Abdominal pain, weight loss, abdominal fullness, lack of appetite, associated with swelling of the abdomen and often a fever are the major presenting liver cancer symptoms.
Only about 10% of liver cancer patients complain of jaundice, but the physician detects jaundice by carefully inspecting the white of the eye (=sclera) in about 40% of the same patients. Blood tests are even more reliable as an elevated bilirubin level in liver cancer is often found when the patient is clinically still not jaundiced.
The examining physician will feel for the size and consistency of the liver and find an enlarged liver in about 90% of cases of liver cancer and an enlarged spleen in about 2/3 -rd of the cases.
Half of the cases have fluid in the abdomen (=ascites). Although only about 10% of patients with liver cancer complain of bone pain, bone metastases are found by autopsy in about 20% of comparable cases. The physician will look for signs of underlying cirrhosis of the liver that might have been present for several years. Inquiries as to life styles, exposure to hepatitis B or C will have to be made. A further history needs to be taken regarding industrial carcinogen exposure as well as alcohol and cigarette consumption.
References
1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Hepatobiliary Neoplasms.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Hepatobiliary Neoplasms.
3. SA Hussain et al. Ann Oncol 2001 Feb;12(2):161-172.
4. M Nakamura et al. J Cell Physiol 2001 Jun;187(3):392-401.
5. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc
