How will I know which type of liver cancer I have?

It can sometimes be difficult to tell which type of liver cancer a patient has developed. Your doctor may need to investigate whether you have had an underlying cause of liver disease, which you may not have even been aware of, that makes primary liver cancer more likely.

Your doctor will wish to examine you and arrange further blood tests or scans which might be necessary to find out if there is any sign of a cancer elsewhere that has spread to the liver. Sometimes the picture that the doctor gets from scans of your liver is so clear-cut that they can be sure of the problem. However, they may recommend taking a biopsy (or small sample) of tissue either from the liver itself or from where the cancer is suspected to have originally arisen. Taking a biopsy is a routine procedure which is either painless or causes only slight discomfort. By examining this sample in detail, doctors can often find out precisely which type of cancer is present in the liver. Sometimes the appearances of the tumour in detailed body scans can give enough information for your doctors to make decisions regarding treatment.

Why have I developed liver cancer?

Primary liver cancer

Primary liver cancer usually occurs in a liver in which cirrhosis (or scarring) has developed. There are several different causes of cirrhosis. In the UK, excessive alcohol consumption is the commonest cause of liver cirrhosis and this is a condition that has increased dramatically in recent years. Long term infection (hepatitis) with certain viruses (for example hepatitis B or C virus), or a rare condition which leads to increased iron deposited within the liver can also result in liver cirrhosis, increasing the risk of primary liver cancer. Patients known to have liver cirrhosis who are at increased risk of liver cancer will often have screening blood tests and liver scans in an attempt to detect the tumour at an early stage of its development.

Secondary (metastatic) liver cancer

In general, the more advanced the primary cancer becomes, the more likely it is to have spread to the liver. Conversely, if cancer can be detected at an early stage when it has not yet spread, the prospects of cure are greater. But why do people develop cancer in the first place? Usually we just don’t know. Cancer is one of the most common causes of death in the UK, and most people know a family member or friend affected by the disease. The risk of cancer can be increased in families with certain inherited genes, by the way we live or the food we eat. Regular exercise, eating plenty of fruit and vegetables and not smoking are ways in which we can
reduce the risk of developing cancer. However, even the most health conscious can still develop cancer. This is why research into the causes and types of liver and other cancers is vital to improving our understanding and treatment of the disease.

What symptoms will I have?

Cancer in the liver may not cause any symptoms. It might have been discovered because your doctor performed some blood tests to see how well the liver was working, or an abnormal area may have been observed during a scan. Liver cancer can cause discomfort or pain in the upper part of the abdomen. Some patients may feel sick or can be generally unwell. Others may lose their appetite. Liver cancer can cause jaundice. If the liver is enlarged, you might notice a lump in the upper part of the abdomen, or under the rib cage on the right hand side.