Liver cancer is a serious condition that affects thousands of Canadians each year. It can start in the liver itself, or it can spread to the liver from another part of the body. Understanding the types, symptoms, causes, and treatment options can help you make informed decisions about your health and know when to seek care.
What Is Liver Cancer?
Liver cancer is a malignant tumour that grows in or on the liver. Doctors place it into two broad categories: primary liver cancer and secondary liver cancer.
Primary liver cancer starts directly in the liver. Secondary liver cancer, also called metastatic liver cancer, begins somewhere else in the body and then spreads to the liver. In Canada and other temperate countries, secondary liver cancer is actually more common than primary liver cancer.
The liver is one of the largest organs in your body. It filters your blood, helps digest food, and removes toxins. Because so much blood passes through it, cancer from other organs can travel there easily. For this reason, it is important to monitor your liver health, especially if you have had cancer before.
Types of Primary Liver Cancer
Primary liver cancer remains relatively rare in Canada and Europe compared to parts of Africa and Asia. However, it is still a condition that Canadians need to be aware of, particularly those with certain risk factors.
Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It is also called hepatocarcinoma. In about 20% of cases, it develops in a previously healthy liver. However, it more often grows in a liver already damaged by disease.
In Canada, alcoholic cirrhosis is one of the leading causes of HCC. Cirrhosis is a condition where healthy liver tissue is replaced by scar tissue over time. Chronic hepatitis B and hepatitis C infections also significantly raise the risk of developing HCC. Health Canada provides resources on hepatitis prevention and liver health that are worth reviewing if you are at risk.
In tropical regions, contamination of food with aflatoxin — a toxic substance produced by certain moulds — is also linked to HCC. This is less of a concern in Canada due to strict food safety standards, but it remains a global health issue.
Cholangiocarcinoma
Cholangiocarcinoma is a much rarer type of primary liver cancer. It forms in the bile ducts inside or around the liver. This type is more commonly seen in Southeast Asia, where certain parasitic infections are thought to play a role in its development. In Canada, it is uncommon but not unheard of.
Angiosarcoma
Angiosarcoma is the rarest form of primary liver cancer. It develops in the blood vessels of the liver. In some cases, it has been linked to long-term exposure to harmful substances such as vinyl chloride or arsenic. Occupational exposure to these chemicals, though now more tightly regulated in Canada, has historically been a risk factor.
Liver Cancer Symptoms to Watch For
One of the challenges with liver cancer is that symptoms often do not appear until the disease has advanced. Therefore, knowing the warning signs is especially important if you have existing liver disease or other risk factors.
Symptoms of Primary Liver Cancer
Hepatocellular carcinoma often causes the liver to become enlarged. A doctor may be able to feel this during a physical examination. Other symptoms can include a moderate, dull pain in the upper right part of your abdomen, and a fever that may mimic the signs of an infection.
In some people, HCC first shows up as a worsening of existing cirrhosis. If you have been diagnosed with cirrhosis and notice your symptoms getting worse quickly, speak to your doctor right away. This change in your condition could signal the development of liver cancer.
Symptoms of Secondary Liver Cancer
Secondary liver cancer can cause a general decline in your overall health. You may feel unusually tired, lose weight without trying, or notice a loss of appetite. In addition, jaundice — a yellowing of the skin and whites of the eyes — can develop as the liver loses its ability to process waste products.
During a physical exam, a doctor may feel that the liver is enlarged and bumpy. This texture has sometimes been described as a “nodular” liver. It may or may not be tender to the touch. The Mayo Clinic offers a detailed overview of liver cancer signs and symptoms that can help you understand what to look for.
How Is Liver Cancer Diagnosed?
If your doctor suspects liver cancer, they will order several tests to confirm the diagnosis. Early and accurate diagnosis is key to finding the best treatment path.
An ultrasound is usually the first imaging test used. It uses sound waves to create images of your liver and can help identify abnormal growths. A CT scan (sometimes called a scanography) provides more detailed images and helps doctors understand the size and location of any tumours.
A liver biopsy is often needed to confirm a diagnosis. During this procedure, a small sample of liver tissue is removed — usually guided by ultrasound — and examined under a microscope. This test confirms whether the tumour is cancerous and, in secondary liver cancer, helps identify where the cancer originally started.
Liver cancer carries a significant risk of spreading to other parts of the body. The lungs and bones are the most common sites for metastasis, or secondary spread, from primary liver cancer. Doctors will often check these areas as part of the diagnostic process.
Liver Cancer Treatment Options
Treatment for liver cancer depends on the type of tumour, its size, its location, and the overall health of your liver. Your cancer care team will work with you to create a treatment plan that fits your situation. In Canada, cancer treatment is covered under provincial health plans, though the specific services available may vary by province.
Surgery
When possible, surgery is the preferred treatment for liver cancer. A partial hepatectomy involves removing the part of the liver that contains the tumour. The liver has a remarkable ability to regenerate, which makes this operation possible in many cases.
In exceptional situations, a liver transplant may be considered. This option is typically reserved for people whose cancer has not spread beyond the liver and who meet specific medical criteria. Liver transplant programmes exist across Canada, including major centres in Toronto, Vancouver, and Edmonton.
Non-Surgical Treatments
When surgery is not an option, doctors may recommend other treatments. Chemotherapy — either systemic (affecting the whole body) or local — is one approach. Local chemotherapy involves delivering medication directly to the tumour through a catheter inserted into the hepatic artery, the main blood vessel supplying the liver. This method can reduce side effects compared to systemic chemotherapy.
Another technique is tumour ablation using alcohol injection. In this procedure, a doctor injects ethanol (a type of alcohol) directly into the tumour. This destroys the cancer cells without major surgery. Other ablation methods, such as radiofrequency ablation, may also be available at Canadian cancer centres.
Radiation therapy and newer targeted drug therapies are also part of the treatment landscape. Your oncologist — a cancer specialist — will explain which options are most suitable for your case. The World Health Organization outlines global cancer treatment approaches that provide helpful context.
Preventing Liver Cancer
Prevention is one of the most powerful tools we have against liver cancer. Several lifestyle choices and medical steps can meaningfully lower your risk.
Reducing alcohol consumption is one of the most important things you can do. Heavy, long-term alcohol use damages the liver and leads to cirrhosis, which is a major risk factor for hepatocellular carcinoma. Canada’s low-risk alcohol drinking guidance recommends limiting drinks per week to protect your health.
Getting vaccinated against hepatitis B is another critical step. The hepatitis B vaccine is safe, effective, and available across Canada through provincial immunisation programmes. While there is currently no approved vaccine for hepatitis C, effective treatments exist that can cure the infection and dramatically reduce the risk of liver damage. If you think you may have been exposed to hepatitis B or C, ask your family doctor about testing.
Maintaining a healthy weight, eating a diet rich in fibre and vegetables, and avoiding exposure to toxic chemicals can also help protect your liver over time.
When to See a Doctor
If you notice any of the symptoms described in this article — such as unexplained weight loss, abdominal pain, jaundice, or persistent fatigue — see a doctor as soon as possible. Do not wait to see if symptoms improve on their own.
You can start by booking an appointment with your family doctor. If you do not have a family doctor, a walk-in clinic is a good first step. Your doctor can order initial tests, refer you to a specialist, and connect you with the right cancer care resources in your province.
People with existing liver conditions, such as cirrhosis or chronic hepatitis, should already be having regular check-ups. These appointments are important for catching any changes early. Early detection of liver cancer significantly improves treatment outcomes. Always consult a qualified healthcare provider before making any decisions about your health or treatment.
Frequently Asked Questions About Liver Cancer
What are the early warning signs of liver cancer?
Early liver cancer often causes no symptoms at all, which makes it difficult to detect. When symptoms do appear, they may include upper abdominal pain, an enlarged liver felt during a physical exam, unexplained weight loss, and fatigue. If you have risk factors such as cirrhosis or hepatitis, ask your doctor about regular liver cancer screenings.
Is liver cancer curable?
Liver cancer can be curable when it is caught at an early stage and the tumour can be surgically removed. A partial hepatectomy or, in select cases, a liver transplant may offer a chance for long-term remission. However, treatment success depends greatly on the size and spread of the cancer, as well as the overall health of the liver.
What causes liver cancer in Canada?
In Canada, the most common causes of primary liver cancer are alcohol-related cirrhosis and chronic hepatitis B or C infections. Secondary liver cancer — which spreads to the liver from another organ — is more common overall, and can result from colorectal, stomach, pancreatic, or gynaecological cancers. Reducing alcohol intake and getting vaccinated against hepatitis B are two of the best ways to lower your risk.
How is liver cancer diagnosed in Canada?
Doctors typically use a combination of ultrasound, CT scan, and a liver biopsy to diagnose liver cancer. These tests are available through the Canadian healthcare system and are usually covered under provincial health plans. Your family doctor can refer you to a specialist if liver cancer is suspected.
Can liver cancer spread to other organs?
Yes, liver cancer — particularly hepatocellular carcinoma — can spread to the lungs and bones. This spread is called metastasis and is a key reason why early detection and treatment are so important. Your care team will monitor for signs of spread as part of your ongoing treatment and follow-up plan.
Does the hepatitis B vaccine help prevent liver cancer?
Yes, the hepatitis B vaccine is one of the most effective tools for preventing liver cancer caused by chronic hepatitis B infection. The vaccine is part of routine immunisation programmes across Canadian provinces and is recommended for all children and at-risk adults. Talk to your family doctor or visit a walk-in clinic to confirm your vaccination status.
Key Takeaways
Liver cancer can be primary (starting in the liver) or secondary (spreading from another organ).
In Canada, secondary liver cancer is more common than primary liver cancer.
The most common type of primary liver cancer is hepatocellular carcinoma, often linked to cirrhosis or chronic hepatitis.
Symptoms may include upper abdominal pain, an enlarged liver, jaundice, and unexplained weight loss.
Diagnosis involves ultrasound, CT scan, and liver biopsy, all available through the Canadian healthcare system.
Treatment options include surgery, chemotherapy, and tumour ablation, depending on the stage and type of cancer.
Prevention includes limiting alcohol, getting the hepatitis B vaccine, and treating chronic hepatitis infections.
If you notice any warning signs, speak with your family doctor or visit a walk-in clinic as soon as possible.
Always consult a qualified healthcare professional for personalised medical advice.
