What is liver cancer?
Chapter 01
What is liver cancer?
Liver cancer can be grouped into either primary liver cancer or secondary liver cancer. Secondary liver cancer occurs when the cancer itself starts in another part of the body and moves (metastasises) to the liver. In Australia, secondary liver cancer is generally more common than primary liver cancer.1
Primary liver cancer is a malignant tumour that starts growing in the liver. There are different types, including:1
- hepatocellular carcinoma (HCC), which is the most common type of primary liver cancer. It starts in the main cell type in the liver, which is called the hepatocytes
- cholangiocarcinoma, also known as bile duct cancer, starts in the cells lining the bile ducts (which connect the liver to the bowel and gall bladder)
- angiosarcoma, which starts in the blood vessels, is considered to be a rare type of liver cancer.
Cancer cells from a primary cancer can spread from another part of the body through the bloodstream or lymph vessels to the liver. This is called secondary liver cancer. In Australia, secondary liver cancer is more common than primary liver cancer.
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Often, primary liver cancer will develop in people who may already have a type of liver disease – commonly cirrhosis. Cirrhosis may be caused by a long-term infection with the hepatitis B or C virus, too much alcohol consumption, metabolic-associated fatty liver disease (resulting from obesity and/or type 2 diabetes or a condition called haemochromatosis (where there is too much iron in your blood).1
There are also other risk factors that people can have that may be associated with liver cancer, including:1
- Smoking tobacco
- Family history of liver cancer
- Aboriginal or Torres Strait Islander peoples.
- Migrants from areas where hepatitis B infection is greater (such as Asia, the Pacific Islands and Africa).
Often in its early stages, there are no symptoms of liver cancer. Symptoms may only start developing once the cancer has grown or spread. Symptoms may include:1
- Weakness and tiredness
- Pain in the abdomen
- Pain below the right shoulder blade
- Swelling of the abdomen due to a build-up of fluid
- Pain in the right shoulder
- Appetite loss and feeling nauseous
- Unexplained weight loss
- Yellowing of the skin and eyes (jaundice)
- Pale and frothy bowel motions
- Itchy skin.
If you have one or more of these symptoms it doesn't necessarily mean that you have liver cancer. It's suggested to make an appointment with your GP or specialist if you have any questions or concerns.
Diagnosis
Chapter 02
Diagnosing liver cancer
A range of tests may be performed to analyse symptoms and to diagnose liver cancer (and to determine the type and stage of liver cancer). Following a physical examination, further tests may include:1
Blood tests: These tests examine liver function, blood clotting, whether you have Hepatitis B or C, and to test for tumour markers
Ultrasound: A commonly used method to look for primary liver cancer, it can show the size and location of abnormal tissue in your liver
Computed tomography scan (CT): With the help of x-rays to take detailed images of your liver and also other organs (if necessary)
Magnetic resonance imaging (MRI) scan: Uses a strong magnet and radio waves to take detailed cross-sectional pictures of the body and can show the size of a tumour and whether it is affecting the main blood vessels around the liver
Biopsy: A sample of tissue is taken from the liver for examination under a microscope to see if it looks like cancer.
If you have secondary cancer in the liver, you may have further tests to find out where the primary cancer started, if this is not already known.
Treatment options
Chapter 03
Treatment options for liver cancer
The treatment options recommended to you following a liver cancer diagnosis, will depend on a few different factors including your general health, the stage of the tumour, severity of symptoms and your age.1 Your doctors will discuss the treatment options with you. They may include:1
- Surgery: The type of surgery recommended to treat liver cancer depends upon a range of factors including the tumour size, number of tumours, location in the liver, and whether you have cirrhosis. Types of surgery utilised may include removing part of the liver or a liver transplant
- Tumour ablation: This type of treatment is usually recommended for small primary liver cancers and if surgery is not an option. There are different types of tumour ablation available including thermal ablation, alcohol injection, and cryotherapy. The type offered depends on the size, shape, and location of the tumour
- Transarterial chemoembolisation (TACE): This type of treatment is a form of chemotherapy. If it's not possible to have surgery or if you are waiting for a liver transplant, then TACE may be recommended as a treatment option. This is a way of delivering high doses of chemotherapy directly to the tumour while also blocking its blood supply
- Radiation therapy: Radiation therapy uses high energy x-rays or other particles to treat cancer and can be used at all stages
- Biological therapy - A range of treatments that aim to work against the cancer cells by either stopping their growth or function, or by helping the body's immune system destroy them. Biological therapies are usually offered for both primary and secondary cancers in the liver, and may be used in conjunction with, or after other treatments for cancer.
- Targeted therapy: Targeted therapy refers to treatment with drugs that are designed to specifically attack cancer cells without harming normal cells. These types of drugs affect the way that cancer cells grow, divide, repair themselves or interact with other cells
- Immunotherapy: This is another type of drug treatment that is intended to help your own immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.
Side effects
Chapter 04
Potential side effects
Side effects of cancer treatment
All cancer treatments may have side effects. The type and severity of side effects will vary between individuals. You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.
Recommendations to help you stay well during treatment1
- Get as much rest as possible
- Healthy eating is important, but you should also try to think about eating foods that interest you rather than what you think you should eat
- Appetite changes are common, and you may experience taste changes or nausea
- It may help to eat smaller meals rather than three large ones throughout the day
- Drink lots of fluids
- To prevent dehydration, aim to drink water between meals and avoid filling up on fluids during mealtimes to ensure you have enough room for nutrient-rich foods
- Reach out to support groups and others who have had cancer treatment
- Record your side effects in a diary or journal
- Speak to your doctor about incorporating some gentle exercise into your weekly routine
- It is important to acknowledge when you are fatigued and rest when you need to
- Ask for and accept help from family, friends and neighbours
- Be open with employers about your treatment and discuss flexible working options if you need them
Treatment with GenesisCare
Chapter 05
Learn more about patient care at GenesisCare
A cancer diagnosis can be life changing. Even before your initial encounter with the GenesisCare team, you may experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness. We strive to help strengthen your confidence, settle your emotions, and to create care experiences that offer the best possible clinical outcomes.
Our care team aim to know your name and to get to know who you are as a person. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you and to help get the support you need which may include a psychologist, exercise physiologist, physiotherapist, and dietitian.
If you have any enquiries about our centres or services, please contact your local centre team. View a list of our centres here.
Helpful services
Chapter 06
Other helpful services
Other liver cancer information, resources and support services are available to help assist you during your cancer journey. These include:
Cancer Council
T: 13 11 20
Cancer.org.au
Pancare Foundation
T: 1300 881 698
Pancare.org.au
Australian Cancer Research Foundation
T: 02 9223 7833
Acrf.com.au
Liver Foundation
T: 1300 4 LIVER (1300 454 837)
liver.org.au
GI Cancer Institute
T: 1300 666 769
gicancer.org.au
Read Next
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Our centres
In Australia, we have more than 40 oncology centres in metro and regional Queensland, New South Wales, Victoria, South Australia, and Western Australia.
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Our doctors
Our experienced, specialised doctors offer bespoke, dedicated care aiming to provide the best possible clinical outcomes.
Treatment
Radiation therapy
Radiation therapy uses high energy X-rays or other particles to treat cancer and can be used at all stages.
Disclaimer
This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure, or prevent any disease. It should not be used as a substitute for your own health professional's advice.
Any medical procedure or treatment involving the use of radiation carries risks, including skin irritation and associated pain. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.
- Cancer Council. Understanding liver cancer. Available at: https://www.cancer.org.au/assets/pdf/understanding-liver-cancer-booklet (accessed February 2024).