Primary liver cancer is a malignant tumor that begins in the liver. There are different types:
- hepatocellular carcinoma (HCC) or hepatoma, is the most common type of primary liver cancer and it starts in the main cell type in the liver, the hepatocytes
- cholangiocarcinoma, or bile duct cancer, starts in the cells lining the bile ducts (which connect the liver to the bowel and gall bladder)
- angiosarcoma, which starts in the blood vessels. This is a rare type of liver cancer that is more likely to occur in people over 70.
Secondary cancer in the liver is cancer that started in another part of the body but has spread to the liver. If you have secondary cancer in the liver, it may be useful to read information about the primary cancer in conjunction with this information or about cancer of unknown primary.
Secondary cancer is named after the primary site where it began, for example, bowel cancer with liver secondary. In this information, we use the term “secondary cancer in the liver” to refer to any cancer type that has spread to the liver.
It is estimated that 3,208 people will be diagnosed with liver cancer in 2024. The average age at diagnosis is 69 years old.
Liver cancer signs and symptoms
Liver cancer symptoms are more likely to appear as the cancer grows or becomes advanced.
Symptoms may include:
- weakness and tiredness
- pain in the abdomen
- swelling of the abdomen due to a build-up of fluid (ascites)
- pain in the right shoulder
- appetite loss and feeling sick
- weight loss
- yellowing of the skin and eyes (jaundice)
- pale bowel motions
- fever
Causes of liver cancer
Hepatitis B or C viruses which result in long-term (chronic) infection can cause liver cancer. This is the biggest known risk factor for primary liver cancer in Australia.
Other factors can increase the risk of developing liver cancer, such as:
- fatty liver disease or genetic disorders including hemochromatosis, or alpha 1-antitrypsin deficiency
- type 2 diabetes
- hepatitis B or C
- alcohol consumption
- obesity
- smoking tobacco
- exposure to certain chemicals
Diagnosis of liver cancer
Tests to diagnose both liver cancer and secondary cancer of the liver include:
Blood tests
Blood tests can check how well the liver is working; and how well your blood clots; as well as checking certain chemicals known as tumor markers; whether you have hepatitis B or C; and any genetic problems.
Ultrasound
The most commonly used method to look for primary liver cancer, an ultrasound produces pictures of the organ and can show the size and location of abnormal tissue in your liver.
CT scan
CT scans produce three-dimensional pictures of several organs at the same time and can help doctors plan the surgery. It can also see if the cancer has spread.
MRI
An MRI scan produces detailed cross-sectional pictures of the body, and can show the extent of a tumor and whether it is affecting the main blood vessels around the liver.
PET-CT scan
More commonly used for secondary cancers in the liver, PET-CT scans produce three-dimensional color images that show where any cancers are in the body.
Biopsy
A biopsy is when a small amount of tissue is removed for examination under a microscope.
A biopsy is done by either: fine needle aspiration, which involves a local anesthetic, and a thin needle that removes the cells; or laparoscopy (keyhole surgery), which is done under general anesthetic and allows the doctor to look at the liver and surrounding organs, as well as take tissue samples using a laparoscope.
After a diagnosis of liver cancer
After finding out you have liver cancer you may feel shocked, upset, anxious, or confused. These are normal responses. For most it will be a difficult time, however some people manage to continue with their normal daily activities.
Talk about your treatment options with your doctor, family, and friends. Seek as much information as you need. It is up to you how involved you want to be in decisions about your treatment.
