AARP Hearing Center
What to Know About Liver Cancer: Causes, Symptoms and Treatments
Rates of the life-threatening disease are increasing in the U.S.
VIDEO: Why Are Liver Cancer Rates Rising?
In the last four decades, rates of liver cancer have tripled in the U.S. This year alone, an estimated 42,340 new cases will be diagnosed, according to the American Cancer Society.
Heavy drinking is a well-known risk factor for the disease. But experts say a lesser-known driver is playing a bigger role in rising rates: obesity. Research shows that the increase in U.S. liver cancer diagnoses closely tracks with growing obesity levels.
More Ways to Benefit
- Related Benefit 1
- Related Benefit 2
- Related Benefit 3
- Related Benefit 4
- Related Benefit 5
“A common myth is that only alcohol can damage the liver, but the truth is that fat buildup can also do it,” says Dr. Ani Kardashian, a hepatologist with Keck School of Medicine at the University of Southern California. A swift uptick in obesity rates has led to a “significant rise in the prevalence of fatty liver disease,” also known as metabolic dysfunction-associated steatotic liver disease, or MASLD, she adds.
A study published recently in The Lancet found that the rate of MASLD-linked liver cancer is expected to climb over the next decade; by 2040, more than 55 percent of adults in the U.S. could have MASLD (formerly known as nonalcoholic fatty liver disease), the study estimates.
“MASLD refers to a state where there is fat without inflammation or scarring, and while it is considered an abnormal liver condition, by itself it doesn’t raise the risk of liver cancer significantly,” explains Dr. Scott Friedman, director of the Institute for Liver Research at the Icahn School of Medicine at Mount Sinai. “However, when MASLD develops into metabolic dysfunction associated steatohepatitis (MASH), which occurs in approximately 20 percent of patients with MASLD who develop inflammation and scarring, then the risk of liver cancer rises with progressive scarring of the liver.”
Keep reading to learn more about liver cancer, including its causes, symptoms, treatment, and what you can do to lower your risk for the disease.
Types of liver cancer
The overwhelmingly most common type of primary liver cancer — meaning cancer that starts in the liver itself — is hepatocellular carcinoma (HCC), which is often linked to long-term liver damage from hepatitis B and C, or cirrhosis (scarring) of the liver caused by heavy drinking.
The second most common type of liver cancer is intrahepatic cholangiocarcinoma (ICC), which occurs in the liver’s bile ducts. The survival rates of both HCC and ICC are extremely low: Only 1 in 5 people with HCC or ICC are alive five years after they’ve been diagnosed.
Secondary liver cancer is cancer that originates elsewhere — like in the colon, breast, pancreas, stomach or lung — and then spreads (or metastasizes) to the liver. Although the cancer is in the liver, it’s still classified by its original location; for example, if colon cancer spreads to the liver, it’s called metastatic colorectal cancer, not liver cancer.
Secondary liver cancer is more commonly diagnosed than primary liver cancer, says Kardashian. “This is because the liver filters a large volume of blood, which allows cancer cells from other parts of the body to easily travel to the liver and establish tumors there.”
Common causes of liver cancer
If severe enough, fatty liver can lead to cirrhosis, a condition in which liver cells are damaged and then replaced by scar tissue, which prevents the liver from functioning properly, says Kardashian. “Cirrhosis of the liver is one of the biggest risk factors for liver cancer, and fatty liver is one of the most common causes of cirrhosis in the U.S.”
Indeed, the overwhelming majority of adults in the U.S. who are diagnosed with liver cancer have cirrhosis, usually from MASLD, chronic hepatitis B or C infections, if not from excessive alcohol consumption.
Signs and symptoms of liver cancer
A tell-tale sign that something’s amiss with the liver: jaundice, which is caused by the buildup of a yellow pigment found in bile known as bilirubin. Damage to the liver can diminish its ability to process and remove bilirubin, causing the whites of the eyes and skin to take on a yellowish tint.
Bloating, unexplained weight loss and loss of appetite, pain in the upper right abdomen (just below the rib cage), unusual fatigue, abnormal bruising, pale bowel movements and dark urine are also tip-offs. But these common symptoms don’t usually appear until cancer has advanced to later stages. That’s why liver cancer is often called a silent killer; there are often no symptoms in the early stages.
“Most early-stage liver cancers are found either incidentally or through routine screening for high-risk individuals [like] those who have cirrhosis or viral hepatitis,” says Kardashian. That’s why “it’s important for those at high risk to undergo regular screening with imaging of the liver to catch the cancer early when curative treatment is possible.”
Treatments for liver cancer
The goal of treatment depends on the size and features of the cancer. Liver cancer that’s diagnosed at an early stage has a good chance of being cured with surgery, ablative techniques that destroy tumors without surgery, chemotherapy or a liver transplant.
“Larger cancers that are not curable by surgery can be treated with a growing list of advanced cancer therapies,” says Friedman. “Even with patients who have incurable liver cancer, the quality and length of life can be prolonged with effective treatments.”
Is liver cancer preventable?
Most cases are. Indeed, The Lancet study found that 3 in 5 cases of liver cancer could be prevented by reducing its major causes: hepatitis B, hepatitis C, alcohol consumption e and MASLD.
“Liver cancer almost never arises in patients with a completely normal liver,” notes Friedman, adding that the key to prevention is to have regular screenings if you’re at risk. “Any patient with underlying inflammation or scarring, particularly if advanced, needs to be screened with blood and imaging tests every six months to exclude the presence of early cancer.”
Many patients with obesity-associated liver disease (specifically, MASH) will be candidates for new therapies to prevent the progression of liver disease and reduce the risk of liver cancer, he adds. As for alcohol-associated liver disease, “there are no specific medical treatments apart from abstinence, which is critically important to improve the prospects for a normal life, free of liver disease and risk of cancer.”
Other lifestyle changes can also play a significant role. In addition to avoiding alcohol, giving up cigarettes, losing weight, eating a healthy diet and exercising regularly can go a long way toward reversing MASLD. A recent study published in The New England Journal of Medicine found that taking the weight-loss medication semaglutide can also help reverse scarring. (The U.S. Food and Drug Administration recently approved Wegovy to treat MASH, the most serious form of MASLD.)
AARP Membership
Join AARP for only $15 per year with automatic renewal. Get instant access to members-only products and hundreds of benefits, a free second membership, and a subscription to AARP The Magazine.
More From AARP
The 9 Worst Habits for Your Liver
What you eat and drink, and how much you move can affect the health of your liver
More Americans are Surviving Cancer
Advancements in screening and treatments are impacting many older adults