveillance visits and report changes that could suggest recurrence or worsening liver disease.
- Continue treatment and monitoring for hepatitis, cirrhosis, or other causes of liver injury.
- Avoid alcohol when advised and ask how much is safe for your liver condition.
- Review all medicines, vitamins, and supplements with your care team before starting or stopping them.
- Maintain adequate nutrition and activity at a level that is safe for your health.
- Ask for emotional, practical, or financial support if cancer-related stress affects daily life.
