When the liver is injured, it works hard to repair itself by making new cells. Sometimes, changes (mutations) can happen in the genes during this process. Over time, these changes can lead to cells overgrowing out of control and may result in the growth of a tumour. Liver cancer begins with the formation of a malignant tumour and can, over time, grow larger and spread from more than one site in the liver.
- Primary liver cancer: Primary liver cancer starts in the liver. The most common type is hepatocellular carcinoma (HCC).
- Secondary (metastatic) liver cancer: Secondary liver cancer starts in another organ (like the colon or lungs) and spreads to the liver. This is 20–40 times more common than primary liver cancer.
what are liver tumours?
A liver tumour is a mass or growth in the liver that results when liver cells begin to grow in an abnormal way. The liver has the incredible capacity to regenerate, which is why abnormal growths can occur relatively easily. Liver tumours are often discovered during routine medical tests, even before any symptoms appear. If symptoms do develop, they may include discomfort or pain in the abdomen, fatigue, or swelling. Healthcare teams often use blood tests, imaging scans, and biopsies to detect a tumour and guide treatment decisions.
Types of tumours
Benign (non-cancerous) liver tumours:
Hemangioma: The most common benign tumour. They almost never turn into cancer and rarely need treatment unless they grow large, cause discomfort, or cause complications.
Hepatic Adenoma: A rare growth often linked to hormonal treatments. It may cause mild discomfort and occasionally requires surgery if it grows or carries risk.
Focal Nodular Hyperplasia (FNH): The second most common benign tumour. It usually has no symptoms and typically doesn’t need treatment unless it grows or causes discomfort.
Malignant (cancerous) liver tumours
Hepatocellular Carcinoma (HCC): The most common primary type of liver cancer, often developing after long-term liver damage. It may not show symptoms early on, and if detected promptly, treatment can be effective.
Cholangiocarcinoma (Bile Duct Cancer): Begins in the bile ducts and may cause jaundice, abdominal pain, itching, or weight loss. Treatment may include surgery or specialized drug therapies.
Hepatoblastoma: A rare liver cancer affecting babies and young children. It presents with belly pain, a swollen abdomen, and unexpected weight loss. It’s highly treatable with chemotherapy and surgery when caught early.
What causes liver cancer?
- Hepatitis B/D or C infections: Chronic (long-term) infection causes liver inflammation which can lead to cirrhosis and cancer.
- Cirrhosis: Scarring from hepatitis, heavy alcohol use, or other chronic liver conditions increases the risk of developing liver cancer.
- MASLD or MASH: Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) happens when fat accumulates in the liver. Over time, this can lead to swelling, and even scarring which increases risk of liver cancer.
- Heavy alcohol use: Long-term drinking can lead to cirrhosis and cancer. Individuals with alcohol-related liver disease are more likely to develop primary liver cancer.
- Smoking: Your liver filters everything that you breathe in, so smoking increases exposure to harmful chemicals that damage the liver and can cause liver cancer.
- Exposure to harmful chemicals: Certain toxic substances, like aflatoxins (from moldy food), or industrial chemicals can damage the liver and increase the risk of developing cancer.
- Genetic conditions: Rare diseases, like hemochromatosis, can harm the liver over time and increase the risk of developing liver cancer.
