What are the main symptoms of advanced liver cancer? The 6 most common symptoms of advanced liver cancer

1. Pain in the liver area: More than half of the patients have pain in the liver area. The pain is equivalent to the location of the tumor, and it is mostly persistent distending pain or dull pain. Liver pain is caused by the rapid growth of the tumor, which pulls the liver capsule. If the lesion invades the diaphragm, the pain may involve the right shoulder. When the cancerous nodule ruptures, it may suddenly cause severe pain and symptoms and signs of peritonitis. If the amount of bleeding is large, it will cause syncope and shock.

2. Hepatomegaly: More than 90% of patients have an enlarged liver, which is progressive and hard in texture. It is uneven, has nodules or lumps of varying sizes, has blunt and irregular edges, and often has varying degrees of tenderness. When liver cancer protrudes under the right costal arch or xiphoid process, the upper abdomen may show local bulge or fullness. If the tumor is located on the diaphragmatic surface, the main manifestation is an elevation of the diaphragm and the lower edge of the liver may not be enlarged. Because the arteries of liver cancer are rich and tortuous, or because the huge tumor compresses the hepatic artery or abdominal aorta, the inner diameter of the artery suddenly narrows, and sometimes a blowing-like vascular murmur can be heard on the abdominal wall close to the tumor.

3. Jaundice: It usually occurs in the late stage and may be caused by liver cell damage, or by compression or invasion of the bile duct near the liver porta hepatis by the cancer mass, or by bile duct obstruction caused by the detachment of cancer tissue and blood clots.

4. Signs of cirrhosis: Patients with liver cancer and portal hypertension may have splenomegaly, ascites, and venous collateral circulation. The ascites increases rapidly and is usually transudate. Bloody ascites is often caused by cancer invading the liver capsule or rupturing into the abdominal cavity, and occasionally by peritoneal metastasis.

5. Systemic manifestations of malignant tumors: progressive weight loss, fever, loss of appetite, fatigue, malnutrition and cachexia. A small number of patients with liver disease may have special systemic manifestations, called paraneoplastic syndrome, with hypoglycemia and polycythemia being the most common, and other rare ones include hypercalcemia, hyperlipidemia, carcinoid, etc.

6. Symptoms of metastatic lesions: If metastasis occurs to the lungs, bones, chest cavity, etc., corresponding symptoms may occur. Chest cavity metastasis is more common on the right side, and there may be signs of pleural effusion. Bone or spinal metastasis may cause local tenderness or nerve compression symptoms, and intracranial metastatic cancer may have nerve localization signs.