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Liver Cancer: What You Should Know.

[fa icon="calendar"] Nov 10, 2020 10:00:00 AM / by Calvin Leong


Liver cancer

Liver cancer is an abnormal growth of cells (tumour) in the liver. The liver is located on the upper right side of the abdomen, just below the ribs.

What Are The Causes of Liver Cancer?

The exact cause of this condition is not known.

What Increases The Risk of Liver Cancer?

You are more likely to develop this condition if you:

  • are a male.
  • have scarring of the liver (cirrhosis). Cirrhosis may be caused by:
    • too much alcohol use.
    • hepatitis B or hepatitis C.
    • smoking
  • have diabetes.
  • have a condition in which the body stores too much iron (hemochromatosis).
  • have a build up of fat in the liver without alcohol use (non-alcoholic fatty liver disease).
  • are exposed to aflatoxins. These are substances made by certain types of mold that grow on food products, such as corn and peanuts.
  • use drugs that build muscles (anabolic steroids) or medicines that prevent pregnancy (oral contraceptives).
  • have a disease caused by parasitic flatworms (schistosomiasis).
  • are obese.

Young tired man sitting at the table with laptop at home

What Are The Signs Or Symptoms?

In some cases, there are few or no symptoms in the beginning. As the disease progresses, symptoms may include:

  • weight loss.
  • loss of appetite.
  • nausea or vomiting.
  • feeling itchy.
  • abnormal bruising or bleeding.
  • feeling very weak and tired.
  • pain on the right side of your abdomen, shoulder, or back.
  • skin or eyes that look yellow in colour (jaundice).
  • dark-coloured urine.
  • white, chalk-like stools.

Liver cancer may cause other medical conditions to develop, such as:

  • High calcium levels in the blood, which may cause weakness, constipation, or confusion.
  • Low blood sugar, which may cause fatigue, confusion, and sweating.
  •  Enlarged breasts in men (gynecomastia).
  •  Small testicles in men.
  •  Looking and feeling flushed due to a high amount of red blood cells in the body.
  •  High levels of fat in the blood (cholesterol).


Couple of doctors performing a medical scan to a patient

How Is Liver Cancer Diagnosed?

This condition is diagnosed with a medical history and physical exam. You may also have tests, including:

  •  Blood tests.
  •  Imaging tests, such as:
    • CT scan.
    • MRI
    • Ultrasound
    • Bone scan.
  •  Laparoscopy. A small, lighted camera is used to look at your liver and other organs.
  •  Biopsy. Samples of tissue from the liver are taken and tested in a lab.

If liver cancer is confirmed, it will be staged to determine its severity and extent. Staging checks:

  • the size of the tumour.
  • if the cancer has spread.
  • where the cancer has spread.

How Is This Treated?

Treatment for this condition depends on the type and stage of the cancer, and your overall health. Treatment may include:

  •  Surgery to remove the cancer cells. Sometimes the entire liver is removed and replaced with a healthy liver (liver transplant).
  •  Chemotherapy. Medicines are used to kill the cancer cells.
  •  Targeted therapy. This targets specific parts of cancer cells and nearby areas to block the growth and spread of the cancer.
  •  Immunotherapy, also called biological therapy. This strengthens your body's immune system to destroy or stop the growth and spread of cancer cells.
  •  Radiation therapy. This uses high-energy X-rays to kill the cancer cells.
  •  Ablation. This destroys the tumour cells using high-energy radio waves, cold therapy, heat therapy, or a type of alcohol.
  •  Embolization. This is a procedure that blocks the blood flow to the tumour in the liver.
  •  Chemoembolization. This combines embolization with tiny beads that deliver chemotherapy directly to the site of the tumour.
  •  Radioembolization. This combines embolization with tiny beads that deliver radiation directly to the site of the tumour.

Follow These Instructions At Home:


  • Take over-the-counter and prescription medicines only as instructed by your health care provider.
  • Ask your healthcare provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.


  • Do not drink alcohol.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your healthcare provider.
  • Consider joining a cancer support group. Ask your health care provider for more information about local and online support groups. This may help you learn to cope with the stress of having liver cancer.

General instructions

  • Talk to your healthcare provider about the side-effects of treatment and the best way to manage them.
  • Keep all follow-up visits as instructed by your healthcare provider. This is important.

Female doctor write on clipboard

Contact A Healthcare Provider If:

  • you cannot eat because you feel nauseous or are vomiting.
  • you feel weaker or more tired than usual.
  • your pain gets stronger.
  • you feel depressed or anxious.

Get Help Right Away If:

  • you feel confused.
  • pain in your abdomen increases suddenly.
  • your abdomen or legs start to swell.
  • you have a fever, chills, or body aches.
  • you notice unusual bleeding or bleeding that does not stop quickly.
  • you have maroon, black, or bloody stools.
  • your eyes or skin become more yellow in colour.


These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (999 in the Malaysia). Do not drive yourself to the hospital.


  • Liver cancer is an abnormal growth of cells (tumour) in the liver that is cancerous (malignant).
  • Treatment for liver cancer depends on the type and stage of the cancer, and your overall health.
  • Talk to your healthcare provider about the side-effects of treatment and the best way to manage them.
  • Keep all follow-up visits as told by your healthcare provider. This is important.


This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your healthcare provider.



Almazroo O.A., Miah M.K., Venkataramanan R.: Drug metabolism in the liver. Clin Liver Dis 2017; 21: pp. 1-20.

Liu J., et. al.: A viral exposure signature defines early onset of hepatocellular carcinoma. Cell 2020; Published online June 9, 2020. https://doi.org/10.1016/j.cell.2020.05.038

Wolf E., et. al.: Utilization of hepatocellular carcinoma surveillance in patients with cirrhosis: a systematic review and meta-analysis. Hepatology 2020; Published online May 8, 2020. https://doi.org/10.1002/hep.31309

Yang J.D., et. al.: A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat. Rev. Gastroenterol. Hepatol. 2019; 16: pp. 589-604.


For more information on liver cancer, visit:

Ministry of Health Malaysia – Liver Cancer

National Cancer Council Malaysia

National Cancer Society Malaysia


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Calvin Leong

Written by Calvin Leong

Calvin Leong holds a Master in Medical Education from the University of Dundee, United Kingdom. He is certified in Clinical Wound Care by the ASEAN Wound Care Association. Calvin has 20 years of clinical and lecturing experience focusing on Mentoring in Healthcare, Traumatology and Medical Sciences. Calvin is HRDC certified trainer. He is also a Life Member of The Malaysian Association for the Study of Pain (MASP) and the Malaysian Society of Wound Care Professionals (MSWCP).

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