The liver is a football-sized organ found in your abdomen on the upper right-hand side, within your rib cage. Its job is to store sugar to be used later as fuel, filter toxins, and wastes out of the body, and make bile (a liquid that helps digest the fats that you eat). If cells within your liver become damaged, they can become cancerous.
Liver cancer is also often grouped with bile duct cancer, which forms in the tubes that carry bile from the liver and gallbladder to the intestines.
Liver cancer is not common, but rates today are much higher than they used to be. Within the United States, rates of this condition are more than three times higher than what they were in 1980. More than 41,000 people in the U.S. are expected to be diagnosed with liver or bile duct cancer in 2022.
These cancers are more common in other parts of the world, including Southeast Asia and sub-Saharan Africa. More than 840,000 people around the world develop the conditions each year.
Liver cancer symptoms
Liver cancer may lead to health changes like:
- Pain, discomfort, or a lump in the upper right side of the abdomen.
- Pain in the back or right shoulder blade.
- Abdominal swelling.
- Frequent bruising or bleeding.
- Nausea or vomiting.
- Jaundice (a yellow tint to the skin and whites of the eyes).
- Loss of appetite or weight loss.
- Pale stool or dark urine.
Schedule a visit with your doctor if you notice any of these symptoms. Blood tests, imaging tests, and biopsies can help doctors measure how well your liver is working, visualize any tumors, and check for cancer cells.
Types of liver cancer
Several types of tumors can start in the liver. Doctors call these tumors “primary liver cancer.”
- Hepatocellular carcinoma (HCC), the most common type of liver cancer.
- Intrahepatic cholangiocarcinoma, or bile duct cancer.
- Angiosarcoma and hemangiosarcoma, which develop in the liver’s blood vessels.
- Hepatoblastoma, a very rare type of liver cancer seen in young children.
Cancer can also arise in a different location and spread to the liver. This is called secondary or metastatic liver cancer. It is much more common for cancer to spread to the liver than it is for cancer to form there.
There are also several types of benign (non-cancerous) liver tumors. Although these tumors can’t spread in the same way that cancer can, they can sometimes grow large enough to cause problems. Benign liver tumors may need to be surgically removed, or they may not need any treatment.
The causes of liver cancer
Liver cancer risk factors include:
- Being male.
- Being over the age of 50.
- A history of heavy drinking.
- Having an autoimmune disease that affects the liver.
- Hepatitis B or hepatitis C.
- Chronic inflammation in the liver.
- Smoking cigarettes.
- Hemochromatosis (high levels of iron in the body).
- Having other rare conditions like glycogen storage disease or Wilson disease.
To lower your chances of developing liver cancer, get proper treatment for any health conditions you may have. Getting vaccinated against hepatitis B also reduces your risk. You can also make lifestyle changes like cutting back on alcohol, quitting smoking, and avoiding aflatoxin B1 (a poison found in certain foods or workplaces).
Other factors may increase your chances of being diagnosed with bile duct cancer, including ulcerative colitis, bile duct cysts, or infections with certain parasites.
Treating liver cancer
Liver cancer and bile duct cancer treatments depend on your overall health and how far your cancer has spread. In some cases, very small tumors don’t need to be treated right away. They can be monitored over time and treated if they start to get worse.
Most people will need treatment for liver cancer. Your doctor may recommend:
- Surgery to remove tumors that have not spread. Doctors may also remove part of the liver where the cancer was found. The remaining liver tissue sometimes regrows to replace the tissue that was cut out. Bile duct cancer is often treated by removing the ducts, part of the liver, or surrounding tissues.
- A liver transplant, in which the entire liver is surgically removed and replaced with an organ from a donor.
- Chemotherapy may be given before surgery to shrink a liver tumor. It is also a common treatment option for bile duct cancer.
- Other cancer-fighting medications like targeted therapy (drugs that specifically attack cancer cells) or immunotherapy (medications that help your immune system fight cancer).
- Radiation therapy to the abdomen, which includes using high-energy beams or particles to kill cancer cells.
- Therapies that involve ablation, in which doctors use various tools to destroy cancer cells. Ablation may be performed with radio waves, microwaves, electrical pulses, extreme cold (called cryoablation), acetic acid (vinegar), or ethanol (alcohol).
- Embolization, a surgical procedure in which the tumor’s blood supply is cut off.
- Palliative care to relieve symptoms and improve well-being.
The outlook for liver cancer
Your liver cancer prognosis largely depends on your cancer’s stage, or how far in your body it has spread:
- Tumors located only within the liver — About 36% of people will live five years or more.
- Tumors that have spread to nearby lymph nodes — About 13% of people will survive at least five years.
- Tumors that have spread to distant locations in the body — About 3% of people will live at least five years.
Liver cancers are most often diagnosed before they have spread, which may lead to a better outcome. Other factors can also affect your prognosis, such as your symptoms, how many tumors you have and their sizes, how well your liver is working, whether you experience blood clots, and levels of alpha-fetoprotein (a protein made by liver cancer cells).
If you are worried that you might have liver cancer, mention your symptoms to your doctor. Additionally, your healthcare team can help you find a treatment plan that works best for your needs and helps improve your well-being.