Most common cause is DNA mutations in the liver cells. Chronic hepatitis infections are also known to be the cause of liver cancer. Sometimes, people with no underlying diseases are also affected by liver cancer. So, it is unclear about what exactly causes primary liver cancer. But secondary liver cancers can occur from metastasis and spread of certain cancers of other organs to the liver. Cancers of colon, breast, lungs, etc can spread to the liver. However, some risk factors have been found that can increase the chances of getting primary liver cancers.

After being diagnosed with liver cancer, the next step your doctor does is staging. Staging refers to the process of figuring out the extent of the spread of cancer. A particular stage of liver cancer describes how severe it is and helps to determine the best treatment. Liver cancer is described as stage I to stage IV.

Stage I: Liver has only one small tumour and the cancer has not yet spread to nearby lymph nodes or distant organs. This is very early-stage liver cancer where the tumour has not affected the portal vein (main blood vessel of the liver) and mostly surgery will be recommended for this stage.

Stage II: Liver has one or more tumours grown to blood vessels but not spread to nearby lymph nodes or distant organs. This is also early-stage liver cancer and treatments like surgery, liver transplant, or radiofrequency ablation will be recommended.

Stage III: Liver has more than one large tumour and has grown into a large vein of the liver but has not yet spread to nearby lymph nodes or distant organs. This is intermediate-stage liver cancer and regional therapies such as transarterial chemoembolization will be recommended.

Stage IV: A single tumour or many tumours of any size have spread to nearby lymph nodes and to distant organs such as bones or lungs. This is advanced-stage liver cancer and targeted therapy will be preferred in certain cases.

Primary liver cancer that has originated in the liver or bile ducts of the liver can spread fastly. Among all types of liver cancer, cholangiocarcinoma and angiosarcoma are fast-growing whereas the most common type of liver cancer, hepatocellular carcinoma is slow-growing. If the liver is infected, cancer will grow faster. You can face symptoms like tiredness, jaundice, unintentional weight loss, enlarged liver or spleen, nausea and vomiting, dark-coloured urine, lump below the rib cage, upper abdominal pain or swelling, lack of appetite, white or chalky stools, etc while it is spreading.

Once you are diagnosed with liver cancer, a panel of doctors together will prepare the best treatment plan for you. During this time you will be given with certain medications to deal with cancer symptoms and to make you ready to receive treatments. After setting up a treatment plan, doctors will discuss with you the expected outcome and possible side effects. Later you can make an informed decision. If you are not confident with the designed treatment plan, you can go for a second opinion. Otherwise, you can start treatment as scheduled by your doctor.

Liver cancer may or may not show early signs. But there are some considerable symptoms such as enlarged liver or spleen, unintentional weight loss, lack of appetite, nausea or vomiting, abdominal pain, swelling of the abdomen, and discolouration of skin and eyes to yellow. If you have or ever had liver infections or liver cirrhosis, it is advised to go for testing in case of experiencing the above symptoms.

Traditional chemotherapy is not an option to cure liver cancer but it helped many liver cancer patients live longer. There is a different form of chemotherapy namely hepatic artery infusion (HAI) that can effectively treat liver cancer. In this treatment, chemo drugs are placed in the hepatic artery (main blood vessel that supplies blood to the liver) through catheter insertion that allows drugs to reach the tumour. Some liver cancer patients can’t tolerate and feel uncomfortable to receive this type of treatment.

Patients with early-stage liver cancer have higher chances to increase their survival rate by up to 5 years or longer. In the case of advanced or metastatic liver cancers, patients can still expect a 5-year survival rate due to the excellence of modern treatments. Adapting a healthy lifestyle along with the best treatments for your liver cancer can also improve your quality of life and life expectancy too.

Long-term liver infections with the hepatitis B virus or hepatitis C virus are known to be the most common causes of liver cancer. As these infections lead to liver cirrhosis which in turn develops as liver cancer. This risk is even higher in alcoholics. Hepatitis vaccines and treatments are available for hepatitis infections to protect yourself from liver damage. These infections can also spread from person to person through unprotected sex, use of contaminated needles, and can also spread from parents (if infected) to children during childbirth. Other potential causes of liver cancer include primary biliary cirrhosis (bile duct damage), avid alcohol or tobacco consumption, obesity, type 2 diabetes, and other liver diseases.

Almost all symptoms are similar in men and in women such as extreme tiredness, jaundice, unintentional weight loss, enlarged liver or spleen, nausea and vomiting, dark-coloured urine, presence of a lump below the rib cage, pain on the right side of the abdomen at the site of the liver, abdominal pain or swelling, lack of appetite or feeling full even after taking small meals, and white chalky stools. These symptoms do not necessarily mean liver cancer as these can also be accompanied by other illnesses. If you experience any of these symptoms, consult your doctor and get your liver tested.

Liver is one of the most important organs in the body responsible for multiple functions including secreting bile for food digestion, producing energy that your body needs, processing and storing nutrients for energy, collecting and filtering blood that circulates from the intestines, producing clotting factors that help the blood to clot in certain situations, etc. So, when you get liver cancer, all these functions will be disturbed and you may face symptoms like weight loss, fatigue, and more (see above).

Pain is a common symptom of liver cancer. It usually occurs in the right abdominal area mainly below the right side of the rib cage and near the right shoulder. Sometimes this pain can radiate to the back. Pain from liver cancer may be associated with tumours in the liver, enlarged liver that puts pressure on the nerves under the diaphragm, and liver diseases like cirrhosis. Inform your doctor about the location and intensity of the pain you are experiencing and get the proper treatment for the cause.

Complete remission from liver cancer depends upon its stage, patient’s health status and age. Early-stage liver cancer can be cured and prevented from recurrence. Though advanced-stage liver cancer is difficult to cure, there are many advanced treatment options available to treat. Successful liver transplants can completely cure early-stage liver cancer, but every patient is not suitable to have a liver transplant.

Your doctor will suggest required tests before starting treatment including imaging scans, blood tests, liver function tests, and biopsy if needed. In maximum cases, there won’t be a need for further testing. But if you are not confident with the current treatment plan, you can go for a second opinion from a multidisciplinary panel of expert oncologists.

Your doctor will discuss with you pre-treatment preparation. If you are already taking any treatment or medication for any other diseases, the doctor might ask you to stop certain medications. Ask your doctor to provide a list of things that you should stop or take before starting the treatment.