Liver Cancer: Symptoms & Prevention

The liver is a large organ that does a lot of multitasking in our bodies. Learn more about the essential functions of the liver, signs you may have liver cancer or other liver conditions, and when to see a doctor about your symptoms.

What Does The Liver Do?

The liver is a secret hero, responsible from essential functions ranging from metabolism to immunity. This organ’s extensive capabilities make the liver central to maintaining overall health, as it influences multiple bodily systems and supports detoxification, energy balance, digestion, and immune function.

“The liver is a really dynamic organ,” Carl Valentin, MD, a board-certified radiologist and independent physician who chooses to practice at Franciscan Health. “It's an actor in many of the processes of the body and whereas you can look at the heart and brain and say, well they seem very important. They do that one important thing. But the liver does several really important things.”

Roles the liver plays in your body’s health include:

1. Making Proteins

“These proteins are necessary to keep fluid in your bloodstream as opposed to having it leaking out into the other parts of your body,” Dr. Valentin said.

2. Detoxing Your Bloodstream

The liver filters out harmful substances, such as drugs, alcohol and metabolic waste products, from your blood. By converting these toxins into harmless compounds, your liver prevents these toxins from circulating in the bloodstream.

“This goes way back to evolutionary time when we're living in the wild and you would eat things in the woods that are poisonous,” Dr. Valentin said. “The liver developed to be a very robust organ for taking in toxins, neutralizing them and excreting them.”

3. Making Bile

The liver is also very important in digestion, Dr. Valentin added.

“It creates bilirubin out of the waste products of old red blood cells, and bilirubin is held as bile in your gallbladder,” he said. “When you eat something fatty, it excretes it into the digestive tract to help you digest fats.”

4. Helping Blood Clotting

The liver produces essential proteins required for blood clotting, which helps in wound healing and prevents excessive bleeding.

“It creates many of the proteins and enzymes that allow your body to clot when it needs to, but not overly clot blood when it doesn't need to,” Dr. Valentin said. “It's very central in metabolizing your ability to stop bleeding, but also not clot off areas where you need blood flow.”

What Are Symptoms Associated With A Problem In The Liver?

Symptoms suggesting a problem with the liver include:

• Jaundice (yellowing of the eyes or skin)
• Pain in the right upper abdomen
• Swelling in your legs or arms

Symptoms of liver cancer

Symptoms of liver cancer can often seem like signs of other conditions. These signs may include:

• Discomfort in the upper right abdomen
• A hard lump on the right side below the rib cage
• A swollen abdomen
• Pain near the right shoulder blade or in the back
• Jaundice (yellowing of your skin or eyes)
• Easy bruising or bleeding
• Unexplained tiredness
• Unexplained nausea, vomiting, loss of appetite or weight loss

If you experience these symptoms, talk to your doctor.

Am I At Risk For Liver Cancer?

Risk factors for liver cancer include:

• Being overweight
• Having hepatitis B or hepatitis C
• Smoking
• Drinking alcohol
• Having cirrhosis, or scarring of the liver
• Having nonalcoholic fatty liver disease, which is extra fat in the liver that is not caused by alcohol.
• Having diabetes.

Reducing your risk of liver cancer

Even if you have risk factors, you can lower your risk of getting liver cancer and other types of cancers by:

• Losing weight if needed
• Being physical active
• Being vaccinated against hepatitis B
• Getting tested for hepatitis C, and receiving medical care if you have an infection
• Avoiding or quitting smoking
• Not drinking alcohol.

Learn more about actions you can take to lower your risk of cancers.

How Does A Person Get Liver Cancer?

Cancer that is in the liver can be caused by originating in the liver or by metastasizing, or by spreading from another organ to the liver.

Liver cancer

“The way you get a primary liver cancer (a cancer that starts in the liver) has to do with other health conditions,” Dr. Valentin said. “The most common liver cancer that originates in the liver is hepatocellular carcinoma, or HCC. And that has a strong correlation with a history of hepatitis or inflammation of the liver due to prior infection. Worldwide, the most common infection is hepatitis C, which is the main risk factor for developing a primary liver cancer. However, chronic alcoholism is also a common cause, especially in the United States.”

Hepatocellular carcinoma is the most common type of liver cancer and the fastest-growing cause of cancer deaths in the United States. Obesity and alcohol use, both risk factors for HCC liver cancer.

“There's also another slightly more unusual liver cancer, which develops in the bile ducts, which are part of the liver, but not the main liver cell,” Dr. Valentin said. “This is known as cholangiocarcinoma. That is somewhat random, however, there are risk factors associated with chronic bile duct disease.”

Up to 60% of liver cancers are only diagnosed in advanced stages, resulting in a survival rate of just 20%.

Cancer that has spread to the liver

“When we talk about cancer, we typically name a cancer for the organ it came from,” Dr. Valentin said. “So if you have, say, colon cancer or breast cancer or pancreatic cancer, all of those are called by their organ of origin. But many of these cancers do spread to the liver. Unfortunately, the liver is a large organ. It has a lot of blood flow, and so when tumors metastasize, they often end up in the liver.”

How Is Liver Cancer Treated?

Treatment options depend on which organ the cancer originated.

Treatment for liver cancer

“The treatments for some cancers that arise in the liver include potentially curable disease because it's not metastatic and it may be definitively cured,” Dr. Valentin said. “For hepatocellular carcinoma, if it's isolated to a certain area of the liver and it's smaller than a certain size, surgery to remove that portion of the liver can be curative. It cures the cancer because you no longer have it. It hasn't spread and it's been removed by surgery.

“The other cures, potentially for liver cancer are transplants. So if the disease status meets certain criteria, it hasn't spread beyond the liver and it's small enough, you can undergo a liver transplant. If you're on the liver transplant list and you your name comes up. That can also be curative of hepatocellular carcinoma. “

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Treatment for cancers that spread to the liver

“For metastatic disease, by definition, any cancer you have that's also in the liver, that comes from somewhere else, is stage 4 disease,” Dr. Valentin said. “The primary treatment for most stage 4 disease is chemotherapy. Metastatic disease can occasionally be cured from other sources, but the success rate of Stage 4 disease is much lower than a contained stage 1 or stage 2 cancer.

“In treating these other cancers that end up in the liver, often the liver becomes the most important organ for treatment,” Dr. Valentin added. “Because it may be the one that's life limiting, that your, life expectancy is based on how well liver disease can be controlled within the liver.”