Liver cancer: symptoms, causes, diagnosis and treatment

The NHS says liver cancer may not have any symptoms, or they might be hard to spot, and that they are the same whether the cancer starts in the liver or spreads from elsewhere. Cancer Research UK says primary liver cancer does not usually cause symptoms in the early stages, and that symptoms are often quite vague and vary depending on where the cancer is.

Many of these symptoms are very common and have many other causes. The NHS stresses that having them does not definitely mean you have liver cancer, but that it is important to get them checked because finding cancer early may make it easier to treat.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if your skin or the whites of your eyes turn yellow, or if you have been sick for more than 2 days.

It says to see a GP if you have a lump in your tummy, have lost a lot of weight without trying, or have symptoms of liver cancer that get worse or do not get better after 2 weeks. Cancer Research UK adds that if you already have a liver condition such as cirrhosis, you should tell your doctor about any new or worsening symptoms.

The NHS says the GP may feel your tummy and listen to your chest, and may arrange an urgent referral for more tests or to see a hospital specialist if they think your symptoms could be cancer. It stresses this does not definitely mean you have cancer.

The NHS says liver cancer is often treatable but can be difficult to treat. The treatment depends on whether the cancer started in the liver or spread from elsewhere (though the treatments are similar), the size and type, where it is, whether it has spread and your general health. Cancer Research UK says it also depends on how well your liver is working.

The NHS says treatment may include surgery, chemotherapy, using heat to destroy the cancer (thermal ablation), targeted medicines, radiotherapy and immunotherapy. Your specialist team explains the benefits and side effects and creates a plan with you, and you will have regular check-ups during and after treatment.

The NHS says anyone can get primary liver cancer and it is not always clear what causes it. You may be more likely to get it if you are over 60 (it is most common in people over 85), are a man, have certain conditions such as hepatitis, liver cirrhosis, gallstones, diabetes, a parasite in the liver (liver flukes) or HIV, or have a brother, sister or parent who had primary liver cancer.

Secondary liver cancer is caused by cancer cells from a cancer somewhere else in the body spreading to the liver. The NHS also says many liver cancers are linked to lifestyle.

It says you cannot always prevent liver cancer, but healthy changes can lower your chances: trying to lose weight if you are overweight, wearing protective clothes and masks if your job exposes you to harmful chemicals, cutting down on alcohol (avoid drinking more than 14 units a week) and trying to quit smoking.

The NHS says that if your GP refers you to a specialist you will need tests and scans to check for liver cancer. These can include blood tests, scans such as an ultrasound, CT or MRI, and a biopsy, which collects a small sample of cells from the liver to be checked for cancer. You may not have all of them. A PET scan may be used if you have had another cancer that might have spread to the liver.

The NHS says it can take several weeks to get test results and that a long wait does not mean anything is definitely wrong. If you are told you have liver cancer, further tests will help find the size of the cancer and how far it has spread (the stage), and you may need a small operation to look inside the tummy called a laparoscopy.

Cancer Research UK says there is no national screening programme for primary liver cancer in the UK, but you might have regular checks if you are at high risk.

The NHS says advanced liver cancer may be very hard to treat and it may not be possible to cure it. In that case the aim of treatment is to limit the cancer and its symptoms and help you live longer. You will be referred to a palliative care or symptom control team who work with you to manage symptoms and help you feel more comfortable, and a clinical nurse specialist can help you and your loved ones get support.

On the NHS, symptoms that could be liver cancer are assessed through your GP, with an urgent referral to a hospital specialist team if needed. A multidisciplinary group of specialists looks after you during diagnosis and treatment, with a clinical nurse specialist as your main point of contact.

Private hepatology and oncology services can arrange scans and consultations, and some people use them to speed up the first assessment. Complex treatment such as liver surgery, ablation and transplant is delivered in specialist centres.