Liver Cancer Symptoms and Signs

Signs and symptoms of adult primary liver cancer to know

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What are the symptoms of liver cancer?  For cancers that we don't have a screening test for, an awareness of symptoms is the only way to find the disease early.  So what do you need to watch for, and when should you be concerned?

Liver Cancer in Adults

It can be confusing if you hear someone talk about liver cancer.  In this article, we will refer to the symptoms of primary liver cancer - in other words, cancer which begins in the liver.

  These include cancers such as hepatocellular carcinoma and cholangiocarcinoma in adults.  Cancer in the liver can also be secondary, in other words, cancers in other parts of the body can spread to the liver. 

The symptoms of cancer metastatic to the liver may be similar, but may also be different in some important ways from primary liver cancer.  With a primary liver cancer a single tumor usually grows quite large, whereas with liver metastases there are often multiple smaller tumors spread out within the liver.

In looking at the symptoms of liver cancer it can be helpful to consider whether or not someone has risk factors for the disease. Risk factors for primary liver cancer may include a history of alcohol abuse, a history of infections with hepatitis B or hepatitis C, exposure to aflatoxins - a fungal toxin found in improperly stored grains, or the inherited disorder hemochromatosis.

Symptoms of Liver Cancer

Like many types of cancers, liver cancer does not usually cause any symptoms or signs in the early stages of the disease. As the disease progresses, liver cancer symptoms begin to appear, prompting one to seek medical attention. Due to the delayed onset of symptoms, liver cancer is often diagnosed in an advanced stage.

  Symptoms that may occur include:

Jaundice - Jaundice refers to a condition in which the skin, as well as the white part of the eyes, appears yellow. It is caused by the build-up of bilirubin in the skin.

Unintentional weight loss - Unexplained weight loss refers to a loss of 5% of body weight (for most people around 10 pounds) over a 6 to 12 month period without trying.  Unintentional weight loss has many causes, but should always be evaluated, as many of these are serious.

Loss of appetite - A loss of appetite may occur with many disorders, but can be quite profound with liver problems.  This may be accompanied by a sense of becoming full very rapidly, even when eating only small meals.

Right sided abdominal pain - Pain, discomfort, or aching on the right side of the abdomen just under the ribs may occur due to pressure of a liver tumor on other structures or pressing on nerves in this region.  If you take in a deep breath and press lightly upwards under your rib cage on the right side, this is roughly where your liver lies.

An abdominal mass or lump - In the region just noted you may feel a lump or swelling. With liver cancer, this mass often feels very hard. You may or may not have any pain in the area of the lump, and in fact may feel more pain in the areas surrounding the mass.

Right shoulder blade pain - Shoulder blade pain can be a sneaky symptom as the condition it is alerting you to may not be anywhere near the shoulder blade due to the way nerves travel in our bodies.  Make sure to see your doctor if you have this symptom.

Systemic symptoms - The term systemic symptoms refers to generalized symptoms that can go along with advanced cancer of any kind.  These include fatigue that is not relieved with rest, fever, weakness, nausea and vomiting and a general sense of being unwell. These symptoms are fairly nonspecific but are of more concern with regard to liver cancer if they are associated with other symptoms noted above.

Diagnosis of Liver Cancer

There is currently no recommended screening test for liver cancer, though people at risk - such as those with cirrhosis or a chronic hepatitis B or C infection - may be monitored more closely for physical signs or symptoms of the disease. 

If you are having any signs or symptoms, your doctor will want to take a full history and perform a physical exam.  Tests that may be done to help diagnose liver cancer include bloodwork with a CBC, calcium, and alpha-fetoprotein test, ultrasound, other imaging tests such as CT and MRI, and possibly surgery (laparoscopy.)  If a tumor is found, your doctor will want to do a biopsy to determine exactly what the tumor is and help design a treatment plan.


American Cancer Society. Signs and symptoms of liver cancer. Updated 01/19/16.

American Society of Clinical Oncology. Cancer.Net Liver Cancer: Symptoms and Signs. Updated 03/2015.