What is liver cancer?
The liver performs metabolic, detoxification, and bile-producing functions. Primary liver cancer is different from cancer that began elsewhere and spread to the liver. Hepatocellular carcinoma develops from liver cells and accounts for most adult primary liver cancers; intrahepatic cholangiocarcinoma begins in bile ducts within the liver and is treated differently. Cirrhosis from any cause, chronic hepatitis B or C, alcohol-associated liver disease, metabolic dysfunction–associated steatotic liver disease, and certain toxins or inherited disorders can increase HCC risk. Some higher-risk people undergo surveillance, often with ultrasound and sometimes alpha-fetoprotein testing, to find tumors earlier. Treatment planning must assess both cancer burden and the liver’s remaining function. Portal hypertension, performance status, blood-vessel invasion, and disease outside the liver also shape options. A small tumor in a severely damaged liver may require a different approach than a larger tumor in a well-functioning liver.
Signs and symptoms
Early liver cancer may cause no symptoms. Possible signs include a hard lump or discomfort under the right rib cage, upper-abdominal or right shoulder-blade pain, abdominal swelling, jaundice, dark urine, pale stools, easy bruising or bleeding, unusual fatigue, fever, nausea, vomiting, reduced appetite, early fullness, and weight loss without a known reason. A person with chronic liver disease may notice a sudden decline rather than a distinct new symptom. Worsening fluid buildup, confusion, or bleeding can also reflect declining liver function and may need urgent care. These symptoms can be caused by noncancer conditions, including hepatitis, gallbladder or bile-duct disease, cirrhosis complications, infection, and benign liver lesions. Evaluation should distinguish a new cancer from the underlying liver disease and from cancer that has spread to the liver from another organ.
Diagnosis and staging
Evaluation includes medical history, examination, liver-function and blood-clotting tests, blood counts, kidney function, hepatitis testing, and often alpha-fetoprotein. Multiphase contrast CT or MRI can sometimes diagnose hepatocellular carcinoma in a high-risk liver based on its characteristic blood-flow pattern. Biopsy is used when imaging is not definitive or when tissue is needed to identify tumor type or biomarkers, but it is not required in every classic HCC presentation. Imaging assesses tumor number and size, blood-vessel invasion, lymph nodes, and distant spread. Staging may use TNM plus liver-specific systems that incorporate liver function and performance status. Transplant assessment also applies defined size and number criteria. Endoscopy may be needed to evaluate varices before a treatment that increases bleeding risk. Care depends on whether this is HCC or bile-duct cancer, extent, liver reserve, portal hypertension, biomarkers, transplant eligibility, health, preferences, and treatment feasibility.
Established treatment paths
Potentially curative options for selected localized hepatocellular carcinoma include partial hepatectomy, liver transplant, and tumor ablation. Resection requires enough functional liver to remain; transplant treats both the cancer and the diseased liver but depends on eligibility and donor availability. Radiofrequency or microwave ablation can control small tumors, especially when surgery is unsuitable. Transarterial embolization or chemoembolization delivers treatment through the tumor’s arterial supply and is used for selected liver-confined disease; radioembolization and external-beam radiation are options in certain settings. Bridging treatment may control disease while an eligible person waits for transplant. For unresectable or metastatic HCC, immunotherapy combinations and targeted agents are established systemic options, selected according to liver function, bleeding risk, prior therapy, and contraindications. Intrahepatic bile duct cancer may be treated with surgery when resectable, systemic chemotherapy, immunotherapy, and biomarker-directed drugs in appropriate cases. Response is followed with imaging, liver tests, symptoms, and sometimes tumor markers. Clinical trials are relevant throughout care. Treatment depends on tumor type, stage, liver function, vascular involvement, biomarkers, prior therapy, transplant status, and goals.
Supportive care
Supportive care should address both cancer symptoms and chronic liver disease. Teams may manage pain, nausea, itching, fatigue, nutrition, abdominal fluid, confusion, bleeding risk, and infection. Dietitian input can help with reduced appetite, early fullness, or sodium and protein questions tailored to liver status. Palliative care can accompany active treatment. Patients should promptly report vomiting blood, black stools, increasing confusion, severe abdominal swelling, fever, jaundice, or sudden worsening. Hepatitis treatment and transplant coordination should remain integrated with oncology care.
Profiles documenting liver cancer care
These profiles mention a matching cancer specialty in their published materials. Browse their locations, reported services, and practical details.
Sources
Source information checked: 2026-09-29. The links below identify the public and clinic-provided materials used for this page.
- NCI: What Is Liver Cancer? ↗Checked 2026-09-29
- NCI: Liver Cancer Treatment ↗Checked 2026-09-29
- NCI: Primary Liver Cancer Treatment (Professional) ↗Checked 2026-09-29
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