George Krucik, MD, MBA
Unfortunately, most people with liver cancer will not have any symptoms during the early stages of the disease, and people may not realize they have liver cancer until the tumor becomes large and difficult to treat. This is because many of the symptoms of liver cancer are common to other diseases. Symptoms include abdominal swelling and pain, jaundice, fatigue, unexplained weight loss, nausea and lack of appetite.
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Abdominal Swelling and Pain
The liver is on the right side of the body under the ribs. Abdominal swelling and pain can be caused by liver swelling and fluid buildup in the abdominal cavity. Normally, it is not possible to feel your liver, but if a person has liver cancer, the liver may become enlarged and swell. A physician may be able to detect an enlarged liver by touching the area. Fluid buildup in the abdominal cavity occurs because the tumor causes pressure to increase on the blood vessels that run through the liver. The increased pressure may result in fluid leaking from the vessels.
Symptoms Related to Bile
Sometimes liver tumors start growing into the bile ducts and block bile from being drained away from the liver. Since the bile can't drain properly, it can cause a person's skin and the whites of the eyes to develop a yellow tint, a condition called jaundice. Blocked bile ducts can also cause dark urine, because the bile must be excreted by the kidneys, and pale feces, because the bile is not being excreted in the usual way, with the stool.
Other Symptoms Due to Hormonal Changes
Liver cancer can cause changes in the levels of chemicals and cells in the blood and result in symptoms that affect the entire body. Many times these changes can be detected in a blood test before the tumor is diagnosed. People with liver cancer may have low blood sugar levels, high blood calcium levels, high cholesterol and high numbers of red blood cells. These changes in the blood may cause constipation, nausea, fatigue or severe diarrhea.
High-Risk Groups and Symptoms
People with certain liver problems, such as cirrhosis of the liver or infections with hepatitis B or C, often have many of the symptoms of liver cancer. These people are also at a higher risk of developing liver cancer, which makes diagnosis especially challenging, as they may not notice any new symptoms early in the disease. If you are in these high-risk groups and notice a new pain, a swollen liver, fever or weight loss, you should see your doctor.