Liver

The liver is the largest organ in the body, and is part of the digestive system.
There are three different types of primary liver cancer.

Hepatocellular carcinoma (HCC) – starts in the hepatocytes, the main cell type in the liver. HCC, also called hepatoma, is the most common type of primary liver cancer.

Cholangiocarcinoma – starts in the cells lining the bile duct, which connects the liver to the bowel and the gall bladder. It is also called bile duct cancer.

Angiosarcoma – a rare type of liver cancer starting in the blood vessels. It usually occurs in people over 70.

Causes

In most cases, primary liver cancer is related to long-term (chronic) infection caused by the hepatitis B or C virus.
Other causes of primary liver cancer aren’t always known, but some factors that increase the risk include:

liver scarring (cirrhosis) – from hepatitis B or C, alcohol, fatty liver disease, or genetic disorders such as iron overload (haemochromatosis) or alpha-1 antitrypsin deficiency type 2 diabetes

drinking too much alcohol

eating a high-fat diet and/or being overweight or obese

smoking tobacco

exposure to certain chemicals or substances (such as aflatoxins or vinyl chloride).

Symptoms

Primary liver cancer doesn’t tend to cause symptoms in the early stages, but they may appear as the cancer grows or becomes advanced.

Symptoms can include:

weakness and tiredness (fatigue)

pain in the upper right side of the abdomen, or in the right shoulder

severe abdominal pain

appetite loss and feeling sick (nausea)

unexplained weight loss

yellowing of the skin and eyes (jaundice)

pale bowel motions

swelling of the abdomen (ascites)

fever.

Diagnosis
Primary liver cancer is diagnosed using several tests. These include blood tests and scans. A tissue examination (biopsy) is rarely done.

If the tests show that you have primary liver cancer, the specialist will work out how far it has spread. This is known as staging.

Treatment
The treatment for primary liver cancer depends on the size of the cancer, whether it is contained in one part of the liver and no major blood vessels are involved, and whether you have cirrhosis. The doctor will also consider your age and general health, as well as the options available.