An adult liver is about the size of a football. It’s the largest internal organ in your body. It’s located in the right upper quadrant of your abdominal cavity, just above your stomach and below your diaphragm.
Your liver is vital to your body’s metabolic functions and immune system. Without a functioning liver, you cannot survive.
There are many types of diseases that can affect the liver. One of these is cancer. When cancer develops in the liver, it destroys liver cells and interferes with the ability of the liver to function normally.
Hepatocellular carcinoma is the most common type of liver cancer. Other types, such as hepatoblastoma and intrahepatic cholangiocarcinoma, occur far less often. It’s more common that cancer in the liver is cancer that has spread (metastasized) from another part of the body such as the lung, colon or breast.
Liver cancer pain is commonly focused on the top right of the abdominal area, near the right shoulder blade. The pain can sometimes extend into the back. It can also be felt in the lower right portion of the rib cage.
The pain might be accompanied by swelling in the abdomen and in the legs and ankles. This type of swelling can also cause discomfort.
People with liver cancer or cancer that has spread to the liver can experience pain from numerous sources, including:
- Tumors. The pain associated with liver cancer can be caused by a tumor or tumors in the liver.
- Capsule stretching. Stretching of the capsule around the liver can cause discomfort.
- Referred pain. Discomfort can also come from referred pain caused by the enlarged liver putting pressure on the nerves under the diaphragm. This may result in pain in the right shoulder, because some of the nerves under the diaphragm connect to nerves there.
- Treatment. Pain can be the result of treatment. Cancer medications have been known to cause gastrointestinal discomfort and nausea. Also, surgery (if it has been performed) can cause postoperative pain.
- Underlying causes. If liver cancer has been caused by cirrhosis, sometimes the pain is not from the tumor, but from the cirrhosis.
Treatment of pain associated with liver cancer can take many forms.
Pain medicines are commonly given orally or intravenously. For liver metastases, common pain medications include:
- opioids such as morphine, tramadol and oxycodone
- corticosteroids such as dexamethasone
- nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil)
Radiation can shrink a tumor and relieve some or all of the pain it is causing.
Sometimes liver cancer pain can be relieved or reduced by an injection of a local anesthetic into or near nerves in the abdomen.
Some people with severe liver cancer pain turn to complementary therapies to address their pain. The Mayo Clinic suggests that you ask your doctor about complementary treatments such as:
- deep breathing
- music therapy
Pain is a common side effect of liver cancer and liver cancer treatment. It’s important to talk with your doctor and ask for information on the options they have to ease your pain.
Tell them about the location of the pain, its intensity, what seems to make it better, and what seems to make it worse. Also think how you might describe it. Stabbing? Burning? Sharp? Dull?
Talking openly with your doctor about your pain can help them make treatment decisions that help with your recovery and lessen your discomfort.