Controlling symptoms

If you have liver cancer, or secondary liver cancer, treating the cancer will often improve your symptoms. Other treatments can also help to 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.

Liver pain

If the cancer stretches the layer or 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 under the diaphragm (the sheet of muscle under the lungs that separates the chest from the abdomen). These nerves connect to nerves in the right shoulder.

There are different types of painkillers your doctor can prescribe. If your pain is not controlled, tell them as soon as possible. They can change the dose or give you a different one that works better for you.

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 drugs called steroids can relieve pain by reducing swelling around the liver. You may have them for a few weeks or months. They can sometimes make you feel more energetic and improve your appetite.

Ascites

Ascites is a build-up of fluid in the tummy area (abdomen). Your abdomen becomes swollen and distended (bloated), which can be uncomfortable or painful. You may lose your appetite. You may also feel breathless. This is because the swelling can prevent your lungs from fully expanding as you breathe.

Your doctor may put a small, fine tube through the skin of your tummy to drain off the fluid. This usually happens in hospital. But sometimes it can be done at home. Your doctor can drain the fluid more than once if needed.

Your doctor may prescribe water tablets (diuretics) to try to stop or slow down the build-up of fluid.

Jaundice (blocked bile duct)

Sometimes the bile duct gets blocked by the cancer. The bile duct is a tube that drains bile out of the liver and into the small bowel. If it is blocked, bile builds up in the liver and flows back into the blood. Symptoms include:

  • yellowing of the whites of the eyes and skin
  • feeling itchy
  • your poo (stools) may become pale
  • your pee (urine) being very dark.

Doctors call these symptoms jaundice. There are other causes of jaundice. We have more information about jaundice and how it can be treated.

Tiredness and weakness

Fatigue means feeling exhausted all or most of the time.

It is a common symptom of cancer in the liver. It may be caused by:

  • the cancer itself
  • other symptoms, such as pain
  • the treatment you are having.

We have more information and tips to help you cope with fatigue.

Loss of appetite

Some people lose interest in food. This may be a:

  • symptom of the cancer
  • side effect of the treatment you are having.

You may not like the sight or smell of food. It may help to:

  • have small, simple meals more often
  • eat your favourite foods.

Sometimes medicines called steroids can help increase your appetite. Your doctor may prescribe these.

Your nurse or a dietitian can give you advice about ways to improve your appetite and eat well.

Feeling sick

Sickness may be caused by:

  • cancer in the liver changing the chemical balance of your blood
  • the liver being bigger and pressing on the stomach – this can also make you feel full quickly
  • cancer treatments
  • some types of drugs, such as painkillers.

Your doctor can give you anti-sickness tablets to help with nausea. There are several different types available. So, tell your doctor if the one you are taking is not working. They can give you another type that works better for you.

Your doctor may prescribe steroids to reduce sickness and improve your appetite.

Extremes in body temperature

The liver makes a lot of the body’s heat. People with cancer in the liver sometimes have swings in body temperature. You may feel:

  • hot and sweat more
  • cold and shivery.

If you have these changes, 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. The diaphragm is the sheet of muscle under the lungs that separates the chest from the abdomen.

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:

Here are some tips to help cope with itching:

  • Keep your nails short and clean.
  • 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 have a bath or shower.
  • Dry your skin by patting rather than rubbing.
  • Apply non-scented moisturisers (emollients) 3 times a day, or as often as your nurse or doctor recommends. Put it on after having a bath or shower.
  • Caffeine, alcohol and spices may make itching worse. If you notice this, try to cut down or avoid them.
  • If itching is affecting your sleep, tell your doctor. They may give you medicine to take at night to help.

About our information

  • 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 cancerinformationteam@macmillan.org.uk

    Melloul E, Hübner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016; 40: 2425–2440. Available from: doi.org/10.1007/s00268-016-3700-1 [accessed Feb 2020] 

    NICE. Lenvatinib for untreated advanced hepatocellular carcinoma: Technology appraisal guidance (TA 551) [Internet]. 2018. Available from: www.nice.org.uk/guidance/TA551 [accessed Feb 2020] 

    NICE. Liver disease. Quality standard (QS 152) [Internet]. 2017. Available from: www.nice.org.uk/guidance/QS152 [accessed Feb 2020] 

    NICE. Liver cancers overview [Internet]. 2019. Available from: pathways.nice.org.uk/pathways/liver-cancers/liver-cancers-overview [accessed Feb 2020]

    NICE. Regorafenib for previously treated advanced hepatocellular carcinoma. Technology appraisal guidance (TA555) [Internet]. 2019. Available from: www.nice.org.uk/guidance/ta555 [accessed Feb 2020]

    Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018; 29 (S4): iv238–iv255. Available from doi.org/10.1093/annonc/mdy510 [accessed Feb 2020]    


  • Reviewers

    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. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.