Liver cancer

Liver cancer does not always have symptoms, but they can include yellow or itchy skin, darker pee or paler poo, loss of appetite and tiredness.

Treatment for liver cancer depends on your situation. It may include surgery, chemotherapy, radiotherapy and targeted medicines.

Anyone can get liver cancer, but it's more common in men, people over 60 and those with conditions like cirrhosis.

Tests for liver cancer can include blood tests, a biopsy or scans like an ultrasound, CT or MRI.

Liver cancer cannot always be prevented. But healthy lifestyle changes like cutting down on alcohol can lower your chances of getting it.

Liver cancer may not have any symptoms, or they might be hard to spot.

The symptoms are the same if the liver cancer starts in the liver (primary liver cancer) or spreads from another part of the body (secondary liver cancer).

Symptoms of liver cancer can include:

• the whites of your eyes turning yellow or your skin turning yellow, which may be less obvious on brown or black skin (jaundice) – you may also have itchy skin, darker pee and paler poo than usual
• loss of appetite or losing weight without trying to
• feeling tired or having no energy
• feeling generally unwell or having symptoms like flu
• a lump in the right side of your tummy

Other symptoms can affect your digestion, such as:

• feeling or being sick
• pain at the top right side of your tummy or in your right shoulder
• symptoms of indigestion, such as feeling full very quickly when eating
• a very swollen tummy that is not related to when you eat

You will need tests and scans to check for liver cancer if the GP refers you to a specialist.

These tests can include:

• blood tests
• scans, like an ultrasound scan, CT scan or MRI scan
• collecting a small sample of cells from the liver (called a biopsy), to be checked for cancer

You may not have all these tests.

If you've already had another kind of cancer and the specialist thinks it might have spread to your liver (secondary liver cancer) you may also have a PET scan.

These tests can also help find problems in your bile ducts, pancreas or gallbladder.

If you have liver cancer, you and your loved ones will be supported throughout your treatment by a group of specialists.

The clinical nurse specialist, or another member of your specialist team will be able to give you information on local support services that you may find helpful.

There are also national cancer charities that offer support and information about liver cancer.

Dedicated charity for anyone affected by liver cancer.

• Website: www.livercanceruk.org
• Helpline: 0800 652 7330
• Liver Cancer UK: Support for you
• Liver UK at HealthUnlocked: online community

Information and support for anyone affected by cancer.

• Website: www.macmillan.org.uk
• Helpline: 0808 808 00 00
• Macmillan Cancer Support: support line service
• Macmillan Cancer Support: online forum
• Macmillan Cancer Support: find local support services

Information and support for anyone affected by cancer.

• Website: www.cancerresearchuk.org
• Nurse helpline: 0808 800 4040
• Cancer Research UK: ask a nurse service
• Cancer Research UK: online cancer chat forum
• Cancer Research UK: find a clinical trial service

Practical, emotional and social support for anyone affected by cancer.

• Website: www.maggies.org
• Helpline: 0300 123 1801
• Maggie's Centres

Care and support for anyone affected by a terminal illness.

• Website: www.mariecurie.org.uk
• Helpline: 0800 090 2309
• Marie Curie: support services

Liver cancer is often treatable, but it can be difficult to treat.

The treatment you have will depend on:

• if the cancer started in the liver (primary) or spread from somewhere else (secondary), but treatments for primary and secondary liver cancer are similar
• the size and type of liver cancer you have
• where it is
• if it has spread
• your general health

It may include surgery, chemotherapy, using heat to destroy the cancer (thermal ablation), targeted medicines, radiotherapy, and targeted medicines and immunotherapy.

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan that is best for you
• help you manage any side effects, including changes to your diet to help you digest your food

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your next check-up.

Anyone can get primary liver cancer. It's not always clear what causes it.

You might be more likely to get it if you:

• are over 60 – it's most common in people over 85
• are a man
• have certain medical conditions, such as hepatitis, liver cirrhosis, gallstones, diabetes, a parasite in the liver (liver flukes) or HIV
• have a brother, sister or parent who had primary liver cancer

Secondary liver cancer is caused by cancer cells from a cancer somewhere else in the body spreading to the liver.

Many liver cancers are also linked to your lifestyle.

You cannot always prevent liver cancer. But making healthy changes can lower your chances of getting it.

• try to lose weight if you're overweight

• wear protective clothes and masks if you work in a job where you're exposed to harmful chemicals

• try to cut down on alcohol – avoid drinking more than 14 units a week

• try to quit smoking