Liver Cancer

About Liver Cancer

Primary liver cancers arise from either the liver cells (hepatocellular cancer, HCC) or the bile duct cells (cholangiocarcinoma, CCA). These cancers start in the liver and may spread to other organs.

Secondary cancers are also called liver metastases. They can spread from many different primary tumour types. The most common indication for liver surgery in Australia is for metastases from a primary colorectal origin.

Primary Liver Cancers

Primary liver cancers are mostly either hepatocellular cancer (HCC) or cholangiocarcinoma (CCA). These cancers start in the liver and may spread to other organs.

Secondary Liver Cancers

Secondary liver cancer is the most common liver cancer in the western world. A secondary liver cancer starts somewhere else in the body and spreads (metastasizes) to the liver. Any cancer can spread to the liver, but the most common ones are breast, stomach and bowel cancers. These liver cancers are named after the primary cancer for example, bowel cancer that has spread to the liver is called metastatic bowel cancer. Sometimes, the liver cancer is discovered first, which leads to the diagnosis of the primary cancer.


Liver cancer usually has no symptoms in the early stages. Symptoms in late stage patients can include:

  • Persistent pain in the upper right side of the abdomen
  • Fever
  • Yellowing of the skin and eyes (jaundice)
  • Nausea
  • Weakness
  • Weight loss
  • Loss of appetite
  • Swelling of the abdomen


Liver cancer is usually diagnosed with several different tests, which may include:

  • Blood tests - to check your general health and to check for tumour markers (AFP, CEA and Ca19-9), which may be raised in people with certain types of liver cancer.
  • Ultrasound- a picture of the liver is taken using sound waves
  • CT scan - a specialised x-ray taken from many different angles to build a three-dimensional picture of the body
  • Magnetic resonance imaging (MRI) - similar to a CT scan but uses magnetism instead of x-rays to build a picture of the body
  • Liver biopsy - a small piece of liver tissue is removed with a needle and examined for cancer cells
  • Laparoscopy - a small cut in the lower abdomen allows a thin mini-telescope (laparoscope) to be inserted to look at the liver and take a sample of the liver tissue. If the tests show you have secondary liver cancer (and you did not know that you had a primary cancer), you may need further tests to find out where the primary cancer is.


Treatment for liver cancer will depend on whether it is a primary or secondary cancer. Treatment options include:

  • Surgery to remove the cancer. This is the main treatment for primary liver cancer. It is only useful for secondary liver cancers if there is no uncontrolled disease outside of the liver
  • Chemotherapy - either tablets or injections of anti-cancer drugs. Sometimes can also be given directly into the artery that feeds the tumour in the liver (hepatic arterial infusion). Chemotherapy is very effective for secondary liver cancers and sometimes is also used for primary liver cancer
  • Radiotherapy - x-rays are used to target and kill cancer cells. It may help in treating some types of primary liver cancers and may be used to relieve symptoms of pain and discomfort from secondary liver cancer

Information Brochures

Professor Hugh will provide you with an information brochure which outlines what to expect in terms of the early post-operative period. This brochure also contains advice on diet and exercise in the early post-operative period.

Liver Metastases and Surgery

Contains information regarding:

  • Liver Mestastases overview
  • Symptoms
  • Planning your treatment
  • Types of Treatment
  • Investigations
  • Types of Liver Surgery
  • Portal Vein Embolisation
  • Your stay in hospital
  • At home after your Liver operation
  • Expected Symptoms
  • Follow Up

Published Articles by Professor Hugh

Full list of publications