A woman is pointing her to shoulder while her doctor examines it
Liver cancer may not cause any symptoms early on.

Liver Cancer Symptoms to Watch For

Your liver is one busy organ. It’s an efficient filter that cleans the blood of harmful substances and sends these substances to be processed as waste, creates bile which helps you digest fat, makes proteins for your body, and stores sugar for the energy you need later.

When this helpful organ is affected by cancer, it brings many unwelcome symptoms. Recognizing the symptoms of liver cancer may help you recognize that it’s time to see a doctor. An earlier diagnosis is beneficial because treatment is likely to be more helpful when it’s started in the initial stages of liver cancer.

Types of Liver Cancer

Primary liver cancer originates in the cells of your liver. Just because cancer is present in the liver, does not make it liver cancer – it may have migrated from a different location. Several types of cancer can form in the liver; the most common type of primary liver cancer is hepatocellular carcinoma.

For instance, lung cancer (because it started in the lungs) may have spread to the liver. When cancer travels like this, it is referred to as metastatic cancer. Cancer that spreads to the liver is more common than cancer that originates in the liver. Cancer that starts in the liver does not usually spread until later stages of the cancer.

Can Liver Cancer Symptoms Be Caught Early?


Liver cancer may not cause any symptoms early on, which is why liver cancer is usually diagnosed at a later phase. The liver is a large organ, and it can maintain its function even while housing a large tumor.

As the tumor grows, it will start to cause changes in the body (creating a blockage to the bile ducts, for instance), and that is when symptoms will start to become noticeable. Symptoms do not show up until later stages of the disease, but in some cases, liver cancer symptoms may show up sooner.

11 Liver Cancer Symptoms to Be Aware Of

The list below may provide a signal that you should see a doctor. Keep in mind, these could also be symptoms of another underlying condition and not unique to liver cancer. For example, cirrhosis (scarring of the liver) can cause the same symptoms as liver cancer and is also an issue that will need to be addressed by a physician.

Symptoms vary depending on the location of the cancer. In addition to general malaise, below are 11 symptoms of liver cancer:

Pain in the Abdomen or Shoulder

Pain is a common symptom for those with liver cancer. The liver sits in the upper right part of the abdomen, which is where a lot of the pain will be concentrated. Sensory nerves are located on the outside of the liver.

Pain occurs when this outer covering is stretched or eaten away by tumors. However, the pain may also occur in your right shoulder as well.

An enlarged liver may put pressure on the nerves found under the diaphragm. Some of these nerves connect to the right shoulder and send pain signals to the area when they are in distress, which is called referred pain.

Nausea and/or Vomiting

Nausea and vomiting are two different symptoms that are present in many advanced diseases, including liver cancer. These symptoms increase in prevalence as the disease develops.

Nausea is characterized by a cold sweat, unhealthy pale coloring of the skin, the feeling of needing to vomit, salivation, increased heart rate, and diarrhea. Vomiting is the coordinated reflex of the gastrointestinal tract, diaphragm, and abdominal muscles to expel gastric contents through the mouth.

Some may describe coughing and spitting up phlegm (expectoration) and regurgitation under the category of vomiting, but these should be described to your doctor as separate symptoms.

A Lump/Mass Under the Ribs

A lump can occur on the right side of the abdomen when the liver swells. This mass could be the tumor or a sign that the liver has become enlarged. The lump will be firm to the touch and should be examined by a doctor as soon as possible. If the lump causes discomfort, changing your body position may help alleviate some of the pain until you are able to see a doctor.

Loss of Appetite

With liver cancer, a common symptom is feeling very full after a small meal. This loss of appetite can be the result of changes in how the body processes food, an enlarged liver putting pressure on the stomach and giving it the feeling of fullness, a side effect of medication, or something else.

When you’re not hungry and you don’t eat, you’re depriving your body of essential nutrients. Without proper nutrition, there is slower recovery and breaks in your treatment.

If you experience this symptom, you may also have nausea and digestive discomfort. Be sure to ask your doctor for options on how to get proper nutrients into your body if you’re unable to eat them—they may recommend supplements or another course of action.

Weight Loss

Losing weight without trying or experiencing unexplained weight loss is a symptom of liver cancer. One of the causes of weight loss is the cancer itself.

When your body defends against cancer, it produces cytokines (cell signaling molecules that prompt movement of cells toward sites of infection). These cytokines lead to weight loss, muscle loss, and decreased appetite.

Other causes for weight loss are a loss of appetite after common cancer treatments and fatigue. If you lose more than 10 percent of your body weight, physicians would refer to this as significant weight loss. For example, if you weigh 150 pounds and lose 15 pounds without trying, you should see your doctor if there is no obvious reason for the weight loss.

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Malignant Ascites

Ascites refers to swelling of the abdomen caused by a buildup of fluid. The swelling can be caused by the growth of the liver from the cancer or increased pressure on the liver that causes blood to back up in the veins. When this happens, fluid is forced out of the veins and into the abdomen, causing the ascites.

The increased pressure may make the veins swollen and visible under the surface of your skin. This is common in patients with cirrhosis.

Malignant cells can spread to other parts of the body through the blood and lymph symptoms. Patients with malignant ascites have increased abdominal girth, pain, and shortened breath. Other indicators of malignant ascites are spider angiomas, jaundice, distended umbilical veins, and distended abdomen. Your physician can conduct an ultrasound to confirm ascites in the abdomen.

Edema

Abnormal swelling and a buildup of fluid is a condition called edema. It typically occurs in the legs, feet, lower back, and hands. Edema can also occur inside the body in the form of ascites, as noted above.

In those with liver cancer, part of their edema is the result when the liver cannot produce albumin properly. Albumin is a gel-like protein, and when there is an issue with the thickening agent of albumin, fluids leak out of the bloodstream and into body tissues instead.

Edema is also caused by aldosterone leakage into the body tissues because your liver can no longer process aldosterone properly. Another fluid that accumulates in the tissues, due to impaired function of the body, is an antidiuretic hormone.

Jaundice

The calling card of jaundice is yellowing of the skin and the whites of the eyes. This symptom occurs when your liver is not functioning as it should, or there is an obstruction in the bile duct. Jaundice may cause itchy skin and cause feelings of illness.

Jaundice also affects your body’s waste elimination; your urine will be darker, and your stool will be white and chalky in color. Another symptom of jaundice is fever, which can indicate inflammation or infection in the body. This high temperature will make you feel sensitive to cold and shivery.

Portal Hypertension

Portal hypertension occurs when the blood pressure in the hepatic portal vein increases. The hepatic portal vein is the main vein that brings blood to the liver. Portal hypertension can develop as a result of cirrhosis or when a liver tumor obstructs blood flow in the hepatic portal vein.

The increased blood pressure causes varices (dilated blood vessels) to develop in the stomach and esophagus as a means to bypass the blockage. The frail nature of varices means that they bleed easily.

Other symptoms of portal hypertension include:

  • A lump on the left side of the abdomen which is caused by a swollen spleen
  • Fluid buildup in the abdomen (ascites)
  • Pleural effusion which is characterized by a shortness of breath caused by a buildup of fluid around the lungs
  • Blood in the stool which makes the stool appear black and tarry
  • Vomiting blood

Hepatic Encephalopathy

Hepatic encephalopathy develops when the liver doesn’t function properly, enabling waste products to build up in the blood. There is a collection of potentially reversible neuropsychiatric abnormalities that occur with hepatic encephalopathy. When this happens, the body can experience the following:

  • Changes to sleep patterns and increased drowsiness
  • Nervousness or anxiety
  • Breath with a sweet or musty odor
  • Confusion or forgetfulness
  • Personality or mood changes
  • Slurred speech
  • Shaking or problems controlling hands and arms
  • Coma (less frequent)

Weakness or Fatigue


Another common symptom of liver cancer, fatigue is often a debilitating symptom but can be ignored for many reasons. This can be the first symptom a patient notices, or the full effect is not experienced until after cancer is diagnosed. Tumors can release toxic substances that get in the way of normal body function.

Fatigue can be the result of anemia, which is when tumors spread to the bone marrow and reduce red blood cell count. Common cancer medications and treatments evoke fatigue as a side effect. Stress, likely due to the diagnosis itself, can also cause chemical changes in the body that result in fatigue.

In order to combat fatigue, try to take supplements, eat liver friendly foods that boost energy, find time to relax, and do your best to stay active.

Prevention

There are no widely recommended screening tests for liver cancer, which is another reason it’s difficult to catch in the early stages. People with a high risk of developing liver cancer may want to talk to a doctor about scheduling alpha-fetoprotein blood tests and ultrasounds at regular intervals to keep an eye on the situation.

Having this information will help catch liver cancer in the early stages if your test results change. If you have a family history or other risk factors, go see your physician so they can recommend steps to monitor or reduce your risk.

Many of the liver cancer symptoms above mirror other types of liver diseases which may be benign, which is why getting a proper diagnosis is crucial. Liver cancer patients are likely to experience these symptoms in varying degrees, so it is important that you stay attuned to what your body is telling you.