What is liver cancer?

Liver cancer is a cancer that starts in the liver. It is sometimes called primary liver cancer. A cancer that starts somewhere else in the body and spreads to the liver is called secondary cancer in the liver.

Primary liver cancer is rare in the UK, but the number of people developing the condition is increasing. Around 5,400 people in the UK are diagnosed with primary liver cancer each year. In parts of Africa and Asia, it is one of the most common cancers.

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MAC11917
eBooks
25 May 2017
This booklet is about primary liver cancer. It is for anyone who has been diagnosed with primary liver cancer.

Types of liver cancer

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It is sometimes called hepatoma. This information is about hepatocellular carcinoma (HCC). To make it simpler, we call it HCC.

We have more information about other types of cancer that start in the liver.

Symptoms of liver cancer

In the early stages of liver cancer (HCC), there are often no symptoms. People with long-term (chronic) liver disease may have regular tests to check their liver. If they develop HCC, these tests may find it before symptoms develop. We have more information about the symptoms of HCC.

Causes of liver cancer

There are certain things that can increase the risk of developing liver cancer. These are called risk factors. Having a risk factor does not mean you will get cancer. And if you do not have any risk factors, you may still develop it.

Diagnosis of liver cancer

You may have some of the following tests to diagnose HCC:

  • Blood tests

    You will have blood tests called liver function tests (LFTs). You will also have a blood test to check a tumour marker called alpha-fetoprotein (AFP).

  • Liver ultrasound scan

    A liver ultrasound scan uses sound waves to make up a picture of the liver.

  • CT scan

    CT (computerised tomography) scan uses x-rays to build a three-dimensional (3D) picture of the inside of the body.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • Laparoscopy

    laparoscopy is a small operation allows the surgeon to look at the liver and other organs close by. It helps them to decide if it is possible to remove the tumour with surgery.

  • Liver biopsy

    You may have a liver biopsy. A small piece of tissue or a sample of cells is removed so that it can be examined under a microscope.

We have more information about how liver cancer is diagnosed.

Waiting for test results can be a difficult time. We have more information that can help.

Stages of liver cancer

The stage of a cancer describes its size and whether it has spread from where it first started.

Knowing the stage helps you and your doctors to decide on the best treatment for you. For liver cancer, doctors also use the Child-Pugh score when planning treatment. This looks at how well the liver is working.

Treatment for liver cancer

Your treatment will be planned by a team of specialists called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. If two treatments are likely to be equally helpful, your doctor may ask you to decide which one to have. They will also talk to you about certain things to think about when making treatment decisions.

The treatment you have will usually depend on:

  • where the cancer is in the liver – there may be several areas of cancer in different parts of the liver
  • the size of the tumour or tumours
  • how many tumours there are
  • whether the cancer has spread outside the liver
  • whether any important blood vessels in the liver are affected
  • how well your liver is working
  • your general health.

Possible treatments include:

  • Surgery - a surgeon operates to remove the cancer
  • Tumour ablation – a doctor applies heat or alcohol to the cancer cells to destroy them
  • Embolisation – a doctor blocks blood vessels close to the cancer to try to shrink it. Chemoembolisation or radioembolisation may be used.
  • Targeted therapy – a tablet called sorafenib may help to control advanced liver cancer.
  • Chemotherapy – this may be used to try to control advanced liver cancer
  • Radiotherapy – stereotactic radiotherapy (SABR) is sometimes used to treat HCC. Or radiotherapy may be used to help symptoms if the cancer has spread outside the liver.

For some people, treatment may be given with the aim of curing the cancer. For others it may be given to help control the cancer, prolong your life and improve symptoms. Your doctor or nurse will talk about what to expect.

We have more information about treatment for liver cancer.

Treatment to control symptoms

Treatments can also be used 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. 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.

We have more information on treatment to control the symptoms liver pain, ascites and jaundice.

After liver cancer treatment

Follow-up after treatment

After your treatment finishes, you will have regular check-ups. Your specialist will do a physical examination. You will usually also have blood tests. Depending on the treatment you had, you may have regular CT scans to check that the tumour has not come back. After a liver transplant, you also have checks to make sure your body is not rejecting the new liver. Your doctor or nurse will talk to you about what to look out for.

Many people find that they get very anxious before appointments. This is natural. It may help to get support from family and friends.

If you have problems or new symptoms between check-ups, contact your doctor or nurse as soon as possible.

Well-being and recovery

After treatment you are likely to feel very tired and you may still be coping with some side effects. It is important to take care of yourself to allow your body time to recover. Tiredness and feeling weak are also common in people with advanced liver cancer. Make sure you get enough rest and eat well.

After treatment, you may want to focus on making the most of your health.

Because the liver breaks down alcohol, your specialist may advise you not to drink for a period of time after treatment. They may ask you to reduce the amount of alcohol you drink, or to stop drinking completely. Your liver may not be able to cope with alcohol, so ask your specialist doctor or nurse for advice.

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