What are the early symptoms of liver cancer? Five major symptoms of early liver cancer

1. Symptoms

Early liver cancer may have no symptoms or signs. Once typical clinical manifestations appear, it is already in the middle or late stage of liver cancer. Common symptoms of liver cancer include: pain in the liver area, poor appetite, weight loss, fatigue, unexplained fever, abdominal distension, diarrhea, jaundice, etc.

1. Pain in the liver area

It is often caused by the rapid growth of liver tumors, which increases the tension of the liver capsule, or the tumor involves the liver capsule. It is often the first symptom of mid-to-late stage liver cancer. The pain is mostly located in the right ribs or under the xiphoid process. At the beginning, it is mostly intermittent or continuous dull pain or stabbing pain. The pain may be mild or severe, or it may be relieved by itself within a period of time, or even disappear. The pain is often obvious at first, and sometimes analgesics are required. If the tumor is located at the top of the diaphragm of the right lobe of the liver, the pain can often radiate to the right shoulder or right back; if the tumor is located in the left lobe of the liver, distension and pain in the upper abdomen will appear earlier; when the tumor is located in the empty part of the right lobe of the liver, pain is generally rare. If the pain in the liver area suddenly intensifies, accompanied by tenderness or positive muscle guarding signs, it should be considered that the liver has ruptured or the tumor has bled under the liver capsule.

2. Digestive tract symptoms

Common symptoms include decreased appetite, upper abdominal fullness after meals, or even nausea, vomiting, or diarrhea. Digestive tract symptoms are often caused by pathological changes in the liver, which lead to increased portal vein system pressure and digestive tract dysfunction; or by enlarged tumors compressing or involving the stomach.

3. Weight loss and fatigue

It often occurs in the middle and late stages of liver cancer. It may be caused by tumor metabolites causing changes in the body's biochemical metabolism, coupled with reduced food intake. In severe cases, cachexia may occur.

4. Fever

The fever caused by liver cancer is generally around 37.5℃～38℃, occasionally reaching above 39℃, with irregular fever pattern, usually without chills, and more common in the afternoon, sometimes with remittent high fever. Fever can be caused by tumor necrosis or its metabolites.

5. Other symptoms

Patients with hepatitis, cirrhosis or large infiltrative tumor growth leading to liver decompensation may have a tendency to bleed, such as gum and nose bleeding and subcutaneous ecchymosis; hypoproteinemia may also occur, leading to edema, ascites, abdominal distension, etc. Tumor metastasis to the lungs may cause coughing. When the tumor invades and blocks the hepatic vein or inferior vena cava, progressive lower limb edema may occur, and even ascites and other manifestations of Budd-Chiari syndrome may occur.

2. Physical signs

Hepatomegaly and upper abdominal masses are characteristic signs of mid- to late-stage liver cancer. Patients with late-stage liver cancer or cirrhosis may also have jaundice, ascites, splenomegaly, lower limb edema, liver palms, spider nevi, varicose veins of the abdominal wall, etc.

1. Hepatomegaly

Liver cancer in the upper right lobe of the liver is manifested by the upper border of the liver shifting upward, the diaphragm being fixed and restricted in movement; liver cancer in the lower right lobe is often found at the lower angle of the right costal arch and a mass; liver cancer in the left lobe is often manifested by a mass under the xiphoid process or a bulge in the upper abdomen. The texture of an enlarged liver is generally hard, but if necrosis and liquefaction or intratumoral bleeding occurs, the texture becomes soft or cystic.

2. Ascites

It is a sign of advanced liver cancer. If it is caused by cold blockage of the hepatic vein or portal vein, it is high-tension ascites, which is manifested by rapid growth of ascites, tympanic percussion sound on the abdomen, and full and distended abdomen. If it is caused by cirrhosis, the tension is lower. If there is hepatic vein or inferior vena cava obstruction or hypoproteinemia, it may be accompanied by lower limb edema. If it is a ruptured liver cancer nodule with ascites, it is often bloody and accompanied by abdominal tenderness. If it is caused by cancer invading the peritoneum, it is cancerous ascites. When the amount of ascites is large or there is liver cancer under the right diaphragm, there may be right-sided pleural effusion.

3. Jaundice

The manifestation of yellowing of the sclera and/or skin is a late-stage sign of liver cancer. It is usually caused by direct compression or invasion of the gallbladder, common bile duct, etc. by the cancer, or damage to liver cells.

3. Paraneoplastic syndrome

Paraneoplastic syndrome is usually caused by the liver cancer tissue itself producing and secreting certain ectopic hormones that cause abnormal metabolism of the body, including hypoglycemia, polycythemia, hypercalcemia, hyperfibrinogenemia, etc. Other paraneoplastic syndromes include hyperlipidemia, thrombocytosis, porphyria cutanea, hyperglycemia, etc.

4. See Complications

Many complications often occur in the late stage of liver cancer, the most common of which include upper gastrointestinal bleeding, hepatic encephalopathy, liver and kidney failure, rupture and bleeding of huge tumors, and cancerous pleural effusion and ascites, which are often life-threatening.