The liver is located at the top right of your abdomen, above and alongside your stomachLiver cancer is cancer in any part of the liver. The liver is a large organ on the top right side of your tummy. It helps the body to digest food and remove toxins. 

About liver cancer

Liver cancer develops due to an accumulation of changes in the DNA of the cells in the liver. (DNA is the genetic material that tells cells what to do.) As these faulty cells divide and multiply, they eventually cause a cancer. 

Cancer that starts in the liver is called primary liver cancer. This page is about primary liver cancer. 

Anyone can get primary liver cancer but you may be more at risk if you:

  • Are aged 60 or over – liver cancer is most people in people aged over 85
  • Are a man
  • Have certain medical conditions such as hepatitis, liver cirrhosis, gallstones, diabetes, a parasite in the liver (liver flukes) or HIV
  • Have a brother, sister or parent who had primary liver cancer 

You can reduce your risk by:

  • Losing weight if you are overweight
  • Stopping smoking
  • Reducing alcohol intake
  • Wearing protective clothing and masks if your job means you are exposed to harmful chemicals 

Sometimes cells from cancer in other parts of the body can spread to the liver. If you have cancer that spread to your liver from another part of your body, your treatment will be based on that cancer type. 

For example, if your cancer started in your breast and spread to your liver – read our breast cancer pages for information about how we will care for you. 

Symptoms of liver cancer may not be obvious. 

Symptoms can include:

  • Whites of your eyes turning yellow or your skin turning yellow (jaundice) – this may be less obvious on brown or black skin
  • Itchy skin, darker pee and paler poo than usual
  • Loss of appetite or losing weight without trying
  • Feeling tired or having no energy
  • Feeling generally unwell or having flu-like symptoms
  • Lump in the right side of your tummy

Sometimes liver cancer can affect your digestion and cause symptoms including:

  • Feeling or being sick
  • Pain at the top right side of your tummy or in your right shoulder
  • Feeling full very quickly when eating, heartburn, burping or farting
  • Swollen tummy not related to when you eat

It is important to see a health professional if you have symptoms or changes in your body that are unusual for you.

Ask for an urgent GP appointment, call 111 or visit 111.nhs.uk if:

  • Your skin or the whites of your eyes turn yellow
  • You're being sick for more than 2 days

 See a GP if:

  • You have a lump in your tummy
  • You have lost a lot of weight without trying
  • You have symptoms of liver cancer that get worse or do not get better after 2 weeks

Treatment depends on a range of factors including the type, size, stage and location of your tumour. It may also depend on your age, general health and genetic factors (linked to the DNA changes in your cells) that tell us how your cancer developed. 

Treatment options can include one or more of the following:

  • Surgery – this may be before, during or after other treatments
  • Drug therapies such as targeted treatment and immunotherapy. The general term for these is systemic anti-cancer therapies (SACT)
  • Radiotherapy
  • Minimally invasive procedures that targets the tumour directly (known as ‘locoregional treatments’). These include TACE (small beads of chemotherapy injected in specific blood vessels in the liver) and radiofrequency ablation (a needle being put into the tumour and killing the cancer cells by heating them up). These types of treatments are given at other hospitals that we collaborate with

When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider the best treatment options for you. Your doctor will discuss this with you so you can decide what is right for you.

Sometimes it might be decided that none of the above treatment options are appropriate for you, usually if your disease is very advanced. Your care will be palliative – concentrating on your quality of life and symptom management – and will be led by your community team of your GP, district nurses and palliative care team. 

Genomics and cancer

Genomics is the study of a person’s genes (or ‘genome’) – the material in DNA that makes each person unique. Cancer is caused by changes in the DNA of a cell and tell it to multiply out of control. 

Understanding where this change has occurred – for example, which gene is faulty – can help us know which treatment will give you the best chance of killing the cancer cells and stopping new ones from growing. 

Your clinical team will explain this to you in more detail at your appointment. 

Our treatments

At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for liver cancer. We also work closely with liver specialists and surgical teams in other hospitals to plan and coordinate your care every step of the way. 

Systemic anti-cancer therapy (SACT)

SACT is a term used to describe the different drug therapies for cancer. These include: 

  • Immunotherapy – which aims to train your immune system to attack cancer. In primary liver cancer, immunotherapy is often combined with another drug that stops the blood vessels around the cancer from forming. 
  • Targeted therapies – which aim to target the DNA and cell changes that cause cancer. 

The treatments we offer for liver cancer include:

Systemic treatment

You might have systemic treatment for liver cancer that cannot be removed or has come back (recurrence). This includes cases where previous treatment such as chemoembolisation (TACE) or radiofrequency ablation (RFA) has failed. The aim of the systemic treatment is to try to control the cancer, slow its growth and to relieve any symptoms you may have.
 
Because different cancers are sensitive to different drugs, everyone’s treatment plan is designed according to the specific type of cancer. Your general health and fitness is also important when deciding on your treatment plan. 

Targeted therapies

In primary liver cancer, tablets with drugs that target specific molecules in the cancer cells can be given to slow down the growth of the cancer. These treatments are called tyrosine kinase inhibitors (TKIs) as they target a specific molecule linked with receptors in the cell membrane of the cancer cell.

Immunotherapy 

You might have immunotherapy if you have locally advanced or advanced (metastatic) liver cancer. Immunotherapy might be combined with another treatment that stops blood vessels from forming around the cancer. 

For more information on immunotherapy click here.

All treatment options will be discussed with you at your outpatient appointment.

Note: Most drugs are processed by the liver. If you have underlying liver disease, such as cirrhosis, this might mean these treatments will not be appropriate for you. 

Find out more about systemic anti-cancer therapy at The Clatterbridge Cancer Centre. 

Radiotherapy

Radiotherapy can be used to treat liver cancer. Sometimes radiotherapy is given instead of surgery. Sometimes it is used to shrink the tumour before, during or after other treatment. Sometimes it is used to relieve symptoms such as pain. 

We use different types of radiotherapy, depending on the type, size, location and stage of the cancer. 

The radiotherapy treatments we offer for liver cancer include:

  • Traditional external beam radiotherapy – where radiation is delivered from outside the body
  • Stereotactic ablative radiotherapy (SABR) – a way of very precisely targeting radiotherapy to certain cancers

Find out more about radiotherapy at The Clatterbridge Cancer Centre. 

Clinical trials

Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.

You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have. 

Find out more about clinical trials. 

Treatment locations

We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes. 

We provide systemic anti-cancer therapies (e.g. chemotherapy, targeted therapies and immunotherapy) for breast cancer at the following sites:

We provide radiotherapy for liver cancer in two of our specialist sites: 

Clinical trials for liver cancer are delivered at most of our sites. Some trials may only be available at our main hospital: Clatterbridge Cancer Centre – Liverpool.   

The team consists of medical oncologists, advanced nurse practitioners, clinical nurse specialists, radiographers, pharmacy, research practitioners and administrative support. 

Our operational management team makes sure the service runs smoothly.

Consultants 

Medical Oncologists

Professor Dan Palmer
Dr Olusola Faluyi
Dr Nils Elander

Nurses 

Advanced Nurse Practitioners

Sarah Stevenson
Diane Foster

Clinical Nurse Specialists

Abbey Phudaphatt
Alison Griffin

Cancer Support Worker

Sarah Wallace

Other team members

Dietitian

Lauren Roberts
 

HPB nursing and support team

Virtual tour of Radiotherapy unit (CCC-Liverpool)

Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support and information about liver cancer include: