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Liver Cancer : Symptoms, Signs and Causes

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In the early stages, liver cancer may not have any symptoms. The symptoms start becoming apparent as the disease progresses into advanced stages. Also, the exact cause of liver cancer is still unknown. Taking appropriate measures to improve and protect liver health and opting for regular health check-ups can help protect oneself against liver cancer.


Who is Mainly Affected by Liver Cancer?

Liver cancer may develop in any individual, and the exact reasons for liver cancer remain unknown. However, there is an increased risk of developing liver cancer in certain groups of people. Men are found to have a relatively higher risk of developing liver cancer than women. Those with underlying liver conditions, like liver cirrhosis and chronic hepatitis, also have a higher risk of developing liver cancer. In addition, heavy alcohol drinkers, especially those with liver diseases, have a higher risk for liver cancer.


What are the Common Signs and Symptoms of Liver Cancer?

The liver has a myriad of functions in the human body, and when it is affected by cancer, it may cause various symptoms. The following are some of the important liver cancer symptoms:

Abdominal Pain, Especially on The Right Side

Patients with liver cancer may experience pain in the upper right abdomen due to the tumor growing in the liver.

Weight Loss

Weight loss is one of the most common symptoms of liver cancer. The liver plays a pivotal role in food metabolism, and when the tumor interferes with this process, it may lead to malnutrition and unintended weight loss in those with liver cancer.

Fatigue

Fatigue is another common symptom of liver cancer. Cancer affects the liver’s ability to take part in energy production, and this causes fatigue in liver cancer patients.

Loss of Appetite

Since liver cancer causes the abdomen to enlarge, those with liver cancer may experience a loss of appetite or feel full after eating food in small quantities.

Nausea and Vomiting

Reduced liver function caused by liver cancer can negatively impact the digestive system, which can lead to nausea and vomiting.

Jaundice

When the liver stops functioning, bilirubin is not metabolized properly, and its levels in the body begin to rise. This leads to jaundice, which causes yellowing of the skin and eyes in liver cancer patients.

Dark Urine

Due to bilirubin buildup, those with liver cancer may pass dark-colored urine. The urine color may be brown, amber, or orange, and this is one of the important liver cancer symptoms that should not be ignored.

Pale Stools

Passing pale stools is also one of the liver cancer symptoms. Liver cancer may affect the organ’s ability to produce bile, the substance responsible for digestion.

Unexplained Fever

Those with liver cancer may have a low-grade but persistent fever of unknown origin.

Easy Bruising or Bleeding

Patients with liver cancer may experience easy bruising and bleeding, as the tumor affects the liver’s clotting abilities.

Abdominal Swelling

Liver cancer can cause fluid build-up in the abdomen and lead to swelling. This is one of the end-stage liver cancer symptoms.

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Liver Cancer Types & Their Symptoms

The symptoms of different types of liver cancer are:


Symptoms of Hepatocellular Carcinoma (HCC)

Hepatocellular carcinoma is the most common liver cancer. Hepatocellular carcinoma symptoms include nausea and vomiting, loss of appetite, weight loss, a feeling of fullness on the right side (liver enlargement) or left side (spleen enlargement), abdominal pain, itching skin, and yellowing of the eyes and skin (jaundice). Hepatocellular carcinoma causes include chronic liver infections and hemochromatosis.

Symptoms of Bile Duct Cancer – Cholangiocarcinoma

It is an aggressive form of liver cancer. Patients with bile duct cancer may experience weakness and fatigue, yellowing of the eyes and skin, white-colored stools, severe itching, night sweats, fever, loss of appetite, abdominal pain, and unexplained weight loss.

Symptoms of Hepatoblastoma

Hepatoblastoma usually occurs in children under 3 or 4 years old. Children with hepatoblastoma experience abdominal pain and irritation, fatigue, and weakness due to anemia, yellowing of the skin and eyes, loss of appetite, weight loss, a lump in the abdomen, and fever.

Symptoms of Fibrolamellar Carcinoma

Patients with fibrolamellar carcinoma experience the presence of a palpable mass, abdominal pain, generalized fatigue, loss of appetite, nausea, abdominal fullness, and pain in the back or shoulder.

Symptoms of Metastatic Liver Cancer

Metastatic liver cancer begins in the liver and spreads to other organs. The symptoms of metastatic liver cancer depend on the organ to which the cancer spreads. For instance, if the cancer spreads to the bones, patients experience bone pain and have an increased fracture risk. If the cancer spreads to the lungs, patients may experience chest pain and trouble breathing.

Symptoms of Angiosarcoma

Angiosarcoma or liver tumor symptoms include abdominal distension, pain, discomfort, jaundice, fatigue, and weight loss. Patients may also have an enlarged liver and abdominal swelling.

What Causes Liver Cancer?

Studies have identified multiple factors as possible liver cancer reasons or risk factors. It is important to note that having any of these risk factors does not guarantee a liver cancer diagnosis; however, it does mean one has a higher chance of developing liver cancer.

Liver cancer symptoms in females are similar to liver cancer symptoms in males. Some of the possible liver cancer causes or risk factors include:


Chronic Liver Disease

Chronic liver diseases like steatohepatitis and cirrhosis may result in liver cancer. It is due to the accumulation of excess fat in the liver or the development of scar tissues, resulting in inflammatory processes.

Hepatitis B and C

Having chronic viral liver infections, such as hepatitis B and C, may be one of the possible reasons for liver cancer.

Certain Inherited Conditions

Various inherited liver conditions, such as Wilson’s disease and hemochromatosis, are also identified as risk factors or possible reasons for liver cancer.

Cirrhosis

It is an irreversible and progressive condition that results in the development of scar tissue in the liver. Patients with this condition may have a higher risk of developing liver cancer.

Non-Alcoholic Fatty Liver Disease (NAFLD)

It is characterized by the accumulation of fat in >5% of the liver cells. The severity ranges from simple steatosis to non-alcoholic steatohepatitis (NASH). It has been estimated that about 4% to 27% of patients with NASH with cirrhosis develop hepatocellular carcinoma.

Obesity

Obesity is also a causative factor for liver cancer. Obesity increases the risk of NAFLD, which is found to be an important liver cancer risk factor.

Diabetes

Diabetes is another factor that may result in liver cancer. Patients with diabetes may have elevated oxidative stress, lipotoxicity, hepatic insulin resistance, and a chronic low pro-inflammatory state that may cause NAFLD.

Hereditary Hemochromatosis

This condition is characterized by excessive iron storage in the body's organs.

Smoking

Smoking has immunological, oncological, and toxicological effects on the liver. Smoking results in the production of cytotoxic substances that cause necro-inflammation and fibrosis. It also assists in producing interleukins and tumor necrosis factor-alpha, which are responsible for chronic liver injury.

Heavy Alcohol Use

Heavy alcohol intake regularly for a substantial period may cause liver injury, inflammation, and scarring, all of which can increase the risk of liver cancer.

Exposure to Aflatoxins

Prolonged exposure to aflatoxins, especially aflatoxin B1, may cause liver cancer. The risk of liver cancer further increases if the patient is infected with the hepatitis virus.



When to See a Hepatologist?


People should visit the hepatologists if they experience yellowing of the skin and eyes, indigestion, loss of appetite, abdominal pain, weight loss, nausea and vomiting, and generalized weakness and fatigue.

Conclusion


Most patients do not experience early-stage liver cancer symptoms. Symptoms, if present, may overlap with other common conditions. Liver cancer causes include obesity, smoking, heavy alcohol intake, and underlying hepatic conditions. Learning about the different symptoms of liver cancer and the possible causes associated with this disease can help one seek medical attention at the right time.

Frequently Asked Questions

How does liver cancer start?

Liver cancer initiates due to genetic mutations in the liver cells. The cause of the genetic mutation is not known. However, infection, chronic inflammation, scarring, smoking, and heavy alcohol intake may play a role in increasing the risk of liver cancer.

Patients with liver cancer have persistent and chronic pain in the upper abdomen (on the right side), shoulder, and back as early signs of liver cancer.

Most patients do not experience any early symptoms of liver cancer. As the disease progresses, one may start experiencing symptoms like abdominal pain, dark-colored urine, pale stools, tiredness, weight loss, etc.

Most patients with stage 1 liver cancer may not have liver cancer symptoms. If present, they vary greatly from patient to patient. Stage 4 liver cancer symptoms, or end-stage liver cancer symptoms, include abdominal pain, abdominal swelling, jaundice, and severe skin itching.

There are no known ways to prevent liver cancer. However, risk can be mitigated by taking good care of the liver, avoiding smoking, limiting alcohol consumption, and managing weight.

Some forms of liver cancer are more aggressive than others and rapidly progress to present as liver cancer with last-stage symptoms. These include bile duct cancer and hepatic angiosarcoma.