Primary liver cancer is cancer that starts in the liver and is either Hepatocellular Carcinoma or Intraductal Cholangio Carcinoma.


Risk factors

Most liver cancers occur around the age of 60-85 years. It is common in Asians especially Chinese males. Other risk factors include:

  • Previous infection from Hepatitis B or Hepatitis C
  • Excessive alcohol consumption
  • Severe fatty liver disease
  • Liver scarring (cirrhosis)
  • Iron overload disease such as haemaochromatosis or alpha 1 antitrypsin deficiency
  • Being overweight or obese
  • Family history


Most symptoms come late when the cancer has progressed. These symptoms include:

  • Unexplained weight loss
  • Yellowing of the skin or white of the eyes (called jaundice)
  • Loss of appetite or energy (easily tired)
  • Itching of the whole body
  • Pain or discomfort of the right side of your abdomen
  • Pain or discomfort on the right side of your shoulder
  • Swollen tummy (ascites)


You will need to do some tests to be able to get the diagnosis of cancer type, to stage the cancer (to see if there is cancer spread outside the liver) and to plan for treatment:

  • Blood tests (blood count, liver function, Hepatitis virus serology, cancer markers)
  • Ultrasound liver (and maybe liver biopsy)
  • MRI / CT scan
  • PET scan

Treatment Options

The treatment depends on many factors such as type and stage of cancer, where the cancer is located, the severity of the disease and how much normal liver function is present. The options include:

  • Surgery (liver resection)
  • Local ablation therapy (Radio Frequency Ablation, Micro Wave Ablation, Cryotherapy or HIFU)
  • Locoregional Chemo / Radio Therapy (Trans Arterial Chemo Embolisation or SIRT)
  • Systemic Chemotherapy
  • Systemic Targeted Cancer Drugs such as Sorafenib (Nexavar) or Lenvatinib (Lenvima)


If you have risk factors mentioned above, you should take steps to live a healthier lifestyle.

  • Avoid excessive alcohol intake
  • Take Hepatitis B vaccination
  • Eat healthy and do regular exercise to get into your ideal weight range
  • If you’re are a Hepatitis B or C carrier, do blood tests and liver ultrasound regularly (twice yearly)
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