5 things to know about liver cancer

Cancer Council NSW

World Liver Day on April 19th aims to raise awareness about liver conditions and promote good liver health.

Here are 5 things to know about liver cancer.

1. What is liver cancer?

Cancers in the liver can be either a primary or secondary cancer. Primary liver cancer is cancer that starts in the liver.

The most common type of primary liver cancer in adults is hepatocellular carcinoma (HCC). HCC starts in the hepatocytes, the main type of liver cell.

Less common types of primary liver cancer include; cholangiocarcinoma or bile duct cancer, angiosarcoma and hepatoblastoma.

Secondary liver cancer is cancer that started in another part of the body and has spread to the liver. The points below cover only primary liver cancer.

2. There are rarely symptoms so check with your doctor if you are worried

Liver cancer often doesn’t cause any symptoms in the early stages, and cancer that is diagnosed and treated before symptoms appear often has very good outcomes.

As the cancer grows or spreads, it may cause symptoms, such as:

  • weakness and tiredness (fatigue)
  • pain in the abdomen (belly) or below the right shoulder blade
  • hard lump on the right side of the abdomen
  • appetite loss, feeling sick (nausea), or unexplained weight loss
  • yellowing of the skin and eyes (jaundice)
  • dark urine (wee) and pale faeces (poo)
  • itchy skin
  • a swollen abdomen caused by fluid build-up (ascites).

3. Liver cancer affects men three times more than women

In Australia, more than 2800 people are diagnosed with primary liver cancer each year, with about three times more men than women affected.

The rate of primary liver cancer has almost doubled since 2002, which is possibly due to increasing rates of obesity, type 2 diabetes, hepatitis B and C infections, drinking too much alcohol, and an ageing population.

More than 70% of cases occur in people aged 60 and over.

4. Liver cancer most often develops in people with underlying liver disease.

Primary liver cancer most often develops in people with underlying liver disease, usually cirrhosis. In cirrhosis, healthy liver cells are replaced by scar tissue, and benign nodules (non-cancerous lumps) form throughout the liver. As this gets worse (advanced cirrhosis), the liver stops working properly.

Cirrhosis may be caused by:

  • long-term (chronic) infection with hepatitis B or C virus
  • drinking too much alcohol
  • metabolic-associated fatty liver disease (MAFLD) as a result of obesity and/or type 2 diabetes
  • having too much iron in the bloodstream (haemochromatosis).

A small but increasing number of people are developing liver cancer without cirrhosis. This may occur in people with long-term hepatitis B infection, or with liver disease related to obesity or type 2 diabetes.

Other risk factors for liver cancer are smoking tobacco or having a family history of HCC. Aboriginal and Torres Strait Islander peoples and migrants from countries with higher rates of hepatitis B infection (including Asia, the Pacific Islands and Africa) are also at greater risk of developing primary liver cancer.

The more risk factors a person has, the greater the chance of developing liver cancer.

5. Liver cancer is often linked to hepatitis B or C

Worldwide, up to 8 in 10 cases of liver cancer (HCC) can be linked to infection with the hepatitis B or C virus (viral hepatitis). This is changing as vaccinations and effective treatments for viral hepatitis are helping to reduce the rates of hepatitis-related liver cancer.

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