Liver cancer is cancer that begins in the liver. If the cancer has metastasized, that means it has spread outside of the liver.

The most common form of liver cancer is hepatocellular carcinoma (HCC). This cancer starts in liver cells called hepatocytes.

Other rare liver cancers include angiosarcomas and hemangiosarcomas. These cancers start in the cells that line the liver’s blood vessels. Another type of liver cancer called hepatoblastoma usually strikes children under age 4.

When cancer starts in the liver, it’s considered primary liver cancer. Other types of cancer can spread to the liver, but they’re not liver cancer. These are called secondary liver cancers. Secondary liver cancer is more common than primary liver cancer in the United States and Europe.

You may not have symptoms at first. As the disease progresses, you may experience:

  • a lump on the right side of your abdomen
  • abdominal pain
  • bloating
  • pain near your right shoulder
  • loss of appetite
  • nausea
  • weight loss
  • fatigue
  • weakness
  • a fever
  • dark-colored urine
  • yellowing of the skin and eyes, or jaundice

The symptoms of metastasis depend on where new tumors form. If you’ve ever been diagnosed with liver cancer, be sure to report all unexplained symptoms to your doctor.

Abnormal cells usually die off and are replaced by healthy cells. Sometimes, instead of dying off, the cells reproduce. As the cell numbers grow, tumors begin to form.

The overgrowth of abnormal cells can invade nearby tissue. By traveling through lymph or blood vessels, the cancerous cells can move all around the body. If they invade other tissues or organs, new tumors can form.

If the cancer invades nearby tissue or organs, it’s considered “regional spread.” This can happen during stage 3C or stage 4A liver cancer.

In Stage 3C, a liver tumor is growing into another organ (not including the gallbladder). A tumor could also be pushing into the outer layer of the liver.

In Stage 4A, there are one or more tumors of any size in the liver. Some have reached blood vessels or nearby organs. Cancer is also found in nearby lymph nodes.

Cancer that has metastasized to a distant organ, such as to the colon or lungs, is considered stage 4B.

In addition to telling how far the cancer has spread, staging helps determine which treatments may be beneficial.

You’re at higher risk of developing liver cancer if you’ve had other diseases of the liver. These can include cirrhosis, hepatitis B, and hepatitis C.

You’re also at greater risk of getting liver cancer if you have a family history of it or if you’re obese and have fatty liver disease. Men tend to be diagnosed with liver cancer more often than women.

After a physical exam, you may need a series of tests to help your doctor arrive at a diagnosis.

Blood tests, such as an alpha-fetoprotein (AFP) test, can screen for liver problems. The test measures the amount of AFP present in the blood. AFP is typically elevated in people with liver cancer. Testing AFP levels can also help determine treatment options and monitor for recurrence.

Imaging tests, such as ultrasound, CT scan, and MRI, can locate tumors. If a mass is found, a biopsy can help your doctor determine if it’s cancer.

There’s no cure for advanced liver cancer, but treatment can help slow its spread and ease symptoms. Your doctor will recommend a treatment based on how many tumors are found and where they are. If there are too many tumors or they’re difficult to get to, you’ll have fewer options. Other key factors to consider include any previous treatments you’ve had, the health of your liver, and your overall health.

Treatments for metastatic liver cancer can include the following:

  • Chemotherapy may be used to destroy cancer cells throughout your body.
  • Radiation may also be used to treat targeted areas.
  • Ablation and embolization are more common forms of local therapy.
  • Sorafenib is a medication approved to treat metastatic liver cancer. It works by blocking growth signals and new blood vessel formation.

You may also need medications to deal with pain, fatigue, and other symptoms.

Whatever treatment you choose, side effects can be expected. Don’t hesitate to ask questions and to speak openly with your doctor about anything that’s affecting your quality of life.

Your oncologist may also be able to provide information on clinical trials.

Dealing with metastatic liver cancer can be physically and emotionally overwhelming. You may need supportive care to help you cope. Your medical team can refer you to local support groups and organizations that offer assistance.

The five-year relative survival rate for people with regional spread, or stage 3, is 7 percent. If you have distant spread, or stage 4, this rate is 2 percent.

Certain factors contribute to this outlook. Many people with metastatic liver cancer also have other liver conditions such as cirrhosis. Having cirrhosis can make your outlook worse.

You should also keep in mind that these are general figures. To get a better idea of your personal outlook, speak to your oncologist.

You can’t control all risk factors, but there are a few things you can do to lower your risk. You can do the following:

  • Get vaccinated for hepatitis B virus.
  • Get tested for hepatitis C virus. If you test positive, ask your doctor if treatment is an option.
  • Get regular checkups if you have any kind of liver disease. Follow your doctor’s recommendations.
  • Tell your doctor if you have a family history of liver cancer or other risk factors for liver cancer.
  • Eat right and exercise regularly to maintain a healthy weight.
  • Drink alcohol only in moderation. If you have cirrhosis of the liver due to a drinking problem, ask your doctor for help in quitting.

If you’ve been treated for liver cancer before, it’s important to tell your doctor about any symptoms you may have. These lifestyle changes may help prevent a recurrence.