Liver cancer signs and symptoms

In its early stages, liver cancer may not show any apparent signs and symptoms. Over time, though, as a tumor in the liver grows, a patient may see or feel it. Or a doctor may see or feel it during a checkup. At this point, the cancer may be advanced and more difficult to treat.

Primary liver cancer (cancer that starts in the liver) and secondary liver cancer (cancer that begins elsewhere and spreads to the liver) cause the same symptoms.

Early warning signs of liver cancer

The symptoms of liver cancer may differ for each person, and any one of these symptoms may be caused by other conditions. Also, while it’s true that liver cancer symptoms are more common in the later stages, some patients develop them earlier.

Common early warning signs for liver cancer

Some common early warning signs include:

• Pain in the upper abdomen on the right side or near the right shoulder blade that tends to remain consistent and does not come and go
• Abdominal swelling (ascites) or bloating in the abdomen that develops as a mass
• Enlarged liver (hepatomegaly) felt as a mass under the ribs on the right side Jaundice (yellowing of the skin and eyes)

Other signs and symptoms of liver cancer

Other signs and symptoms include:

• Fever
• Dark urine
• Pale/chalky stools
• Easy bruising or bleeding 
• Fatigue
• Weakness
• Unexplained and unintentional weight loss
• Poor appetite
• Enlarged spleen felt as a mass under the ribs on the left side
• Feeling of fullness after eating a small amount of food
• Nausea
• Vomiting

Many of these symptoms may be caused by other types of benign liver infections or diseases. In the case of liver cancer, the symptoms may continue to evolve and worsen as the tumor grows and the disease advances. If the patient notices potential symptoms, it’s important to see a doctor for an accurate diagnosis. Pain is especially common in patients with advanced-stage liver cancer. Because the cancer has likely spread by that point, the patient may be experiencing pain in both the primary liver cancer site and in areas the cancer has spread.

Paraneoplastic syndromes

In rare cases, other disorders may develop as a result of liver cancer, especially in the early stages of the disease. Paraneoplastic syndromes cause symptoms in other parts of the body. Awareness of these symptoms may help with diagnosing liver cancer. Some paraneoplastic syndromes related to liver cancer include:

• Hypercalcemia (high blood calcium levels), a serious condition that may cause extreme thirst, headache, nausea, vomiting, fatigue, frequent urination and constipation
• Hypoglycemia (low blood sugar levels), which can cause irregular heartbeat, numbness in facial features like the lips or cheek, fainting and fatigue
• Erythrocytosis (high red blood cell count), often marked by headaches, high blood pressure, blurred vision, dizziness, confusion, fatigue and nosebleeds
• Hypercholesterolemia (high cholesterol levels), which, if untreated, may lead cholesterol deposits to accumulate on the walls of the arteries, raising the risk of stroke and heart attack
• Gynecomastia (male breast enlargement), characterized by swollen breast tissue, breast tenderness and sometimes nipple discharge
• Shrinking of testicles in men, mainly marked by pain and swelling in the testicles along with atrophy

Liver cancer screening

Based on symptoms alone, it may be difficult to detect liver cancer early, when it’s often easier to treat. For some people who have a higher risk of developing liver cancer, screening may be recommended or beneficial. If you have one or more risk factors for liver cancer, connect with your care team to discuss screening options.