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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 not fully understood. 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 2022, approximately 41,260 new cases of liver cancer are expected to be diagnosed and approximately 30,520 people are expected to die from liver cancer in the United States.
  • In Texas, 4,430 people are expected to be diagnosed with liver cancer and an estimated 2,790 will die from the disease in 2022. 
  • Globally, liver cancer accounts for more than 700,000 deaths each year and is a leading cause of cancer-related deaths globally.
  • Liver cancer incidence and death rates are on the rise, with the incidence more than tripling since 1980.

Risk Factors

  • Cirrhosis and Alcohol: Heavy alcohol use is a leading cause of cirrhosis, a disease that scars the liver. Many people who develop liver cancer show signs of cirrhosis. Liver cells that are damaged from cirrhosis demonstrate a greater risk of developing liver cancer.
  • Obesity: Being very overweight increases the risk of liver cancer. Non-alcoholic steatohepatitis, a subtype of non-alcoholic fatty liver disease commonly found in those very overweight, can develop into cirrhosis and liver cancer. 
  • Long-Term Hepatitis Infections: Hepatitis B and C viral infections left untreated over an extended period of time can lead to cirrhosis. These strains of hepatitis spread through unprotected sex, sharing needles, or from mother to child during pregnancy.
  • Diabetes: People with type 2 diabetes, especially those who consume high amounts of alcohol or have viral hepatitis, face an increased risk for fatty liver disease, cirrhosis, and 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 in its early stages 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, or back
  • Unusual bruising or bleeding
  • Lump under ribs on right side
  • Itching
  • Hard lump under ribs on right side
  • Bloating, fluid build-up or swelling in the abdomen
  • Enlarged liver or spleen
  • Pale stools or dark urine


Taking proactive measures to limit risk factors 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, seek early treatment for viral hepatitis, cirrhosis, and other diseases that increase risk, and avoid exposure to certain chemicals and toxins. It is also important to prevent contact with the hepatitis B and C viruses as best as possible. 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, radiofrequency ablation, tumor embolization, or palliative medicine. 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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