Liver Cancer: Signs, Symptoms, and Complications

Liver Problems And Their Causes

Liver disease is a general term that refers to any condition affecting your liver. These conditions may develop for different reasons, but they can all damage your liver and affect its function.

Your liver is a vital organ that performs hundreds of tasks related to metabolism, energy storage, and waste filtering. It helps you digest food, convert it to energy, and store the energy until you need it. It also helps filter toxic substances out of your bloodstream.

Read on to learn about the types, causes, symptoms, and treatment of liver disease.

Liver disease symptoms vary, depending on the underlying cause. It's also possible for someone to have liver disease and not have any symptoms at all. However, Hepatitis NSW says that a few general symptoms can indicate some kind of severe liver damage.

These include:

yellowish skin and eyes, known as jaundice

pale, bloody, or black stools

enlarged stomach due to ascites, which may make it uncomfortable to lie down or eat

encephalopathy, a brain issue resulting in marked changes in mood, sleep, and cognition

Many conditions can affect your liver. Here's a look at some of the main ones.

Hepatitis

Hepatitis is defined as an inflammation of the liver. When that inflammation is caused by a virus, it's referred to as viral hepatitis. Hepatitis can cause liver damage, making it difficult for your liver to function as it should.

Most types of viral hepatitis are contagious, but you can reduce your risk by getting vaccinated for types A and B and by taking other preventive steps, including using a condom during sex and not sharing needles.

Five types of hepatitis include:

Hepatitis A. Hepatitis A is typically spread through contact with contaminated food or water. Symptoms may clear up without treatment, but recovery can take a few weeks.

Hepatitis B. This type of viral hepatitis can be acute (short-term) or chronic (long-term). It's spread through bodily fluids, such as blood and semen. While hepatitis B is treatable, there's no cure for it. Early treatment is key to avoiding complications, so it's best to get regular screenings if you're at risk.

Hepatitis C. Hepatitis C can also be acute or chronic. It's often spread through contact with blood from someone with hepatitis C. While it often doesn't cause symptoms in its early stages, it can lead to permanent liver damage in its later stages.

Hepatitis D. This is a serious form of hepatitis that only develops in people with hepatitis B — it can't be contracted on its own. It can also be either acute or chronic.

Hepatitis E. Hepatitis E is usually caused by drinking contaminated water. Generally, it clears up on its own within a few weeks without any lasting complications.

Fatty liver disease

Fat buildup in the liver can lead to fatty liver disease.

There are two types of fatty liver disease. These two types can manifest alone, or they can overlap:

alcoholic fatty liver disease, which is caused by heavy alcohol consumption

nonalcoholic fatty liver disease, which is caused by other factors experts are still trying to understand

Without management, both types of fatty liver disease can cause liver damage, leading to cirrhosis and liver failure. Diet and other lifestyle changes can often improve symptoms and lower your risk of complications.

Autoimmune conditions

Autoimmune conditions involve your immune system mistakenly attacking healthy cells in your body.

Several autoimmune conditions involve your immune system attacking cells in your liver, including:

Autoimmune hepatitis. This condition causes your immune system to attack your liver, resulting in inflammation. Without treatment, it can lead to cirrhosis and liver failure.

Primary biliary cirrhosis (PBC). This results from damage to the bile ducts in your liver, causing a buildup of bile. PBC can eventually lead to cirrhosis and liver failure.

Primary sclerosing cholangitis. This inflammatory condition causes gradual damage to your bile ducts. They eventually become blocked, causing bile to build up in your liver. This can lead to cirrhosis or liver failure.

Genetic conditions

Several genetic conditions, which you inherit from one of your parents, can also affect your liver:

Hemochromatosis causes your body to store more iron than it needs. This iron remains in your organs, including your liver. This can lead to damage over a long period of time if not managed.

Wilson's disease causes your liver to absorb copper instead of releasing it into your bile ducts. Eventually, your liver may become too damaged to store more copper, allowing it to travel through your bloodstream and damage other parts of your body, including your brain.

Alpha-1 antitrypsin deficiency occurs when your liver can't make enough alpha-1 antitrypsin, a protein that helps prevent enzyme breakdowns throughout your body. This condition can cause lung disease as well as liver disease. There's no cure, but treatment can help.

Drug-induced liver disease

It's possible to damage your liver by overexposing it to certain drugs and supplements, as seen in a 2019 study. Many times, this damage can be reversed once you stop taking the drug. But if it continues, the damage can become chronic.

Cancer

Liver cancer first develops in your liver. If cancer starts elsewhere in the body but spreads to the liver, it's called secondary liver cancer.

The most common type of liver cancer is hepatocellular carcinoma. It tends to develop as several small spots of cancer in your liver, though it can also start as a single tumor.

Complications of other liver diseases, especially those that aren't treated, may contribute to the development of liver cancer.

Cirrhosis

Cirrhosis refers to scarring that results from liver diseases and other causes of liver damage, such as alcohol use disorder. Cystic fibrosis and syphilis may also lead to liver damage and, eventually, cirrhosis — although these two causes are much less common.

Your liver can regenerate in response to damage, but this process usually results in the development of scar tissue. The more scar tissue that develops, the harder it is for your liver to function properly.

In its early stages, cirrhosis is often treatable by addressing the underlying cause. But without management, it can lead to other complications and become life threatening.

Liver failure

Chronic liver failure typically happens when a significant part of your liver is damaged and can't function properly. Generally, liver failure related to liver disease and cirrhosis happens slowly. You may not have any symptoms at first. But over time, you might start to notice:

jaundice

diarrhea

confusion

fatigue and weakness

nausea

It's a serious condition that requires ongoing management.

Acute liver failure, on the other hand, happens suddenly, often in response to an overdose or poisoning.

Certain things can make you more likely to develop certain liver diseases. One of the most well-known risk factors is heavy drinking, which the Centers for Disease Control and Prevention (CDC) defines as more than 8 alcoholic drinks per week for women and more than 15 drinks per week for men.

Other risk factors include:

sharing needles

getting a tattoo or body piercing with nonsterile needles

having a job where you're exposed to blood and other bodily fluids

having sex without using protection against sexually transmitted infections

living with diabetes or high cholesterol

having a family history of liver disease

living with extra weight

being exposed to toxins or pesticides

taking certain supplements or herbs, especially in large amounts

mixing certain medications with alcohol

taking more than the recommended dose of certain medications

While not all liver disease or damage can be prevented, lifestyle choices can make a big difference when it comes to keeping your liver healthy. Like the risk factors above, many of the methods around prevention involve dietary decisions and physical activity.

The American Liver Foundation says that you can help prevent liver disease by:

eating a nutritious diet that includes lots of fruits, vegetables, lean proteins, and whole grains

increasing physical activity

limiting alcohol

avoiding smoking and using drugs

maintaining a moderate weight

interacting cautiously with toxic chemicals like aerosol cleaners, bug sprays, and other cleaning products

using a condom or other barrier method during sex

visiting your doctor for annual physicals, including blood work

If you're concerned about liver disease, it's best to make an appointment with a healthcare professional.

They'll start by looking over your medical history and asking about any family history of liver problems. Next, they'll likely ask you some questions about symptoms you may be experiencing, including when they started and whether certain things make them better or worse.

Depending on your symptoms, they'll likely ask you about your drinking and eating habits. Make sure to also tell them about any prescription or over-the-counter medications you take, including vitamins and supplements.

Once they've collected all this information, they may recommend:

liver function tests

a complete blood count test

CT scans, MRIs, or ultrasounds to check for liver damage or tumors

a liver biopsy, which involves removing a small sample of your liver and examining it for signs of damage or disease

Many liver diseases are chronic, meaning they last for years and may never go away. But even chronic liver diseases can usually be managed.

For some people, lifestyle changes are enough to control symptoms. These might include:

limiting alcohol

maintaining a moderate weight

drinking more water

adopting a liver-friendly diet that includes plenty of fiber while avoiding unhealthy fats, refined sugar, and salt

Depending on the specific liver condition you have, your doctor may recommend other dietary changes. For example, people living with Wilson's disease should limit foods containing copper, including shellfish, mushrooms, and nuts.

Depending on the condition affecting your liver, you may also need medical treatment, such as:

antiviral drugs to treat hepatitis

steroids to lower liver inflammation

blood pressure medication

antibiotics

medications to target specific symptoms, such as itchy skin

vitamins and supplements to boost liver health

In some cases, you may need surgery to remove all or part of your liver. Generally, a liver transplant is only done when other options have failed.

Many liver diseases are manageable if you catch them early. Without treatment, however, they can cause permanent damage.

The complications of untreated or unmanaged liver disease can lead to cirrhosis, severe scarring that cannot be reversed. If cirrhosis has gone too far, a liver transplant may be your only option.

Because some liver diseases can develop without symptoms, making it a point to schedule annual physicals, along with the typical physical blood work, can help you and your doctor stay one step ahead.

Focusing on a nutritious diet, physical exercise, and other healthy lifestyle choices such as limiting alcohol can also help with prevention or management.

Unusual Liver Cancer Symptom That Can Be Noticed When Carrying Shopping

According to Cancer Research UK, figures show in an average year more than 6,000 people are diagnosed with liver disease - and early symptoms are often hard to spot

A sign of liver cancer might be pain in your shoulder while carrying shopping (

Image: Getty)

When you are doing your shopping or housework, it is normal to feel a bit tired and achy - but if you notice a pain in your shoulder, it could be a sign of something more serious.

Cancer Research UK says that pain in the shoulder is one of the lesser-known symptoms of liver cancer. Every year, over 6,000 people are diagnosed with the disease, but many cases are not spotted until it is too late. This means that less than one in ten will survive for more than ten years after their diagnosis.

The charity explains that primary liver cancer, which starts in the liver, does not usually cause symptoms in the early stages. However, there are some key signs to watch out for, and some can even show up when you're doing ordinary tasks.

One of these signs is a pain in the right shoulder, which can be noticed even when carrying shopping or washing up. Cancer Research UK explains: "A swollen (enlarged) liver can cause pain in your right shoulder. This is because the enlarged liver stimulates nerves that connect to nerves in the shoulder. This is called referred pain."

This shoulder pain is just one of several symptoms that the charity advises people to look out for. It also lists other symptoms to be aware of.

Several symptoms of liver cancer affect the abdomen. This could be due to the liver swelling from the growing cancer, causing a bulge on the right side of your tummy or increased pressure in the liver forcing fluid into the abdomen (ascites).

The NHS advises that you should see a GP if you have a lump in your tummy or have lost a lot of weight without trying. It also recommends seeing your doctor if you have any other symptoms of liver cancer that get worse or don't improve after two weeks.

The NHS says: "Many of these symptoms are very common and can be caused by different conditions. Having them does not definitely mean you have liver cancer. But it's important to get them checked by a GP. This is because if they're caused by cancer, finding it early may mean it's easier to treat."

Symptoms of liver cancer:

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

* An AI tool was used to add an extra layer to the editing process for this story. You can report any errors to webhomepage@mirror.Co.Uk

Can A FibroScan Detect Liver Cancer?

FibroScan is a diagnostic test that uses ultrasound to visualize the liver. Detecting cancer is not its main use. However, because the scan evaluates overall liver health, it may provide an indication.

FibroScan allows doctors to assess the liver without using invasive procedures. The test bounces sound waves off the liver tissue to gauge its characteristics.

The scan can show signs of liver damage, such as fat buildup or scarring. These findings can indicate a person is at a higher risk of liver cancer, but it does not confirm liver cancer on its own.

This article examines FibroScan as a cancer detection tool, how it works, and the procedure.

FibroScan is a test that can evaluate liver stiffness, fat buildup, and scarring. Doctors can also use it to monitor liver changes over time, which may indicate if a person is at risk of liver cancer.

For example, there is an association of liver scarring with the most common type of liver cancer, hepatocellular carcinoma (HCC).

A 2020 study explored cancer diagnoses in people with cirrhosis, or advanced scarring, due to hepatitis C. The researchers noted that those who had liver stiffness of 24 kilopascals (kPa) or more in a FibroScan were more at risk of cancer.

It is also possible for liver tumors to affect the results of a FibroScan, causing a higher score. However, only a liver biopsy can confirm cancer.

FibroScan can detect cirrhosis and other forms of liver damage. It can also diagnose and track the following liver conditions:

FibroScans use elastography to evaluate liver health. A specialized probe sends low-frequency sound waves into the liver, and the device calculates the speed at which these waves travel through the tissue. The resulting measurement quantitatively assesses liver stiffness.

FibroScan cannot accurately confirm or rule out cancer, but its accuracy for assessing liver health more generally is well-documented in previous research.

The United Kingdom's National Health Service (NHS) notes that in around 1 in 10 cases, accurate FibroScan results are difficult to obtain. Certain conditions can interfere with FibroScan results, such as:

Liver inflammation or congestion may also produce a result that is too high. In cases where the result is unclear or unreliable, a doctor may recommend a liver biopsy.

Some evidence has suggested that FibroScan measurements can be different in those with a higher BMI. However, a 2020 study found these differences were not clinically significant in terms of accuracy.

The FibroScan procedure is as follows:

Preparation: Before the FibroScan procedure, a person should not eat or drink for 3 hours to ensure optimal conditions for accurate results. The person should wear comfortable, loose clothing.

Positioning: Before the scan, a person needs to get into position. This usually involves lying on one's back with the right arm raised behind the head. This positioning exposes the right side of the chest and the area beneath the right ribcage, facilitating access to the liver for the procedure.

Gel application: A health professional will apply a water-based gel to the skin on the right side of the abdomen. This gel ensures proper contact between the skin and the FibroScan probe, allowing for the efficient transmission of sound waves.

Exam: The doctor will place the FibroScan probe on the skin. The probe will emit low-frequency sound waves that pass through the liver tissue, calculating the tissue's stiffness based on the speed of wave transmission. The person may feel a slight vibration or pulse against the skin each time the doctor takes a reading. Around 10 readings are typical. The scan should take 10–20 minutes.

Post-procedure: After the FibroScan, the individual can resume their usual activities.

FibroScan provides immediate results in the form of kPa, which measures liver stiffness, and controlled attenuation parameter (CAP), which measures fat buildup.

A typical liver usually has 2–7 kPa. The higher the result beyond this, the more likely it is that a person has fibrosis or cirrhosis. The highest possible measurement is 75 kPa.

An older 2013 review of previous research suggests that HCC risk increases by 11% for each increase in kPa number.

For the CAP score, the measurement is in decibels per meter (dB/m). A CAP score of 238 dB/m is usually healthy. The ranges for CAP scores are as follows:

Because fat accumulation in the liver can lead to cirrhosis, it is also important in assessing cancer risk. However, the CAP score can change over time with treatment and lifestyle changes.

If the FibroScan indicates typical liver stiffness, the doctor may recommend routine monitoring of liver health, and possibly lifestyle modifications, to maintain optimal liver function.

In cases of mild or moderate scarring, the doctor may suggest additional diagnostic tests to assess the underlying cause. These may include blood tests or imaging studies.

For those with severe fibrosis or cirrhosis, prompt intervention is essential. The doctor may suggest a comprehensive evaluation of liver function, additional imaging studies, and possibly a liver biopsy to assess the extent of damage. If cancer is possible, a liver biopsy can confirm or rule this out.

Once doctors know the cause of the changes, they will tailor treatment plans to manage the specific condition.

Learn about liver cancer treatment options.

FibroScan cannot detect liver cancer by itself, but it can detect liver stiffness, scarring, or fat buildup. These symptoms can be signs of liver damage that may raise the risk of cancer.

Liver cancer itself can also lead to a high FibroScan score. However, the only way to confirm the cause of the high score is to run additional tests. In the case of cancer, this will mean a liver biopsy.

If a person has questions about their FibroScan results, they should discuss them and what the next steps are with their doctor.

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