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Liver cancer at a glance

Liver cancer that starts in the liver is relatively rare in the UK and other countries in the West, but is more common in Africa and Asia.

Each year, there are over 2,800 new cases in the UK, accounting for less than one per cent of all new cancers diagnosed. It is more common in men than in women.

Primary liver cancer should not be confused with secondary liver cancer, where cancer has spread to the liver from another part of the body.

The liver is a large organ in the abdomen below your right lung, which carries out a wide range of vital functions in the body. It stores nutrients, converts fats into energy, makes blood proteins and other chemicals the body needs. The liver also breaks down harmful substances such as alcohol.

Liver cancer may spread to other parts of the body. It can grow into the bile duct, blocking the drainage of bile from the liver. This results in jaundice, with yellowing of the skin and the whites of the eyes.

Click on the links below to find out more about liver cancer.

• Risks and causes
• Signs and symptoms
• Prevention
• Screening
• Detection
• Treatment

If you are a patient looking for information on liver cancer, please visit our patient information website, CancerHelp UK.

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Risks and causes

The following things affect a person's chances of developing liver cancer:

Cirrhosis is scarring of the liver. It can be caused by viral infections like hepatitis B and C. It can also be caused by alcohol or by certain inherited conditions such as haemochromatosis and alpha 1 antitrypsin deficiency.

This toxic substance is found in mouldy peanuts, wheat, soybeans, ground nuts, corn and rice. People who eat these over a long period of time are at increased risk of developing liver cancer. This problem is more common in Africa and Asia than in the UK.

Exposure to these chemicals can increase the risk of certain types of liver cancer.

Long-term use of anabolic steroids slightly increases the risk of developing liver cancer.

Arsenic may be present in high concentrations in the drinking water of some developing countries. Long-term exposure to arsenic increases the risk of developing liver cancer.

There is some evidence that smoking may increase the risk of developing liver cancer.

People with chronic inflammation of the bowel, as in ulcerative colitis, or with inflammation of the gallbladder, may be at slightly increased risk of developing some types of liver cancer.

Similarly, chronic infection with liver fluke, a parasite usually found in parts of Africa or Asia, may increase the risk of the cancer. This type of infection is very rare in the UK.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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Signs and symptons

The symptoms of liver cancer can include:

• loss of weight that cannot be explained
• loss of appetite over a period of a few weeks
• vomiting
• feeling full or bloated after eating, even after a small meal
• pain or discomfort in the abdomen
• swollen abdomen (caused either by an enlarged liver or by a collection of fluid)
• jaundice (a yellow colour of the skin and the eyes, dark urine and pale faeces)
• a sudden change in the health of someone with known chronic hepatitis or cirrhosis

More commonly, these signs and symptoms will indicate problems other than cancer. However, people who notice any of these changes should see their doctor.

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Prevention

Liver cancer is less common in the UK than in developing countries.

However, if you want to reduce your risk of the disease, avoid excessive drinking and take precautions against infection with hepatitis, such as having vaccinations and practising safe sex.

Find out more about how to reduce your cancer risk in the Healthy Living section of this website.

Screening

There is no national screening programme for detecting liver cancer.

However, people at increased risk of developing the cancer can be screened. For example, some people with hepatitis infection may have regular blood tests or ultrasound scans of the liver.

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Detection

Initially the doctor will ask questions about medical history and carry out a physical examination. The doctor may arrange for referral to a specialist for further tests.

If cancer is detected, the specialist will want to find out if it is liver cancer or a cancer that has started elsewhere in the body.

Tests can include:

• Blood tests
  Blood tests can show how well the liver is working and detect any abnormalities. They can also check for substances whose levels are increased in some cases of liver cancer.
• Ultrasound scan
• CT or MRI scans
• Laparoscopy
  This procedure involves passing a small thin tube with a camera being passed through a very small cut in the abdomen. It allows the doctors to see into the abdomen and view the liver.
• Biopsy
  The only clear, definite way to distinguish between cancer and benign growth is to perform a biopsy. Doctors will remove a sample of tissue for examination under a microscope, usually with a needle inserted through the skin under local anaesthetic.
• Hepatic angiography
  This is a modified X-ray, which uses a dye to show the blood supply to the liver.

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Treatment

The main treatments for liver cancer are:

Surgery may be the treatment for liver cancer if the cancer is contained in one area of the liver. Cirrhosis often prevents surgery. In very few cases, a liver transplant may be considered.

Chemotherapy can be useful to help control the growth of the cancer when surgery is not possible. Some people may have chemotherapy after surgery to help lower the chance of the cancer coming back. In certain cases, chemotherapy may be given to shrink the tumour before surgery.

Normal doses of radiotherapy are not very effective in treating liver cancer. It can also damage the part of the liver not affected by the cancer. However, doctors may use lower doses of radiotherapy to relieve symptoms.

In some cases, liver cancer may be quite advanced, and people may be too ill to tolerate intense chemotherapy, radiotherapy, or surgery. Treatment will then aim to control and manage some problems caused by the cancer, such as pain, breathing problems or weight loss.

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