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Liver Cancer

Primary liver cancer refers to a malignant or solid tumour that starts in the liver. It occurs when abnormal cells grow uncontrollably in the liver, forming a cancerous tumour.

Last modified: January 13, 2022

Quick facts about liver cancerQuick facts

  • The most common type of primary liver cancer is hepatocellular carcinoma (HCC) or hepatoma. HCC starts in the hepatocytes, which is the main liver cell
  • Approximately 2,800 people in Australia are diagnosed with primary liver cancer each year. Almost three times more men are affected by liver cancer than women
  • Primary liver cancer is different to secondary (or metastatic) liver cancer, which refers to a cancer that started somewhere else in the body and has spread to the liver

Types of liver cancerTypes of liver cancer

There are three different types of primary liver cancer, which include:

Hepatocellular carcinoma Cholangiocarcinoma Angiosarcoma

Hepatocellular carcinoma

Hepatocellular carcinoma (HCC), also known as hepatoma, is the most common type of primary liver cancer. HCC is a liver cancer which starts in the main liver cells, called hepatocytes. It occurs most often in people with an underlying or long-term liver disease.

Cholangiocarcinoma

Cholangiocarcinoma, also known as bile duct cancer, is a type of liver cancer which develops in the cells lining the bile ducts. These bile ducts connect the liver to the bowel and gallbladder. Cholangiocarcinoma is less common than HCC, making up 10-15% of primary liver cancer diagnoses worldwide.

Angiosarcoma

Angiosarcoma is an uncommon liver cancer which starts in the blood vessels. This liver cancer is very rare and is more likely to occur in people over 70.

Signs and symptoms of liver cancerSigns and symptoms

Liver cancer can be difficult to detect early, as most people don’t show any signs and symptoms in its early stages. Signs and symptoms of liver cancer are more likely to appear in later stages of the disease as the cancer grows. This is why it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a liver cancer diagnosis. Symptoms may include:

  • Weakness and tiredness

  • Pain in the upper right side of the abdomen

  • Severe pain and/or swelling of the abdomen

  • Appetite loss and feeling sick

  • Weight loss

  • Yellowing skin and eyes

  • Pale bowel motions

  • Fever

Stages of liver cancerStages

The TNM staging system is used to stage liver cancer, and it helps doctors understand what your cancer looks like. Learn more about the TNM staging system.

People with Hepatocellular carcinoma cancer often have liver cirrhosis as well. Prognosis can be affected by either of these conditions, so a hybrid staging system called The Barcelona Clinic Liver Cancer (BCLC) is used in liver cancer as it includes both the cancer size and extent, as well as the degree of liver dysfunction.

A Child-Pugh score helps your doctor to better understand how liver cancer is impacting your ability to carry on daily life.

The Child-Pugh score is defined as:

  • Child-Pugh A – The liver is working well and cirrhosis is less advanced
  • Child-Pugh B – The liver is working moderately well
  • Child-Pugh C – The liver is not working well and cirrhosis is advanced

BCLC Staging System

Stage 0 liver cancer Stage A liver cancer Stage B liver cancer Stage C liver cancer Stage D liver cancer

Stage 0 (very early)

There is a single tumour less than 2 cm in size. The Child-Pugh score is Child-Pugh A.

Stage A (early)

There is a single tumour greater than 2 cm in size or up to three tumours less than 3 cm. The Child-Pugh score is Child–Pugh A or B.

Stage B (intermediate)

More extensive than Stage A but the cancer is still confined to the liver. The Child-Pugh score is Child-Pugh A or B.

Stage C (advanced)

The tumour has grown into one of the main blood vessels of the liver, or spread to the lymph nodes or other body organs. The Child-Pugh score is Child–Pugh A or B.

Stage D (end-stage)

The tumour is any size. The Child-Pugh score is Child-Pugh C.

Treatment for liver cancer

There are many different types of treatment for liver cancer. Your treatment will depend on you and your cancer.

Learn more

Frequently asked questions about liver cancerFAQs

Is liver cancer hereditary?

Liver cancer is not considered hereditary but having a family history of both hepatitis B and liver cancer is considered a risk factor.

What causes liver cancer?

Long term infection caused by the hepatitis B or C viruses is the biggest known risk factor for primary liver cancer in Australia.

Other factors which contribute to the risk of developing liver cancer include:

  • Smoking
  • Chronic liver infection with the hepatitis B or C virus
  • Fatty liver disease or genetic disorders including haemochromatosis, or alpha 1-antitrypsin deficiency
  • Type 2 diabetes
  • Cirrhosis
  • Obesity
  • Family history
  • Being over the age of 60
  • High levels of long-term alcohol consumption
How common is liver cancer?

Approximately 2,800 people in Australia were diagnosed with primary liver cancer in 2021. Almost three times more men than women are affected by liver cancer. In 2019, liver cancer was the seventh most common cause of cancer death in Australia.

What can I do to decrease my risk of liver cancer?

You can reduce your risk of developing liver cancer by reducing your exposure to known risk factors for this disease, such as:

  • Avoiding infection with hepatitis B and C and receiving treatment if you have been diagnosed
  • Limiting alcohol and tobacco use
  • Getting to and staying at a healthy weight
  • Limiting exposure to cancer-causing chemicals
  • Treating diseases that increase liver cancer risk, such as hemochromatosis
Is there a screening program for liver cancer?

There is no national screening program for liver cancer in Australia.

Are there clinical trials available for liver cancer that I can participate in?

Icon delivers Australia’s largest private cancer clinical trials and research program participating in international and national trials across medical oncology, haematology and radiation oncology. If you would like more information on participating in a clinical trial, please speak with your doctor.

See current clinical trials delivered by Icon Cancer Centre.

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ReferencesReferences

For a full list of references, click here.
  1. Australia Government. (2022, January 7). Liver Cancer Statistics. Retrieved from Cancer Australia: https://www.canceraustralia.gov.au/cancer-types/liver-cancer/statistics
  2. Cancer Council. (2022, January 7). Liver Cancer. Retrieved from Cancer Council: https://www.cancer.org.au/cancer-information/types-of-cancer/liver-cancer
  3. Cancer Council. (2022, January 7). Liver Cancer Prevention. Retrieved from Cancer Council: https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/prevention.html
  4. Cancer Council. (2022, January 7). Liver Cancer Staging and Prognosis. Retrieved from Cancer Council: https://www.cancercouncil.com.au/liver-cancer/diagnosis/staging-prognosis/
  5. Cancer Council Australia. (2022, January 7). Liver Cancer. Retrieved from Cancer Council: https://www.cancer.org.au/cancer-information/types-of-cancer/liver-cancer
  6. Cancer Council NSW. (2022, January 7). Understanding Cancer in the Liver. Retrieved from Cancer Council NSW: https://www.cancercouncil.com.au/wp-content/uploads/2014/05/Understanding-Cancer-in-the-Liver-2020.pdf
  7. Liver Foundation. (2022, January 7). Liver Diseases. Retrieved from Liver Foundation : https://www.liver.org.au/news-events
  8. Pancare Foundation. (2022, January 7). Liver Cancer Symptoms and Risk Factora. Retrieved from Pancare Foundation: https://www.pancare.org.au/cancer/liver-cancer/liver-cancer-symptoms-risk-factors
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