Early symptoms of liver cancer

Liver cancer

It might be argued that one of the early symptoms of liver cancer is cirrhosis. Cirrhosis is scar tissue formation from liver damage, and it may predate hepatocellular carcinoma (HCC) – the most common form of liver cancer. A worsening of long-standing cirrhosis is a warning sign of HCC. As a matter of fact, by the time cancer is diagnosed, the patient may already know that they have cirrhosis.

Moreover, some of the symptoms they experience – such as abdominal swelling from ascites (fluid accumulation) and needing more diuretics to manage this fluid accumulation. Otherwise, a patient may not experience any symptoms during early HCC, but when they do they may encounter the following:

·         Effortless weight loss.

·         Appetite loss.

·         A feeling of fullness after a small meal.

·         Nausea or vomiting.

·         A mass under the ribs on the right side that is either a tumor or the enlarged liver.

·         A mass under the ribs on the left side that is in fact an enlarged spleen.

·         Abdominal pain or pain near the right shoulder blade.

·         Itching.

·         Jaundice (yellowing of the skin and whites of the eyes).

·         Weakness and fatigue.

·         White, chalk-like stool.

A small liver tumor may be difficult to find because the majority of the liver is covered by the right rib cage. Once the lump under the ribs is noticeable it is probably because the tumor has grown rather large. Additionally, there are no screening tests for individuals not at risk. For those who are at an increased risk as a result of cirrhosis, most physicians advise liver cancer screening every 6-12 months. Though cirrhosis is not always caused by alcohol abuse – other causes include viral hepatitis types B and C – the major causes of cirrhosis in the United States is alcohol consumption. Other risks factors are:

·         Being male.

·         Being older than 60 years of age.

·         Being overweight.

·         Being exposed to certain chemicals or food contaminated with aflatoxins.

·         Having certain hereditary diseases like hemochromatosis or Wilson’s disease.

·         Having non-alcoholic fatty liver disease.

Patients who are on a waiting list for a liver transplant on account of the severity of their cirrhosis should also be first on the list for screening tests. A doctor will check the abdomen, liver, spleen, and other organs of a person with the early symptoms of liver cancer for lumps, swelling, and other warning signs. Simultaneously, the doctor may conduct an alpha-fetoprtein (AFP) blood test. AFP is protein found in abundance in the blood of fetuses but which disappears soon after delivery. Its presence in the blood of adults may indicate HCC.

There are other blood tests in addition to an AFP test, such as the following:

·         Liver function

Measures how well a liver already damaged by hepatitis and/or cirrhosis is working.

·         Blood clotting

A damaged liver may not be able to produce the proteins needed to help blood clot.

·         Viral hepatitis

Patients who have been infected with hep B or C are more likely to have liver cancer.

·         Kidney function

Measures how well the kidneys work.

·         Complete blood count

Measures how well the bone marrow works.

·         Blood chemistry

Assesses the levels of minerals and substances such as calcium and blood glucose that are affected by HCC.


Further testing – particularly imaging tests – may show the existence, location, size, and stage of liver cancer include:

·         Ultrasound.

·         Computed tomography scan.

·         Magnetic resonance imaging.

·         Angiogram.

·         Laparoscopy.

·         Bone scan

In broad strokes, liver cancer is localized resectable or localized unresectable. In other words, the tumor is either only in one place in the liver – and the rest of the organ is healthy – and can be surgically removed, or it is in only one part of the liver but cannot be surgically removed because the rest of the organ is so badly damaged – often by cirrhosis – that there would not be enough left of it after surgery to keep the person alive and well. More specific staging below:




Tumor has not spread to any blood vessels, nearby lymph nodes, or distant parts of the body.


A tumor has spread to nearby blood vessels or several tumors are 2” or less across, but cancer has not spread to regional lymph nodes or distant parts of the body.


More than one tumor, at least one of which is larger than 2”, but cancer has not spread beyond the liver.


At least one tumor involves a branch of a major vein of the liver, but cancer has not spread to nearby lymph nodes or distant parts of the body.


A tumor has spread to nearby organs other than the gallbladder or has broken through the outer covering of the liver, but cancer has not spread to nearby lymph nodes or distant parts of the body.


Tumors have spread to nearby lymph nodes, may have grown into blood vessels or nearby organs, but not spread to distant parts of the body.


Any number of tumors of any size have spread to distant parts of the body and may have spread to nearby lymph nodes.


Liver cancer can also be grouped into summary stages, as follows:



5-year survival rate


The cancer is confined to the liver. Includes stages I, II, and some stage III cancers.



The cancer has spread to nearby organs or nearby lymph nodes. Includes stages IIIC and IVA cancers.



The cancer has grown to distant sites. Same as stage IVB.



As implied above, surgery is only a treatment option if the tumor is smaller than 2 inches, the rest of the liver is functioning well, and the cancer has not spread to other organs.

Hepatectomy. This is a procedure to remove part of the liver. The rest assumes the duties of the entire organ, and may grow back to its previous size in a matter of weeks. Advanced cirrhosis precludes hepatectomy even if the tumor is small.

Liver transplant. The patient may be given a new liver provided that the cancer has not metastasized to other organs and if a befitting donor is found, among other requisites.

Other possible treatments include:

·         Cryoablation.

·         Thermal or radiofrequency ablation.

·         Percutaneous ethanol injection.

·         Chemoembolization.

·         Radiation therapy.

·         Chemotherapy.

·         Hepatic arterial infusion.

·         Immunotherapy.

Acupressure, acupuncture, deep breathing, music therapy, and massage therapy have been suggested as alternative medicine options, and while they may have no effect on liver cancer itself, they may help relieve pain and side effects of medications, as well as reduce the stress that a cancer diagnosis can cause.

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