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Liver Cancer

Liver cancer usually begins in the tissues or nodules of the liver, but can also occur within cells of the liver bile ducts. The most common form of liver cancer is hepatocellular carcinoma. The exact causes of liver cancer are unknown. Some symptoms for early liver cancer are similar to other cancers and non-cancer related illnesses, which can make liver cancer difficult to detect and diagnose.


  • In 2019, approximately 42,030 new cases of liver cancer are expected to be diagnosed and approximately 31,780 people are expected to die from liver cancer in the United States.
  • In Texas, 3,898 people are expected to be diagnosed with liver cancer and an estimated 2,606 will die from the disease in 2019.
  • Liver cancer is a leading cause of cancer-related deaths globally, accounting for more than 700,000 deaths annually.
  • Liver cancer incidence and death rates are on the rise, with the incidence more than tripling since 1980.

Risk Factors

  • Cirrhosis and Alcohol: Many people who develop liver cancer show signs of cirrhosis, a disease that scars the liver. Liver cells that are damaged from cirrhosis demonstrate a greater risk of developing liver cancer. Heavy alcohol use is a leading cause of cirrhosis.
  • Obesity: Being very overweight increases the risk of liver cancer.
  • Long-Term Hepatitis Infections: Hepatitis B and C virus infections left untreated over an extended period of time can lead to cirrhosis. These strains of hepatitis spread through unprotected sex, used needles, and childbirth.
  • Diabetes: People with type 2 diabetes, especially those who consume high amounts of alcohol or have viral hepatitis, face an increased risk for liver cancer.
  • Exposure: People who are exposed to Thorotrast, vinyl chloride, anabolic steroids, and aflatoxins have an increased risk of liver cancer.
  • Tobacco Use: Liver cancer risk is higher in current smokers than former smokers, but both have elevated risk.
  • Gender: Liver cancer is more common in men.
  • Inherited Diseases: Hereditary hemochromatosis, tyrosinemia, alpha1-antitrypsin deficiency, porphyria cutanea tarda, glycogen storage diseases, and Wilson disease increase risk of liver cancer.


Liver cancer is difficult to diagnose because symptoms often do not appear until the disease has progressed to later stages. Symptoms may include:
  • Fatigue or weakness
  • Yellow eyes and skin
  • Nausea or vomiting
  • No appetite or feelings of fullness
  • Fever 
  • Unexplained weight loss
  • Pain in right shoulder blade or abdomen, where liver is located
  • Unusual bruising or bleeding
  • Lump under ribs on right side
  • Itching
  • Bloating, fluid build-up or swelling in the abdomen
  • Enlarged liver or spleen
  • Pale stools or dark urine


Limiting certain risk factors and taking proactive measures can decrease the incidence of liver cancer. To reduce the risk of the disease, men and women should limit alcohol and tobacco use, maintain a healthy weight, treat cirrhosis and other diseases that increase risk in the early stages, and avoid exposure to certain chemicals and toxins. It is also important to prevent contact with the hepatitis B and C virus. The hepatitis B virus vaccination is recommended for all infants, children, and high-risk adults.

Treatment Options

Treatment options vary, depending on the liver’s condition, the age and overall health of the patient, and the size, location, and stage of the cancerous tumor. Treatment for liver cancer may include a combination of surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, cryosurgery, proton therapy, radio frequency ablation, or tumor embolization. In rare cases, a liver transplant may be appropriate.

Sources: American Cancer Society, American Liver Foundation, American Society of Clinical Oncology, Centers for Disease Control and Prevention, National Cancer Institute, and Texas Cancer Registry

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