A Guide to Liver Cancer: Types, Symptoms, Diagnosis & Treatment Approaches

Liver cancer has emerged as a major public health concern, with increasing incidence driven by chronic viral hepatitis, fatty liver disease, alcohol abuse, and metabolic disorders. As early symptoms of liver cancer could be mild or overlooked, many cases are detected at later stages, limiting treatment options. Therefore, increasing awareness about the disease, especially among high-risk groups, is important to support earlier diagnosis, which can greatly improve long-term outcomes. To help patients and families understand the condition better, this guide outlines the common types of liver cancer, early warning signs, diagnostic methods, and treatment approaches.

What is Liver Cancer?

Liver cancer is a condition in which abnormal cells grow within the liver and disrupt its essential functions, including detoxification, metabolism, and nutrient processing. The disease may appear as a single tumour or as multiple nodules, depending on the underlying liver condition. Because the liver can maintain many of its functions despite internal damage, early-stage disease may not cause noticeable symptoms, which is why regular evaluation is important for high-risk individuals.

Doctors classify liver cancer into two broad categories.

• Primary liver cancer , which begins in the liver’s own cells and includes hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
• Secondary liver cancer occurs when cancers from other organs, such as the colon, breast, or lungs, spread to the liver.

Understanding this distinction helps guide the diagnostic approach and influences treatment planning. Individuals with chronic liver disease, hepatitis infections, or cirrhosis especially benefit from regular monitoring, as early detection offers the best chance for effective treatment.

Types of Liver Cancer

Liver cancer includes several distinct diseases, each arising from different cell types within the liver or bile ducts. These cancers have unique patterns of growth and treatment responses, making accurate identification important for developing an effective treatment plan. The types include:

Hepatocellular Carcinoma (HCC)

Hepatocellular carcinoma is the most common type of primary liver cancer. It typically develops in individuals with chronic liver disease, especially those with hepatitis B or C infections, cirrhosis, alcohol-related liver injury, or fatty liver disease. HCC may grow as a single tumour or multiple nodules and can progress silently in its early stages.

Intrahepatic Cholangiocarcinoma (Bile Duct Cancer)

This cancer arises from the small bile ducts located within the liver. It is less common than HCC but tends to be more aggressive. Cholangiocarcinoma is associated with conditions such as chronic bile duct inflammation, primary sclerosing cholangitis, and certain parasitic infections in endemic regions.

Hepatoblastoma (Primarily in Children)

Hepatoblastoma is a rare liver cancer that mostly affects young children, usually under the age of five. It often presents as a painless abdominal mass and is typically diagnosed at earlier stages compared with adult liver cancers.

Other Rare Liver Tumours

Conditions such as fibrolamellar carcinoma and angiosarcoma represent uncommon subtypes that affect specific age groups or arise from unique cell types. These cancers require highly specialised evaluation and treatment.

Causes and Risk Factors of Liver Cancer

Liver cancer often develops in the setting of long-standing liver injury or chronic inflammation. Several factors can increase the likelihood of abnormal cell growth in the liver, and understanding these risks supports early detection and prevention efforts. The major causes and risk factors include:

• Chronic hepatitis B infection: A significant cause of liver cancer worldwide, hepatitis B can lead to long-term inflammation and scarring of the liver. Individuals with chronic infection remain at risk even without cirrhosis.
• Chronic hepatitis C infection: Hepatitis C damages liver tissue over many years and is one of the leading causes of cirrhosis, which increases the risk of hepatocellular carcinoma.
• Cirrhosis from any cause: Cirrhosis results from repeated liver injury and forms a major background in which liver cancer develops. Causes include viral hepatitis, alcohol use, and fatty liver disease.
• Alcohol-related liver disease: Long-term heavy alcohol consumption can lead to cirrhosis and increase the risk of liver cancer.
• Non-alcoholic fatty liver disease (NAFLD): Associated with obesity, diabetes, and metabolic syndrome, NAFLD is becoming a common risk factor in India. Its severe form, non-alcoholic steatohepatitis (NASH), can progress to cirrhosis.
• Aflatoxin exposure: Consuming foods contaminated with aflatoxin, a toxin from certain fungi found in improperly stored grains or nuts, increases liver cancer risk.
• Genetic and metabolic disorders: Conditions such as haemochromatosis and Wilson disease can cause chronic liver damage and raise the likelihood of cancer.
• Family history of liver cancer: A family link may increase risk, particularly in the presence of shared environmental or viral factors.
• Smoking: Smoking contributes to chronic inflammation and may raise the risk of liver cancer, especially in individuals with existing liver disease.

Having risk factors does not mean liver cancer will occur, but these factors highlight who may benefit most from regular monitoring and preventive strategies.

Early Signs and Symptoms of Liver Cancer

Liver cancer often progresses quietly in its early stages, which is why many individuals notice symptoms only when the disease becomes more advanced. Awareness of common warning signs can support earlier medical evaluation, especially in people already living with chronic liver disease. The symptoms may include:

• Unexplained weight loss: A noticeable reduction in weight without changes in diet or activity levels.
• Loss of appetite or Feeling Full Quickly: Reduced interest in food or feeling full after small meals, often due to pressure on the stomach.
• Persistent fatigue or weakness: Ongoing tiredness that interferes with daily activities.
• Pain or discomfort in the upper right abdomen: A dull ache or sense of fullness where the liver is located.
• Abdominal swelling: Fluid buildup in the abdomen, known as ascites, may occur as liver function declines.
• Jaundice: Yellowing of the skin or eyes caused by impaired processing of bilirubin.
• Dark urine and pale stools: Changes in bile flow can alter the colour of urine and stool.
• Nausea or vomiting: Digestive changes caused by liver dysfunction.
• Itching: A build-up of bile salts in the skin may cause persistent itching.

These symptoms can also occur in other liver conditions, so it is important to seek timely medical evaluation if they persist or worsen.

How is Liver Cancer Diagnosed?

Diagnosing liver cancer involves multiple steps to confirm the presence of a tumour, understand its behaviour, and assess overall liver health. Doctors use a combination of examinations, blood tests, and imaging studies to form a complete picture of the condition. The diagnostic process typically includes:

• Medical history and physical examination: Doctors review symptoms, risk factors such as hepatitis infection or alcohol use, and examine the abdomen for signs of liver enlargement or fluid buildup.
• Blood tests: These include liver function tests to assess how well the liver is working and tumour markers such as alpha-fetoprotein (AFP). Elevated AFP levels may suggest liver cancer, but they are not diagnostic on their own and must be interpreted with imaging findings.
• Ultrasound: Often the first imaging test performed, ultrasound can detect suspicious liver nodules and guide further investigations.
• CT or MRI scans: These imaging techniques provide detailed views of the liver, blood vessels, and tumour characteristics. Multiphasic CT or MRI scans are particularly helpful in identifying typical patterns of hepatocellular carcinoma.
• PET-CT (in selected cases): PET-CT may be used to check the spread of cancer beyond the liver or to evaluate certain tumour types.
• Biopsy: A biopsy may be performed when imaging results are unclear. A small sample of liver tissue is examined under a microscope to confirm the diagnosis. In many cases of hepatocellular carcinoma, characteristic imaging features may allow diagnosis without biopsy.

Staging tests help determine whether the tumour is confined to the liver or has spread, which is essential for choosing the most effective treatment approach.

Stages of Liver Cancer

Staging helps doctors understand how far the cancer has progressed and guides decisions about the most appropriate treatment options. Liver cancer is commonly described using staging systems that assess tumour size, spread, and liver function. The general stages include:

• Stage I:  A single tumour is present within the liver, and it has not spread to blood vessels or nearby organs.
• Stage II: A tumour may begin to involve nearby blood vessels, or several small tumours are found within the liver.
• Stage III: Multiple larger tumours may be present, or the cancer has spread to major blood vessels or nearby structures within the abdomen.
• Stage IV: The cancer has spread to distant organs or lymph nodes, indicating advanced disease.

Staging is an important step in planning treatment, as early-stage liver cancer may be suitable for surgery or local therapies, while advanced stages often require systemic or combination treatments.

Treatment Approaches for Liver Cancer

Treatment for liver cancer depends on the stage of the disease, the number and size of tumours, overall liver function, and the individual’s general health. Doctors may use one or a combination of the following approaches to control the disease and improve long-term outcomes. The main treatment options include:

• Surgery (Liver Resection): Surgical removal of the tumour may be possible when the cancer is confined to one area of the liver and enough healthy liver tissue remains. Resection offers potential for long-term survival in carefully selected cases.
• Liver Transplantation: A transplant may be recommended for individuals with early-stage liver cancer and underlying cirrhosis, when the tumour fits criteria such as the Milan criteria. This approach replaces the diseased liver with a healthy donor liver and can be curative for selected patients.
• Ablation Therapies: Techniques such as radiofrequency ablation (RFA) and microwave ablation use heat to destroy cancer cells. These methods are typically used for small tumours or when surgery is not suitable.
• Embolisation Procedures (TACE and TARE): Transarterial chemoembolisation (TACE) and transarterial radioembolisation (TARE) deliver treatment directly into the blood vessels feeding the tumour. These procedures help shrink tumours, slow growth, and relieve symptoms, especially in individuals who are not candidates for surgery.
• Targeted Therapy: Targeted medicines block specific pathways that support tumour growth. These treatments may be used for advanced liver cancer or when cancer does not respond to local therapies.
• Immunotherapy: Immunotherapy helps the body’s immune system recognise and attack cancer cells. It may be used alone or in combination with other treatments for advanced disease.
• Radiation Therapy: High-precision radiation techniques can be used for selected liver tumours that cannot be treated surgically. Advanced methods limit radiation exposure to healthy liver tissue.
• Chemotherapy: While traditional chemotherapy has a limited role in hepatocellular carcinoma, it may be used in certain types of liver cancer such as cholangiocarcinoma or when other treatments are not suitable.

Treatment plans are personalised to each individual’s needs and guided by specialists from surgery, medical oncology, radiation oncology, and interventional oncology.

Who is at Higher Risk of Developing Liver Cancer?

Certain individuals are more likely to develop liver cancer due to long-standing liver conditions or metabolic health issues. Those who may be at increased risk include:

• Individuals with chronic hepatitis B or hepatitis C infection: Long-term viral infection is one of the strongest predictors of liver cancer, even in the absence of cirrhosis.
• Individuals living with cirrhosis: Cirrhosis significantly increases cancer risk, whether it results from alcohol use, viral hepatitis, or fatty liver disease.
• Those with non-alcoholic fatty liver disease (NAFLD) or NASH: Individuals with obesity, diabetes, and metabolic syndrome may develop advanced fatty liver disease, which raises cancer risk.
• Long-term heavy alcohol consumers: Prolonged alcohol use can damage the liver, leading to cirrhosis and increased cancer risk.
• Individuals with inherited metabolic disorders: Conditions such as haemochromatosis or Wilson disease can cause chronic liver injury.
• People exposed to aflatoxin: In regions where food contamination is more common, exposure to aflatoxin can elevate risk.
• Those with a family history of liver cancer: Genetic and shared environmental factors may contribute to higher likelihood.
• Smokers with existing liver disease: Smoking compounds liver inflammation and raises the risk of developing malignancy.

People who fall into these higher-risk groups benefit from regular liver check-ups, imaging tests, and blood investigations as advised by their healthcare team.

Preventing Liver Cancer: Steps to Lower Your Risk

While not all cases of liver cancer can be prevented, many risk factors are modifiable through healthy lifestyle habits, early treatment of liver diseases, and regular monitoring. The following measures can help reduce the likelihood of developing liver cancer, especially in individuals at higher risk:

• Vaccination against hepatitis B: Hepatitis B vaccination is highly effective and significantly reduces the risk of developing chronic infection and liver cancer.
• Screening and treatment for hepatitis C: Early detection and antiviral treatment for hepatitis C can prevent long-term liver damage and lower cancer risk.
• Limiting alcohol intake: Reducing alcohol consumption helps prevent liver inflammation, scarring, and cirrhosis.
• Managing fatty liver disease: Maintaining a healthy weight, staying physically active, and controlling conditions such as diabetes and high cholesterol can prevent the progression of fatty liver disease.
• Avoiding aflatoxin exposure: Proper food storage and safe handling of grains, nuts, and spices can reduce exposure to aflatoxin, a known liver carcinogen.
• Quitting smoking: It lowers the risk of several cancers, including liver cancer.
• Regular monitoring for high-risk individuals: People with chronic liver disease, cirrhosis, or hepatitis infections benefit from scheduled check-ups and imaging tests to detect early changes.

Preventive care, vaccination programs, and ongoing follow-up play important roles in lowering the burden of liver cancer and supporting better long-term outcomes.

Why RGCIRC is a Leading Centre for Liver Cancer Care in India

Liver cancer treatment requires accurate diagnosis, advanced technology, and coordinated expertise across multiple specialties. At Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), individuals receive comprehensive, evidence-based care supported by modern facilities and experienced specialists. As one of India’s foremost cancer centres, RGCIRC is committed to delivering safe, effective, and patient-focused liver cancer management. The key strengths that make RGCIRC a trusted centre for liver cancer care include:

Specialised Hepatobiliary and Gastrointestinal Oncology Expertise

RGCIRC’s dedicated team of hepatobiliary surgeons, medical oncologists, radiation oncologists, and interventional radiologists work together to manage all stages of liver cancer through coordinated, evidence-based care.

Advanced Diagnostic and Imaging Facilities

High-end technologies such as multiphasic CT, MRI, PET-CT, and ultrasound-guided procedures enable accurate diagnosis, staging, and treatment planning.

Comprehensive Treatment Options Under One Roof

Patients have access to the full spectrum of liver cancer treatments, including surgical resection, liver transplantation evaluation, ablation therapies, embolisation procedures, targeted therapy, immunotherapy, and precision radiation techniques.

Multidisciplinary Tumour Board Approach

Each case is reviewed by specialists from multiple disciplines, ensuring that every treatment plan reflects the latest evidence and personalised clinical judgment.

Strong Supportive and Follow-Up Care Services

Nutrition counselling, pain and symptom management, rehabilitation, psycho-oncology support, and long-term follow-up programs help individuals maintain quality of life during and after treatment.

Commitment to Research and Innovation

As an ICMR-recognised research centre, RGCIRC participates in clinical research and applies emerging scientific insights to improve patient outcomes.

Trusted Legacy and Patient-Centred Care

With more than three decades of experience, RGCIRC has established itself as one of the country’s leading non-profit cancer hospitals known for compassionate care, clinical excellence, and ethical medical practices.

RGCIRC’s integrated approach ensures that individuals receive holistic care from diagnosis through recovery, supported by advanced technology and specialist expertise.

Taking the Next Step Towards Timely Liver Cancer Care

Liver cancer can be challenging to detect early, but timely evaluation and specialised treatment significantly improve outcomes, especially for individuals living with chronic liver disease. Understanding the symptoms, risk factors, and available treatment approaches empowers patients and families to make informed decisions and seek expert help without delay. For advanced evaluation and personalised liver cancer care, contact Rajiv Gandhi Cancer Institute & Research Centre at +91-11-47022222 or +91-11-27051037, or fill out the contact form to reach a cancer specialist.

Frequently Asked Questions (FAQs)

Q: What are the early symptoms of liver cancer?

Early symptoms of liver cancer may include unexplained weight loss, persistent fatigue, loss of appetite, and discomfort in the upper right abdomen. Because these signs can be subtle, individuals with hepatitis infections, cirrhosis, or fatty liver disease benefit from regular screening.

Q: What is the first sign of liver cancer that people commonly notice?

Many individuals first notice abdominal discomfort, jaundice, or unexplained weight loss. However, liver cancer can remain silent for long periods, which is why routine monitoring is important for high-risk groups.

Q: How is liver cancer diagnosed?

Doctors diagnose liver cancer using blood tests, ultrasound, CT or MRI scans, and sometimes a biopsy to confirm the findings. Centres such as RGCIRC in Delhi offer comprehensive diagnostic services for accurate evaluation.

Q: Can liver cancer be cured?

Liver cancer may be curable when detected at an early stage and treated with surgery, ablation, or liver transplantation. In more advanced stages, treatment focuses on controlling tumour growth and improving quality of life.

Q: What are the main causes of liver cancer?

Common causes include chronic hepatitis B and C infections, cirrhosis, alcohol-related liver disease, fatty liver disease, aflatoxin exposure, and certain metabolic conditions. These risk factors increase the chance of abnormal liver cell changes.

Q: What do AFP levels indicate in liver cancer?

Alpha-fetoprotein (AFP) levels may rise in some liver cancers, especially hepatocellular carcinoma. AFP helps support diagnosis and treatment monitoring, but elevated levels alone do not confirm cancer.

Q: What treatment options are available for liver cancer near me in Delhi-NCR?

Treatment options include surgery, ablation, embolisation (TACE or TARE), targeted therapy, immunotherapy, and radiation therapy. Comprehensive liver cancer treatment in Delhi-NCR is available at expert centres such as RGCIRC.

Q: What are the common stages of liver cancer?

Liver cancer stages range from Stage I (confined to the liver) to Stage IV (spread to distant organs). Staging guides decisions about liver cancer treatment and helps determine prognosis.

Q: Who is at higher risk of developing liver cancer?

Individuals with hepatitis B or C, cirrhosis, fatty liver disease, long-term alcohol use, or a family history of liver cancer have a higher risk and should undergo regular checks.