Liver Cancer Basics: What You Need to Know

In 2022, liver cancer was the sixth most diagnosed cancer and the third leading cause of cancer death in the world. The American Cancer Society estimates that about 41,630 new cases were diagnosed in the United States in 2024. If you know someone with liver cancer, have been diagnosed with liver cancer yourself or are worried about your liver cancer risk, read on to learn about the basic facts of liver cancer. Being aware of these facts may help you to better understand this disease, whether you are facing it yourself or helping someone else through this tough journey.

Liver cancer refers to cancer that originates from the liver, and to understand its implications, we must first know what the liver is and its roles and functions in the human body.

The liver is a football-sized organ that is located above your stomach and below your diaphragm, around the upper right part of your abdomen. It is made of many lobules that are connected to a network of small tubes (bile ducts) that carry bile, which helps remove waste from the liver and break down fats in the small intestine during digestion, inside the liver. These tubes connect to form the right and left hepatic ducts, which lead out of the liver. The two ducts then join outside the liver to form the common hepatic duct. Liver cancer can form both in the liver itself and in the lining of the bile ducts within the liver.

The liver is an important organ and has many roles, including but not limited to:

• Producing bile
• Filtering and processing chemicals and other poisonous substances in the blood
• Balancing glucose levels by converting excess glucose to glycogen and glycogen to glucose, as needed
• Removing bacteria from the bloodstream
• Preventing an accumulation of bilirubin from red blood cells, which can turn the eyes and skin yellow (also known as jaundice)

In a healthy liver, cells grow and multiply as needed. When cells are abnormal, mutate or get old, they die through a process called apoptosis. Cancer begins when this process doesn’t take place when it’s supposed to. The abnormal cells don’t die as they should and instead, multiply uncontrollably. This is how a cancerous tumor forms and starts growing. As the cancer cells continue to multiply, they start crowding the healthy cells and impede them from performing their intended functions.

Liver cancer that starts from the liver is called primary liver cancer, and liver cancer that is spread from other organs to the liver is known as secondary liver cancer.

There are a few main types of primary liver cancer:

• Hepatocellular carcinoma (HCC)
  This is the most common type of liver cancer in adults. 
• Intrahepatic cholangiocarcinoma (bile duct cancer)
  This type of cancer starts in the cells lining the bile ducts in the liver.
• Combined HCC-cholangiocarcinoma
• Angiosarcoma and hemangiosarcoma
  These are rare cancers that begin in the lining of blood vessels in the liver.

Learn more: The 3 Most Common Liver Cancer Types

Secondary cancers are also called metastases. The way in which secondary liver cancers are treated depends on where it originated from. For example, breast cancer that spreads to the liver is still treated as breast cancer, as the cancer cells are breast cells that have spread to the liver.

One of the reasons why liver cancer results in so many deaths is that in its early stages, it does not usually cause symptoms. Once noticeable symptoms do appear, the cancer has usually already progressed.

Common symptoms include:

• Unintended weight loss
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• Abdominal swelling or bloating
• Jaundice
• Pale, chalky stools
• A lump in the right side of your tummy
• Feeling of fullness after a small meal
• Itchy skin
• Dark urine
• Swollen veins on the abdomen
• Abnormal bruising or bleeding
• Fever

If you have liver cancer, you may or may not experience these symptoms. It is important to note that they may also be caused by other health conditions. If you have any of these symptoms, it is best to consult a healthcare professional. These symptoms do not always indicate cancer, but it is always safe to check and be sure.

Learn more: Liver Cancer Symptoms

Causes of liver cancer (or any other cancer, in fact) are not always clear. Fundamentally, cancer occurs due to DNA mutations in cells, causing them to malfunction. However, the reason for DNA mutations cannot always be traced to any particular factor. There are only known risk factors that may slightly or greatly increase liver cancer risk.

There are certain risk factors for liver cancer that you should be aware of. Some of these risk factors include:

• Chronic viral hepatitis B or C infections
• Heavy alcohol use
• Cirrhosis
• Nonalcoholic fatty liver disease
• Diabetes
• Being obese or overweight
• Exposure to certain harmful chemicals (such as vinyl chloride and thorium dioxide)
• Exposure to toxic substances (such as aflatoxin)

Learn more: 4 Health Conditions That Could Increase Your Liver Cancer Risk

It is important to note that having these risk factors does not necessarily mean that you will get liver cancer. Similarly, you may still get liver cancer even if you do not have any of these risk factors. If you do have any of these risk factors and are concerned about your liver cancer risk, consult a healthcare professional about it.

As with all cancers, it is difficult to guarantee survival outcomes for liver cancer. Every cancer journey is different and may be affected by many factors. The five-year relative survival rates for those with liver cancer are as follows*.

Looking at liver cancer survival rates serves as a very rough guide of liver cancer patient outcomes, but do bear in mind that survival rates for liver cancer are calculated based on the average experience of liver cancer patients and should not be used to predict an individual’s outcome, as there are several factors that may affect it. Moreover, these rates are based on data collected several years ago, when diagnostic technology and treatments were not as advanced as they are now. Instead of focusing too much on these numbers, it may be more helpful to focus on the professional advice and treatment plan recommended by healthcare professionals.

Treatment for liver cancer will largely depend on the stage of the cancer and the health of your liver. Your cancer care team will consider your overall health and the intended outcome of your treatment, including its chances of curing the disease, extending life, or relieving symptoms. It is also important for both you and your cancer care team to consider and discuss the potential side effects of treatment.

Common liver cancer treatments include:

• Surgery
  • Partial hepatectomy
  • Liver transplant
• Ablation
• Embolization
• Radiation therapy
• Immunotherapy
• Targeted drug therapy
• Chemotherapy

Deciding on your treatment plan is an important step in your cancer journey. It is crucial to be aware of the options available and the potential impact of these treatments on your health, survival and quality of life. Communication with your cancer care team is essential for you to make the best possible decision for you and your family.