According to 2010 information from the American Liver Foundation, cancer that begins in the liver is less common in the United States than in other parts of the world, with approximately 21,000 cases diagnosed each year, but the number is increasing. Risk factors include cirrhosis or scarring of the liver, hepatitis B or C, diabetes and possibly, obesity. Liver cancer can be difficult to detect, according to the Merck Manual. Some patients have no symptoms until the disease is in its advanced stages, and others have vague symptoms that could be caused by other disorders.
General Malaise
Some patients have no symptoms in the early stages of liver cancer, reports the American Liver Foundation. If symptoms occur, they may be vague and include fatigue, weakness, itching and fever. A patient with known liver disease, such as hepatitis or cirrhosis, who becomes sicker may need to be tested for liver cancer, according to the American Cancer Society.
Abdominal Distress
Liver cancer is rarely found early, according to the American Cancer Society. There are no screening tests for the disease and small tumors are difficult to detect on examination. Sometimes, patients have symptoms related to an enlarged liver, according to the American Liver Foundation, such as a lumpy, tender mass in the upper right quadrant of the abdomen, as well as nausea, loss of appetite, weight loss, and a feeling of fullness. Pain may occur in the abdomen, back or shoulder. Sometimes, the spleen is enlarged as well, according to the Merck Manual. In advanced cases, the abdomen may be swollen and the veins under the skin may be visible, according to the American Cancer Society.
Jaundice
At first, there may be mild or even no jaundice, which is a yellowing of the skin and whites of the eyes due to a build-up of bilirubin in the blood, according to the Merck Manual. Jaundice will worsen as the disease progresses.
Hormonal Imbalances
Some patients with liver tumors present with symptoms that appear to be related to disorders of the nervous system or endocrine system, according to the American Cancer Society. Hormone imbalances may cause flushing due to high levels of red blood cells, breast enlargement, shrunken testicles, low blood sugar or high calcium levels that cause nausea, constipation, weakness, confusion or muscle problems.
Positive Tests
Screening of patients with cirrhosis or long-term hepatitis B is controversial and may not reduce the death rate from liver cancer, notes the Merck Manual. If screening is indicated, performing an ultrasound test or measuring the alpha-fetoprotein level of the patient’s blood every 6 to 12 months may help to detect liver cancer.
References
- “The Merck Manual;” Mark H. Beers, M.D., ed.; 2006
- American Liver Foundation: Liver Cancer
- American Cancer Society: How is Liver Cancer Found?
