Primary liver cancer (see box, left) is a rare but serious type of cancer that mostly affects older people. The initial symptoms of liver cancer are often vague and non-specific. They include:
- unexplained weight loss
- nausea (feeling sick)
- vomiting
- tiredness
- jaundice – yellowing of the skin and the whites of the eyes
In many cases, cancer of the liver does not cause noticeable symptoms until it has reached an advanced stage. See Liver cancer - symptoms for more information about the possible warning signs of liver cancer and when to contact your GP.
The liver
The liver is one of the most complex organs in the human body and it performs more than 500 functions. Some of the liver’s most important functions include:
- digesting proteins and fats
- removing toxins (poisons) from the body
- helping to control blood clotting (thickening)
- releasing bile, a liquid that breaks down fats and aids digestion
Liver cancer is a serious condition because it can disrupt these functions or cause them to fail completely, which could prove fatal.
How common is liver cancer?
Liver cancer is rare in England, but much more common in other parts of the world (see box, left).
In England, an estimated 2,750 new cases of liver cancer are diagnosed each year. Around 60% of cases affect men and 40% affect women. The number of people who are affected by liver cancer rises sharply with age: 70% of cases involve people who are 65 or older.
Risk factors for liver cancer include:
Non-alcoholic fatty liver disease
The reason obesity is a risk factor for liver cancer is that over time, high levels of fat in the body can damage the liver, similar to the way in which alcohol damages the liver. The medical term for this type of liver damage is non-alcoholic fatty liver disease.
People with type 2 diabetes also have a higher risk of developing non-alcoholic fatty liver disease and liver cancer.
Over the past 15 years, rates of liver cancer in England have risen by 70% as a result of the above risk factors becoming more widespread. In particular, this is due to alcohol misuse, obesity and type 2 diabetes.
Screening
As liver cancer is a relatively rare condition, there is currently no national routine NHS screening programme for it because it would not be an effective use of resources.
However, regular check-ups for liver cancer (known as ‘surveillance’) are recommended for people known to have a high risk of developing the condition, such as those with a confirmed hepatitis C infection or those who have had cirrhosis (scarring of the liver) as a result of alcohol misuse, diabetes or obesity.
If you are in a high-risk group for developing liver cancer, having regular check-ups will help to ensure that the condition is diagnosed early. The earlier that liver cancer is diagnosed, the more effective the treatment is likely to be.
See Liver cancer - diagnosis for more advice about when screening for liver cancer is recommended.
Outlook
Generally, the outlook for people with liver cancer is poor. This is because the majority of cases are detected at quite a late stage. However, if a cancer is diagnosed at an early stage, treatment options include:
- surgical resection – surgery is used to remove a section of liver
- liver transplant – the liver is replaced with a donor liver
- radiofrequency ablation – a small electrical current is used to destroy the cancerous cells
See Liver cancer - treatment for more information about surgical resection, liver transplant and radiofrequency ablation.
However, these curative treatment options may not always be possible even if the cancer is diagnosed early. This is either because the liver is too damaged by scarring (cirrhosis) to survive ablation or resection of the tumour, or the person is not well enough to withstand the effects of a liver transplant.
Currently, only 1 in 10 people is diagnosed for liver cancer at an early stage. In most people who are diagnosed with liver cancer, the cancer has advanced too far to be cured. As a result, only 1 in 5 people live for a least a year after being diagnosed with liver cancer. Just 1 in 20 people live for at least five years.
However, it is hoped that this trend can be reversed as surveillance for liver cancer among high-risk groups becomes more widespread.
