Controlling the symptoms of cancer in the liver
Treating the cancer will often ease your symptoms, but other treatments can also be used to control symptoms.
Controlling symptoms
If you have liver cancer, or secondary liver cancer, treating the cancer will often improve your symptoms. Other treatments can also help control symptoms. This is sometimes called palliative treatment or supportive care.
Your doctor may refer you to a palliative care team, who are experts in controlling symptoms. You may have support from a palliative care team while having your cancer treatment. They will support you and your family.
The team often includes a doctor and nurses. They often work closely with a local hospice and can visit you and your family at home.
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Pain
If the cancer stretches the layer of tissue surrounding the liver (capsule), it may cause pain. Some people get pain in the right shoulder. Doctors sometimes call this referred pain. It can happen if the liver stimulates the nerves below the diaphragm (sheet of muscle under the lungs).
Painkillers
There are different types of painkillers your doctor can give you. If your pain is not controlled, tell your doctor or nurse as soon as possible. They can change the dose or give you a different painkiller that works better for you. Make sure you take painkillers regularly and as your doctor has prescribed.
Strong painkillers often cause constipation. Your doctor can prescribe a laxative for you. Eating foods containing fibre and drinking plenty of fluids will also help.
Sometimes steroids can relieve pain by reducing swelling around the liver. You usually take them for a few weeks or months.
Ascites
Ascites is a build-up of fluid in the tummy area (abdomen). Your tummy becomes swollen and bloated, which can be uncomfortable or painful. You may also feel breathless.
Ascites can be caused by the cancer in the liver. But in primary liver cancer, it is often caused by the effects of cirrhosis on the liver.
Your doctor will usually prescribe water tablets (diuretics) to try to stop or slow down the build-up of fluid.
If the ascites does not improve, your doctor can put a small, fine tube put through the skin of your tummy to drain off the fluid.
This relieves the symptoms and helps you feel more comfortable.
We have more information about ascites.
Jaundice
Jaundice can be caused by a blockage of the bile duct or by the liver not working properly.
The bile duct drains bile out of the liver. Bile is a yellow fluid made by the liver that breaks down fats.
When the bile duct is blocked, bile builds up in the liver and flows back into the blood. This causes the symptoms of jaundice.
Symptoms of jaundice include:
- yellowing of the whites of the eyes and skin
- feeling itchy
- your poo (stools) may become pale
- your pee (urine) being very dark.
Treating liver cancer may help to shrink it and improve jaundice.
If the bile duct is blocked, some people might have a narrow tube put into the bile duct. This is called a stent. The stent helps keep the bile duct open.
We have more information about jaundice and how it can be treated and the symptoms managed.
Tiredness and weakness (fatigue)
Tiredness is a common symptom of cancer in the liver. It may be caused by:
- the cancer itself
- its treatment
- symptoms or side effects.
You may feel you do not have the energy to do everyday activities. Try to pace yourself. Save your energy for the things that matter to you and that you enjoy.
Make sure you get enough rest. But try to balance this with some physical activity, such as short walks.
We have more information and tips to help you cope with tiredness (fatigue).
Loss of appetite
Some people lose their appetite. This might be a symptom of the cancer or side effect of treatment. If the liver is bigger, it can press on the stomach and make you feel full quickly.
It may help to eat small, frequent meals or snacks instead of 3 meals a day. Ask your nurse or a dietitian for advice. They can give you food or drink supplements. Your doctor may prescribe medicines called steroids to help improve your appetite.
We have more information on coping with eating problems.
Feeling sick (nausea)
Sickness may be caused by:
- cancer in the liver changing the chemical balance of the blood
- the liver being bigger and pressing on the stomach
- the cancer treatment
- some types of drugs, such as painkillers.
Your doctor can give you anti-sickness tablets to help with nausea. Tell your doctor if the tablet you are taking is not working. They can give you another type that works better for you. Your doctor may give you steroids to reduce sickness.
Extremes in body temperature
The liver makes a lot of the body’s heat. Cancer in the liver can sometimes cause changes in body temperature. You may feel:
- hot and sweat more often than usual
- cold and shivery.
If you notice these symptoms, talk to your doctor. There may be medicines that can help.
Hiccups
If your liver is pressing on the nerve that leads to the diaphragm, you may have hiccups.
There are medicines that can help reduce or stop hiccups. Your doctor can prescribe these for you.
Itching
If you have itching, tell your doctor about it. The treatment they give you depends on the cause of the itching. Itching may be caused by:
- jaundice
- cancer treatment
- medication.
Your doctor or nurse can prescribe lotions or medicines that can help reduce itching. If itching is affecting your sleep, tell your doctor.
Here are some tips to help you cope with itching:
- Try not to scratch. It can damage your skin and make the itching worse.
- Wear loose clothing made of natural fibres, such as cotton. Avoid scratchy fabrics, such as wool.
- If possible, keep the temperature around you cool. Use slightly warm water when you bathe or shower.
- Dry your skin by patting rather than rubbing.
- Apply non-scented moisturisers (emollients) after a shower or bath.
- If caffeine, alcohol and spices make the itching worse, try to cut down or avoid them.
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About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our primary liver cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
ESMO Guidelines Committee. Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines. eUpdate. March 2021. Available from: www.esmo.org/guidelines/guidelines-by-topic/esmo-clinical-practice-guidelines-gastrointestinal-cancers/hepatocellular-carcinoma-esmo-clinical-practice-guidelines-for-diagnosis-treatment-and-follow-up/eupdate-hepatocellular-carcinoma-treatment-recommendations [accessed April 2023].
Huang QD, Teng MLP. Hepatocellular carcinoma – symptoms, diagnosis and treatment. BMJ Best Practice Guidelines. 2022. Available from: www.bestpractice.bmj.com/topics/en-gb/369 [accessed March 2023].
Vogel A, Cervantes A, Chau I, Daniele B, Llovet JM, Meyer T, et al. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018;29(4): 238–255. Available from: www.doi.org/10.1093/annonc/mdy308 [accessed April 2023].
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