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Liver Cancer

Primary liver cancer refers to a malignant or solid tumour that starts in the liver. It occurs when abnormal cells grow uncontrollably in the liver, forming a cancerous tumour.

Quick facts about liver cancerQuick facts about liver cancer

The most common type of primary liver cancer is hepatocellular carcinoma (HCC) or hepatoma. HCC starts in the hepatocytes, which is the main liver cell
The number of new cases (incidence) of liver cancer has risen the second fastest amongst the 20 most common types of cancer over the past decade in the UK. This amounts to 17 new liver cancer diagnoses each day, and around 6,000 each year
Primary liver cancer is different to secondary (or metastatic) liver cancer, which refers to a cancer that started somewhere else in the body and has spread to the liver.

Types of liver cancerTypes of liver cancer

There are three different types of primary liver cancer, which include:

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Hepatocellular carcinoma

Hepatocellular carcinoma (HCC), also known as hepatoma, is the most common type of primary liver cancer. HCC is a liver cancer which starts in the main liver cells, called hepatocytes. It occurs most often in people with an underlying or long-term liver disease.

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Cholangiocarcinoma

Cholangiocarcinoma, also known as bile duct cancer, is a type of liver cancer which develops in the cells lining the bile ducts. These bile ducts connect the liver to the bowel and gallbladder. Cholangiocarcinoma is less common than HCC, making up 10-15% of primary liver cancer diagnoses worldwide.

Angiosarcoma

Angiosarcoma is an uncommon liver cancer which starts in the blood vessels. This liver cancer is very rare and is more likely to occur in people over 70.

Signs and symptoms of liver cancerSigns and symptoms of liver cancer

Liver cancer can be difficult to detect early, as most people don’t show any signs and symptoms in its early stages. Signs and symptoms of liver cancer are more likely to appear in later stages of the disease as the cancer grows. This is why it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a liver cancer diagnosis.

Symptoms may include:

Weakness and tiredness
Pain in the upper right side of the abdomen
Severe pain and/or swelling of the abdomen
Appetite loss and feeling sick
Weight loss
Yellowing skin and eyes
Pale bowel motions
Darkening of urine
Fever

Stages of liver cancerStages of liver cancer

The TNM staging system is used to stage liver cancer, and it helps doctors understand what your cancer looks like.

People with Hepatocellular carcinoma cancer often have liver cirrhosis as well. Prognosis can be affected by either of these conditions, so a hybrid staging system called The Barcelona Clinic Liver Cancer (BCLC) is used in liver cancer as it includes both the cancer size and extent, as well as the degree of liver dysfunction.

A Child-Pugh score helps your doctor to better understand how liver cancer is impacting your ability to carry on daily life.

The Child-Pugh score is defined as:

Child-Pugh A – The liver is working well and cirrhosis is less advanced
Child-Pugh B – The liver is working moderately well
Child-Pugh C – The liver is not working well and cirrhosis is advanced.

BCLC Staging System

Stage 0 (very early)

There is a single tumour less than 2 cm in size. The Child-Pugh score is Child-Pugh A.

Stage A (early)

There is a single tumour greater than 2 cm in size or up to three tumours less than 3 cm. The Child-Pugh score is Child–Pugh A or B.

Stage B (intermediate)

More extensive than Stage A but the cancer is still confined to the liver. The Child-Pugh score is Child-Pugh A or B.

Stage C (advanced)

The tumour has grown into one of the main blood vessels of the liver, or spread to the lymph nodes or other body organs. The Child-Pugh score is Child–Pugh A or B.

Stage D (end-stage)

The tumour is any size. The Child-Pugh score is Child-Pugh C.

Treatment for liver cancer

There are many different types of treatment for liver cancer. Your treatment will depend on you and your cancer.

Learn more

Frequently asked questions about liver cancerFAQs

Is liver cancer hereditary?

Liver cancer is not considered hereditary but having a family history of both hepatitis B and liver cancer is considered a risk factor.

What causes liver cancer?

The risk factors for cirrhosis, liver disease and liver cancer are similar. The good news is that there are things you can do to reduce the risks.

In the UK the most important risk factors are:

Infection with a hepatitis virus
Drinking alcohol
Being overweight
Having type 2 diabetes.

How common is liver cancer?

The number of new cases (incidence) of liver cancer has risen the second fastest amongst the 20 most common types of cancer over the past decade in the UK. This amounts to 17 new liver cancer diagnoses each day, and around 6,000 each year.

What can I do to decrease my risk of liver cancer?

To decrease your risk of liver cancer, limit alcohol and tobacco use, both of which contribute to liver damage and increase cancer risk. Maintaining a healthy weight through diet and exercise can help prevent non-alcoholic fatty liver disease, a precursor to liver cancer. It’s also crucial to prevent hepatitis infections through vaccination and safe practices, as chronic hepatitis is a leading cause of liver cancer. Avoiding exposure to aflatoxins and other carcinogens, like vinyl chloride and thorium dioxide, is also important for reducing risk.

Find out more here: Liver Cancer Risk Factors | American Cancer Society | American Cancer Society

Is there a screening program for liver cancer?

The UK does not have a national screening program for liver cancer, primarily because liver cancer is rare, there isn’t a suitable test for screening, and screening would be expensive. Instead, individuals at high risk of developing liver cancer, such as those with liver cirrhosis or chronic hepatitis B or C infection, are offered regular checks or surveillance.

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