Managing symptoms of secondary liver cancer

Secondary liver cancer can cause various symptoms, but there are ways to manage them. As this is an advanced cancer, the palliative care team may be involved in managing symptoms.

Jaundice

Bilirubin is a yellow pigment formed when red blood cells in the body break down. In secondary liver cancer, bilirubin sometimes builds up in the blood. This can be because the cancer has blocked a bile duct or affected how the liver is working.

The build-up of bilirubin in the blood is known as jaundice. It can cause yellowing of the skin and whites of the eyes. People with jaundice may feel  very tired and lose their appetite.

Jaundice can also cause pale faeces, dark urine  and itchy skin, which is often worse at night.  Try to avoid alcohol, spicy food, hot baths and direct sunlight, which can make the itching worse. Keeping your skin moisturised can provide some relief, or your doctor can prescribe medicine  that may help.

Jaundice can sometimes be relieved by inserting a small tube made of plastic or metal (a stent) into the bile duct. Symptoms of jaundice usually go away 2–3 weeks after the stent is placed into the bile duct. However, stenting is not always recommended or possible in advanced cancer

Poor appetite and weight loss

Because the liver plays a key role in the digestive system, secondary liver cancer can affect your appetite and you may lose weight.

Chemotherapy, radiation therapy and other cancer treatments can also have an impact on appetite and weight, especially if you have side effects such as nausea and vomiting, mouth ulcers, and taste and smell changes.

Pain

In some people, secondary liver cancer can cause pain, particularly in the upper right area of the abdomen (belly). Your doctor may prescribe pain medicine, but check before taking any over-the counter medicines because some are not suitable for people with liver cancer.

Radiation therapy, chemotherapy or surgery may also provide relief by reducing the size of a liver tumour that is causing pain. Some people may have an injection of local anaesthetic to numb the nerve sending the pain signals (nerve block).

Learn more about cancer and pain. 

Fatigue

Many people with secondary liver cancer experience fatigue. This is different to feeling tired as it doesn’t always go away with rest or sleep. Fatigue may be a side effect of treatment or caused by the cancer.

Learn more about cancer and fatigue. 

Fluid build-up

Ascites is when fluid builds up in the abdomen (belly). It can be caused by the cancer producing extra fluid or blocking lymph vessels from draining fluid. This fluid build-up causes swelling in the abdomen, which can be uncomfortable and may make you feel breathless. Draining the fluid with a procedure called paracentesis or ascitic tap can help. Diuretics (water tablets) may also be prescribed to reduce the build-up of fluid. 

Confusion

Secondary liver cancer may cause toxic substances to build up in the blood, which can affect brain function. Called hepatic encephalopathy, this can lead to confusion or disorientation and, in severe cases, coma. Hepatic encephalopathy can be controlled with medicines.

Living with secondary liver cancer

Some people diagnosed with secondary liver cancer can feel well and have periods of time without symptoms. But the uncertainty of living with cancer that cannot be cured can have a huge emotional impact. At times, you may feel overcome by fear, anxiety, sadness or anger. Your doctor, nurses, a social worker or counsellor can help you and your family find ways to cope with how you are feeling.

See Living with advanced cancer and listen to Cancer Council's podcast series The Thing About Advanced Cancer.