# Liver cancer: symptoms, treatment and survival > Source: World Aid Network — https://worldaidnetwork.org/cancer/liver-cancer > Last reviewed: 2026-06-19 ## In short Liver cancer develops in the liver, the large organ that processes nutrients and filters the blood. Primary liver cancer is closely linked to long-term liver damage — from hepatitis B or C infection, heavy alcohol use, or fatty liver disease. Early liver cancer often causes no symptoms, with tummy pain, weight loss and yellowing of the skin appearing later. Strongly linked to liver damage — and often preventable by protecting the liver. World Aid Network funds treatment for patients who cannot pay. ## At a glance - ~6,300: UK cases each year - Hepatitis, alcohol, fatty liver: Main causes - ~13%: Survival (overall) - Preventable: Largely ## What is liver cancer? Liver cancer develops in the liver, the large organ that processes nutrients and filters the blood. Primary liver cancer is closely linked to long-term liver damage — from hepatitis B or C infection, heavy alcohol use, or fatty liver disease. Early liver cancer often causes no symptoms, with tummy pain, weight loss and yellowing of the skin appearing later. Liver cancer affects around 6,300 people in the UK each year and causes approximately 5,900 deaths annually, making it one of the most lethal cancers relative to its incidence. The five-year survival rate is approximately 15% — one of the lowest for any UK cancer — primarily because most cases are diagnosed at an advanced stage. The most common type of primary liver cancer is hepatocellular carcinoma (HCC), which develops in the liver cells themselves. The majority of cases arise in a background of liver disease — particularly hepatitis B, hepatitis C or alcohol-related cirrhosis — meaning that many liver cancers are potentially preventable. This guide answers the twenty most commonly searched questions about liver cancer in the UK, drawing on NHS and WHO sources, and examines the stark inequality between liver cancer outcomes in the UK and the situation facing patients in low-income countries where hepatitis B is far more prevalent and treatment is unaffordable. Primary liver cancer is cancer that starts in the liver. The most common type is hepatocellular carcinoma (HCC), accounting for approximately 80% of primary liver cancers, which arises from hepatocytes (the main liver cells). Other types include intrahepatic cholangiocarcinoma (cancer of the bile ducts within the liver), and the rare hepatoblastoma in children. Secondary (metastatic) liver cancer — cancer that has spread to the liver from another primary site (most commonly bowel, breast, lung or stomach) — is actually more common in the UK than primary liver cancer. The liver performs over 500 functions including metabolising nutrients, detoxifying substances, producing bile and synthesising clotting proteins. Both primary and secondary liver cancer disrupt these functions as tumours grow. In the UK, the five-year survival rate for liver cancer is approximately 15%. In low- and middle-income countries, liver cancer is far more common — hepatitis B is endemic across much of South and South-East Asia — and survival is even lower because surveillance, early detection and curative treatment are largely inaccessible to poor patients. The World Health Organization estimates that liver cancer is the third most common cause of cancer death globally, with approximately 830,000 deaths per year. In regions where hepatitis B vaccination coverage is incomplete and antiviral treatment for hepatitis C is unavailable, HCC incidence remains high among people of all ages. The cost of surgical resection, liver transplantation or even TACE is beyond reach for most poor patients without donor support. World Aid Network funds cancer treatment — including liver cancer — for poor patients through locally-licensed oncologists and registered hospitals. A donation today directly supports access to care for a patient who would otherwise have none. ## When should you see a doctor about liver cancer? Most of these symptoms have a less serious cause — but it is always worth getting them checked. See a GP if you notice a new or persistent change. If you feel very unwell, contact NHS 111 or seek urgent help. Take a note of how long the symptom has lasted and whether it is getting worse. You do not need every sign on a list to book an appointment. This guide is general information from World Aid Network, not a diagnosis and not UK NHS care. Only a clinician can assess you. - Yellowing of the skin or whites of the eyes (jaundice) - Pain or swelling in the upper-right side of the tummy - Losing weight without trying, or loss of appetite - Feeling sick, very tired, or generally unwell - Pale poo and dark pee ## What are the symptoms of liver cancer? Early liver cancer often causes no symptoms. According to the NHS, symptoms to report to your GP include: unexplained weight loss; loss of appetite; feeling full after eating only a small amount; nausea; jaundice (yellowing of the skin and eyes); itchy skin; swelling in the abdomen; pain or discomfort in the upper right abdomen; and fatigue. Many of these symptoms can be caused by cirrhosis or other liver conditions, so they do not necessarily indicate cancer. However, anyone with known liver disease should report any new or worsening symptoms to their GP or hepatology team promptly, as liver cancer surveillance (six-monthly ultrasound and AFP blood test) is recommended for high-risk patients. ## What are causes, risk factors and prevention? The main risk factors for hepatocellular carcinoma are: cirrhosis from any cause (the single greatest risk factor, present in approximately 80% of HCC cases); chronic hepatitis B infection; chronic hepatitis C infection; alcohol-related liver disease; non-alcoholic fatty liver disease (NAFLD)/NASH (increasingly common due to obesity and type 2 diabetes); haemochromatosis; and primary biliary cholangitis. Obesity, type 2 diabetes and smoking also increase risk. The World Health Organization estimates that hepatitis B is responsible for approximately 50% of HCC cases worldwide — and that vaccination can prevent hepatitis B infection, making HCC one of the few cancers partly preventable through vaccination. In the UK, hepatitis B vaccination is offered to newborns (since 2017) and to at-risk adults. ## What treatment options are available? Treatment depends on the size, number and location of tumours, the degree of underlying liver disease and the patient's performance status. Potentially curative treatments include: liver resection (surgical removal of the tumour-bearing liver segment); liver transplantation (for patients meeting Milan criteria — up to three tumours, all ≤3 cm, or one tumour ≤5 cm, with no vascular invasion); and thermal ablation (radiofrequency ablation or microwave ablation for tumours ≤3–5 cm). For patients who cannot undergo curative treatment, locoregional therapies include transarterial chemoembolisation (TACE), which delivers chemotherapy directly to the tumour via the hepatic artery while blocking its blood supply, and selective internal radiation therapy (SIRT/Y-90 radioembolisation). Systemic therapy for advanced HCC includes sorafenib, lenvatinib and atezolizumab combined with bevacizumab — the latter combination now the first-line standard for Child-Pugh A advanced HCC in the UK. ## What are the key takeaways? The most important points on liver cancer for patients, families and donors. - Liver cancer affects around 6,300 people in the UK per year. The five-year survival rate is approximately 15%, one of the lowest for any UK cancer. - Hepatocellular carcinoma (HCC) is the most common type, arising most often in livers already damaged by hepatitis B, hepatitis C, alcohol or fatty liver disease. - Hepatitis B vaccination prevents infection and thereby reduces HCC risk — making liver cancer partly preventable through immunisation. - Potentially curative treatments include liver resection, transplantation and thermal ablation for early-stage disease. TACE and systemic therapy (sorafenib, atezolizumab+bevacizumab) are used for advanced disease. - Globally, liver cancer is the third most common cause of cancer death. In low-income countries with high hepatitis B prevalence, treatment access for poor patients is extremely limited. ## What will a donation for liver cancer treatment provide? A gift to World Aid Network's Cancer Emergency Appeal helps pay for diagnosis and treatment that a poor patient has been recommended but cannot afford. Typical partner costs start at £10 for tests and £50 for a chemotherapy session. Trustees direct gifts to the most urgent cases. This is treatment access, not laboratory research and not UK NHS care. Clinicians in partner hospitals decide the medical plan. We fund the bill in Pakistan, Indonesia and Malaysia. The Cancer Emergency Appeal funds all types of cancer. Trustees direct gifts to the most urgent hospital bills in Pakistan, Indonesia and Malaysia. - £10 — Diagnostic tests that help a partner oncologist confirm the next step - £25 — Cancer medication towards a treatment cycle a family cannot afford - £50 — One chemotherapy session for a patient who would otherwise be turned away - £100 — Surgical support or a fuller block of treatment costs ## How can I donate to help people with liver cancer? Donate by card on this page or at worldaidnetwork.org/donate and choose the Cancer Emergency Appeal. World Aid Network is a UK CIO with Charity Commission registration in progress; Gift Aid applies once registration is granted. If you need UK support as a patient or relative, see a GP, NHS 111, Macmillan or the specialist UK charity for this cancer. We fund treatment overseas; we are not a UK helpline. ## Frequently asked questions ### What is liver cancer? Primary liver cancer is cancer that starts in the liver, most commonly hepatocellular carcinoma (HCC) arising from liver cells. Around 6,300 people are diagnosed with primary liver cancer in the UK each year. Secondary (metastatic) liver cancer — cancer that has spread to the liver from elsewhere — is also common. The five-year survival rate for primary liver cancer is approximately 15%. ### What are the symptoms of liver cancer? According to the NHS, symptoms include: unexplained weight loss; loss of appetite or feeling full quickly; nausea; jaundice (yellowing of the skin and eyes); itching; swelling in the abdomen; upper right abdominal pain; and fatigue. Early liver cancer often causes no symptoms, which is why surveillance is important for people with known liver disease. ### How common is liver cancer in the UK? Around 6,300 people are diagnosed with primary liver cancer in the UK each year, and approximately 5,900 people die from it annually. Incidence has more than tripled since the 1990s, driven largely by rising rates of alcohol-related liver disease, hepatitis C and obesity-related fatty liver disease. ### What causes liver cancer? The majority of hepatocellular carcinomas develop in a liver already damaged by cirrhosis. The most common underlying causes are: chronic hepatitis B infection; chronic hepatitis C infection; alcohol-related cirrhosis; non-alcoholic fatty liver disease (NAFLD/NASH); and metabolic conditions such as haemochromatosis. Obesity and type 2 diabetes also independently increase risk. ### What is the link between hepatitis and liver cancer? Chronic hepatitis B and hepatitis C infections are the leading causes of hepatocellular carcinoma worldwide. The WHO estimates that hepatitis B accounts for approximately 50% of all HCC cases globally. Both viruses cause chronic liver inflammation that, over years to decades, leads to cirrhosis — which is the primary risk factor for HCC. In the UK, all newborns are vaccinated against hepatitis B, and antiviral treatment for hepatitis C can achieve cure in over 95% of cases, dramatically reducing future HCC risk. ### What is hepatocellular carcinoma? Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, accounting for approximately 80% of cases. It arises from hepatocytes — the main cells of the liver. It is strongly associated with cirrhosis and chronic viral hepatitis. HCC is one of the most common cancers worldwide, particularly in South and South-East Asia and sub-Saharan Africa where hepatitis B is endemic. ### How is liver cancer diagnosed? Liver cancer is diagnosed through imaging (ultrasound, contrast-enhanced CT or MRI) and the alpha-fetoprotein (AFP) blood tumour marker. In patients with cirrhosis, a characteristic enhancement pattern on CT or MRI can confirm HCC diagnosis without biopsy. Biopsy is performed when imaging is inconclusive. Regular surveillance (6-monthly ultrasound ± AFP) is recommended for all patients with cirrhosis or chronic hepatitis B to detect HCC at an early, treatable stage. ### What are the stages of liver cancer? HCC staging takes into account not only tumour size and spread but also the degree of underlying liver disease. The Barcelona Clinic Liver Cancer (BCLC) staging system is used in the UK, classifying patients as: very early (0), early (A), intermediate (B), advanced (C), or terminal (D). BCLC stage determines eligibility for curative treatment (resection, transplant, ablation), locoregional therapy (TACE) or systemic treatment. ### What is the treatment for liver cancer? Curative options include: surgical resection for patients with sufficient remaining liver function; liver transplantation for patients meeting Milan criteria; and thermal ablation (radiofrequency or microwave) for early tumours ≤5 cm. For intermediate-stage disease: TACE (transarterial chemoembolisation). For advanced-stage disease: systemic therapy with atezolizumab plus bevacizumab (first-line standard) or sorafenib/lenvatinib. Palliative care is appropriate for terminal-stage patients. ### What is ablation therapy for liver cancer? Thermal ablation uses heat — delivered via a needle inserted into the tumour under imaging guidance — to destroy liver cancer cells. Radiofrequency ablation (RFA) uses electrical current; microwave ablation (MWA) uses microwave energy. Ablation is most effective for tumours up to 3–5 cm and is a standard curative-intent treatment for early HCC, particularly in patients not suitable for surgery. It can be performed under sedation or general anaesthetic via percutaneous (skin), laparoscopic or open surgical approaches. ### What is TACE treatment for liver cancer? TACE (transarterial chemoembolisation) is a locoregional treatment for intermediate-stage HCC that delivers chemotherapy directly to liver tumours via the hepatic artery while simultaneously blocking the tumour's blood supply. Because tumours derive most of their blood supply from the hepatic artery (unlike normal liver tissue, which is supplied mainly by the portal vein), TACE achieves high local drug concentrations with limited systemic exposure. It slows tumour growth and can achieve partial responses but is not curative. ### Can liver cancer be cured? Liver cancer can be cured in selected patients diagnosed at an early stage. Potentially curative treatments include surgical resection, liver transplantation and thermal ablation. The majority of UK patients, however, are diagnosed at an intermediate or advanced stage when curative treatment is not possible. Five-year survival after liver resection for early HCC is approximately 50–70% in well-selected patients. ### What is the survival rate for liver cancer? The five-year survival rate for primary liver cancer in the UK is approximately 15% — reflecting the predominance of late-stage diagnoses. For patients diagnosed at an early stage and treated with curative intent (resection, transplantation or ablation), five-year survival is 50–70%. For advanced-stage disease treated with systemic therapy, median survival is 12–20 months with modern immunotherapy-based regimens. ### What is the difference between primary and secondary liver cancer? Primary liver cancer starts in the liver (most commonly as hepatocellular carcinoma). Secondary (metastatic) liver cancer is cancer that has spread to the liver from another primary site — most commonly bowel, breast, lung, stomach or melanoma. Secondary liver cancer is more common in the UK than primary liver cancer. The distinction is critical because treatment is directed at the primary tumour type: bowel cancer that has spread to the liver, for example, is treated as bowel cancer. ### Does alcohol cause liver cancer? Alcohol is a significant risk factor for liver cancer. Heavy, prolonged alcohol consumption causes alcoholic liver disease and cirrhosis, which in turn substantially increases the risk of hepatocellular carcinoma. The NHS advises drinking no more than 14 units of alcohol per week and spreading these over at least three days. Stopping drinking can halt progression of alcoholic liver disease and reduce (though not eliminate) future HCC risk in people who have not yet developed cirrhosis. ### Can you have a liver transplant for cancer? Yes — liver transplantation is a curative treatment option for HCC in patients who meet the Milan criteria (up to three tumours all ≤3 cm, or one tumour ≤5 cm, with no vascular invasion or extrahepatic spread). Transplantation removes the cancer and replaces the diseased underlying liver. Five-year survival after transplant for HCC meeting Milan criteria is approximately 70%. Patients must be fit for major surgery, accept lifelong immunosuppression and wait for a suitable donor organ. ### Is liver cancer hereditary? Most primary liver cancers are not caused by inherited gene faults. However, certain hereditary conditions significantly increase risk: haemochromatosis (iron overload), Wilson's disease, alpha-1-antitrypsin deficiency and hereditary tyrosinaemia all cause chronic liver damage that predisposes to HCC. Mutations in BRCA1 and BRCA2 genes modestly increase intrahepatic cholangiocarcinoma risk. People with first-degree relatives diagnosed with HCC should discuss screening with their GP. ### What is cirrhosis and how is it linked to liver cancer? Cirrhosis is severe scarring of the liver caused by years of chronic liver damage — from hepatitis B or C, alcohol, fatty liver disease or other causes. In cirrhosis, normal liver cells are replaced by scar tissue that cannot perform liver functions. Cirrhosis is present in approximately 80% of hepatocellular carcinoma cases: the abnormal cell turnover and inflammation in a cirrhotic liver create the conditions for cancerous mutations to accumulate. All patients with cirrhosis should be enrolled in surveillance with 6-monthly liver ultrasound. ### Can liver cancer be prevented? Liver cancer is partly preventable. The most effective preventive measures are: hepatitis B vaccination (protecting against the world's leading cause of HCC); successful treatment of hepatitis C with antiviral therapy (achieving cure in over 95%); limiting alcohol consumption; maintaining a healthy weight to prevent NAFLD/NASH; managing type 2 diabetes; and avoiding sharing needles to prevent hepatitis transmission. The NHS Hepatitis C testing programme aims to identify and treat all undiagnosed infections. ### How does liver cancer affect people in developing countries? The WHO reports that liver cancer is the third most common cause of cancer death globally, with the highest incidence in regions where hepatitis B is endemic — including parts of South and South-East Asia. In these settings, liver cancer often affects working-age adults due to perinatal hepatitis B transmission. Curative surgery, liver transplantation, ablation and systemic therapy are largely unaffordable for poor patients. World Aid Network funds cancer treatment through locally-licensed oncologists, working to address this inequality. ## How you can help World Aid Network funds cancer treatment for poor patients in Pakistan, Indonesia and Malaysia through locally licensed oncologists. Donate at https://worldaidnetwork.org/cancer/liver-cancer or https://worldaidnetwork.org/donate?cause=cancer-treatment&appeal=cancer-emergency ## Sources - NHS — Cancer: https://www.nhs.uk/conditions/cancer/ - Cancer Research UK --- This is general information, not medical advice, published by World Aid Network. Always consult a qualified clinician about your own health.