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My name is Aamir Khan, I’m a liver surgeon at the Royal Marsden Hospital in London.

The liver is the powerhouse of the body, involved in regulating many different body functions

as well as regulating different aspects of metabolism within the body.

When there is obstruction to the flow of bile from a liver tumour

then patients can notice as their first symptom that their urine has gone dark in colour,

their stools are paler in colour and they may experience itching.

Early on in the illness patients often experience very vague symptoms

which could be attributable to a number of things,

which accounts for the vast majority of patients presenting quite late.

These could include general lethargy, weight loss, malaise or just not feeling quite right.

More specifically liver cancer can cause yellowness of the eyes

which may be noticed by the patients themselves or indeed by their friends or relatives.

Patients may go to their GP and get routine liver function blood tests done

which are just simply routine blood tests.

Alterations in these blood tests that are picked up by the GP

may trigger more specific liver function assessments including ultrasound of the liver,

as well as viral hepatitis screening tests.

The sort of factors that are considered when defining the treatment plan for each individual patient

include the patient’s age and physical condition,

their other comorbidities, including any other illnesses that are on board

and of course the state and function of the liver itself

because often these cancers, primary liver cancer, can occur in the background

where liver function is not normal.

The treatment options for patients with primary liver tumours

include assessment of whether these tumours are feasible to be removed by surgery,

whether they are suitable to be referred for consideration for liver transplant assessment.

If this is not feasible then other alternative treatments may be considered.

For example, using radiofrequency energy to try to burn these tumours,

which can achieve good long-term outcomes

and something that we call arterial chemoembolisation which is a useful treatment

where patients who have these tumours, the tumour is poisoned

or given chemotherapy via one of the arteries that supplies it

and after that the artery is blocked, in effect starving the tumour.

Approximately three and a half thousand new [liver] cancers are diagnosed each year within the United Kingdom,

partly due to continued excessive alcohol consumption

and also liver tumours that are linked to obesity are increasing.

When I was a medical student and a junior doctor, often the diagnosis of liver cancer,

whether that was primary or whether that was secondary,

often signalled the end of the road for these patients.

But I think the message that we want to give to patients with liver problems is that

specialist treatments are available and often long-term survivorship can be achieved.

For information, help, or if you just want a chat

call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.uk