--- title: "Liver cancer: Symptoms, Causes & Treatment | HealthAnswers" description: "Liver cancer — primary and secondary types, symptoms including jaundice and weight loss, diagnosis, and NHS treatment including surgery and locoregional…" url: https://healthanswers.co.uk/conditions/liver-cancer/ robots: noindex --- # Liver cancer: Symptoms, Causes & Treatment | HealthAnswers Health A–Z Liver cancer — primary and secondary types, symptoms including jaundice and weight loss, diagnosis, and NHS treatment including surgery and locoregional therapy. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is liver cancer? Liver cancer can start in the liver (primary — most commonly hepatocellular carcinoma) or spread from elsewhere (secondary metastases). In the UK, secondary liver cancer is more common than primary. Primary liver cancer is strongly linked to cirrhosis from hepatitis B or C, alcohol, and fatty liver disease. Symptoms include jaundice, upper abdominal pain, weight loss, and swelling of the abdomen. Treatment depends on cancer type, liver function, and spread. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Liver cancer, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 7 sections ## Key facts about liver cancer - Primary liver cancer (hepatocellular carcinoma) is closely linked to cirrhosis — often from hepatitis, alcohol, or fatty liver disease. - Secondary liver cancer — spread from bowel, breast, or lung cancer — is more common in the UK than primary liver cancer. - Jaundice, upper abdominal pain, unexplained weight loss, and abdominal swelling are key symptoms. - Diagnosis uses blood tests including AFP, ultrasound, CT, and MRI — biopsy confirms type. - Treatment ranges from surgery and liver transplant to ablation, chemoembolisation, and systemic therapy. ## Liver cancer — primary and secondary **Liver cancer** is not a single disease. **Primary liver cancer** starts in liver cells — **hepatocellular carcinoma (HCC)** accounts for most cases. **Secondary liver cancer** — **metastases** from cancers elsewhere — is actually **more common** in the UK than primary liver cancer. Understanding which type you have determines **treatment and outlook**. ## Primary liver cancer — hepatocellular carcinoma HCC almost always develops in a liver already damaged by **cirrhosis**. The cirrhosis may result from: - Hepatitis B or C — chronic viral infection - Alcohol-related liver disease - Non-alcoholic fatty liver disease (NAFLD) - Haemochromatosis — iron overload - Primary biliary cholangitis Without cirrhosis, HCC is uncommon but possible — particularly with hepatitis B infection. ## Symptoms Early liver cancer is often **silent** — especially in people used to living with chronic liver disease. As it progresses: - Jaundice — yellowing of skin and whites of eyes - Pain in the upper right abdomen - Unexplained weight loss and poor appetite - Abdominal swelling — ascites (fluid build-up) - Fatigue - Nausea Anyone with **known cirrhosis** should have **6-monthly ultrasound surveillance** — early HCC is treatable; late HCC is much harder to manage. ## Diagnosis - Blood tests — liver function, clotting, AFP tumour marker - Ultrasound — first-line imaging; surveillance tool - CT or MRI with contrast — characterises lesions using LI-RADS criteria - Biopsy — when imaging is inconclusive - Staging — tumour size, vascular invasion, spread, liver function ## Treatment for primary liver cancer Treatment depends on **cancer stage**, **liver function**, and **overall fitness**. **Curative options (early disease, good liver function):** - Surgical resection — removing the tumour - Liver transplantation — selected patients within Milan criteria - Ablation — radiofrequency or microwave destroying small tumours **Locoregional therapy:** - Transarterial chemoembolisation (TACE) — chemotherapy delivered directly to the tumour - Selective internal radiation therapy (SIRT) **Systemic therapy (advanced disease):** - Sorafenib, lenvatinib — targeted drugs - Atezolizumab plus bevacizumab — immunotherapy combination - Best supportive care — symptom management ## Secondary liver cancer When cancer spreads to the liver from **bowel, breast, lung, or pancreas**, treatment follows the **primary cancer pathway**. Selected patients with bowel cancer metastases limited to the liver may be offered **surgical resection** or **ablation**. ## Prevention - Treat hepatitis B and C — antiviral therapy reduces cirrhosis and HCC risk - Limit alcohol — stay within UK guidelines (no more than 14 units weekly) - Manage fatty liver disease — weight loss and diabetes control - Attend surveillance if you have cirrhosis See [liver cirrhosis](https://healthanswers.co.uk/conditions/liver-cirrhosis/) for how chronic liver damage develops and [hepatitis](https://healthanswers.co.uk/conditions/hepatitis/) for viral liver infection management. ## ! When to see a GP about liver cancer See a GP if you develop yellowing of the skin or eyes (jaundice), persistent pain in the upper right abdomen, unexplained weight loss, swelling of your abdomen, or feel very unwell with known liver disease. If you have cirrhosis or chronic hepatitis, attend all recommended surveillance appointments — regular ultrasound every 6 months detects early liver cancer. Urgent assessment for new jaundice or severe abdominal pain. ## Common questions about liver cancer What is the difference between primary and secondary liver cancer? Primary liver cancer starts in the liver — hepatocellular carcinoma (HCC) is the most common type. Secondary liver cancer (liver metastases) has spread from another organ such as the bowel, breast, lung, or pancreas. Treatment differs significantly — secondary cancer is treated according to where it originated. What are the symptoms of liver cancer? Early liver cancer may cause no symptoms. As it grows, signs include jaundice (yellow skin and eyes), pain in the upper right abdomen, unexplained weight loss, loss of appetite, nausea, swelling of the abdomen from fluid (ascites), and fatigue. Symptoms may develop gradually in people with existing liver disease. What causes primary liver cancer? Most primary liver cancers develop in livers already damaged by cirrhosis. Causes of cirrhosis include long-term hepatitis B or C infection, heavy alcohol use, non-alcoholic fatty liver disease, haemochromatosis, and primary biliary cholangitis. Without cirrhosis, primary liver cancer is less common but can still occur. How is liver cancer diagnosed? Blood tests assess liver function and AFP (alpha-fetoprotein) — a tumour marker. Ultrasound, CT, and MRI characterise lesions. Biopsy or imaging criteria confirm diagnosis. Staging considers tumour size, liver function (Child-Pugh score), and spread. Can liver cancer be cured? Early hepatocellular carcinoma in patients with well-preserved liver function may be cured with surgical resection, liver transplant, or ablation. Advanced disease is harder to cure but treatments including transarterial chemoembolisation (TACE), targeted drugs such as sorafenib, and immunotherapy can extend survival. Who needs liver cancer surveillance? People with cirrhosis — from any cause — should have ultrasound every 6 months to detect early liver cancer when treatment is most effective. This includes people with hepatitis B or C, alcohol-related liver disease, and advanced fatty liver disease. How is secondary liver cancer treated? Treatment depends on the primary cancer type. Options may include chemotherapy, targeted therapy, immunotherapy, or in selected cases surgery to remove liver metastases — particularly from bowel cancer with limited spread. ## Sources - [NHS — Liver cancer](https://www.nhs.uk/conditions/cancer-of-the-liver/) - [NICE — Hepatocellular carcinoma](https://www.nice.org.uk/guidance/ng145) - [NHS — Cirrhosis](https://www.nhs.uk/conditions/cirrhosis/)