NHS guidance warns that nerve pain in the right shoulder might be an early symptom of liver cancer. Although the shoulder and liver are located in different parts of the body, problems within the liver can cause “referred pain” felt in the shoulder area.
Referred pain happens when an issue in one part of the body causes discomfort elsewhere, due to shared nerves. Common examples include neck problems causing headaches or hip issues leading to knee pain.
Shoulder discomfort can occur if an enlarged liver presses on nearby nerves. As a tumour grows, it may affect these nerves, sending pain signals to the brain that are perceived near the shoulder blade.
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Cancer Research UK explains that a swollen liver can irritate nerves connected to the shoulder, triggering this type of pain. Other symptoms of liver cancer may include abdominal swelling, feeling full quickly when eating, shortness of breath, or swollen feet.
A growing tumour may cause the right side of the abdomen to swell. This can increase pressure in the liver veins, leading to fluid build-up in the abdomen, known as ascites. Swelling of surface veins on the abdomen may also be visible. Fluid accumulation can result if the liver produces insufficient levels of albumin, a key blood protein.
Liver disease is becoming more common in the UK, causing over 11,000 deaths annually, equating to around 31 per day. Death rates from liver disease have increased fourfold in the past 50 years.
Around 6,200 people in the UK die from liver cancer each year. Most cases of primary liver cancer develop in people with existing liver disease. Approximately 80% to 90% of hepatocellular carcinoma cases and about 30% of bile duct cancers occur in those with pre-existing liver conditions.
The five-year survival rate for liver cancer in the UK is low, at just 13%. Since symptoms often appear at later stages, only around 30% of cases are diagnosed early enough for more successful treatment.
Located in the upper right abdomen, the liver plays a crucial role in processing nutrients and filtering toxins. Liver cancer can originate in the liver itself or spread from other areas of the body.
The outlook depends on factors like tumour size, location, whether it has spread, type of cancer, and the patient’s overall health. It’s important to see a doctor promptly if you notice possible symptoms, as liver cancer can affect anyone, regardless of risk factors.
Early liver cancer may cause no symptoms or signs that are difficult to identify. Symptoms shared by both primary and secondary liver cancers can be subtle and easily mistaken for other conditions.
If you have a liver condition such as cirrhosis, it is vital to notify your doctor immediately if new symptoms appear or existing ones worsen. Possible signs of liver cancer include:
- Pain or discomfort in the right shoulder or upper abdomen
- Abdominal swelling or bloating
- Feeling full quickly when eating
- Shortness of breath
- Swollen feet or legs
Digestive symptoms may also occur, though they are not specified here.
The NHS advises that although many symptoms are common and can result from different causes, it is important to have them checked by a GP. Early diagnosis may make treatment more effective if cancer is the cause.
Cancer Research UK also stresses the importance of consulting a doctor about these symptoms. While primary liver cancer is uncommon in the UK and these signs may indicate other conditions, assessment is crucial.
Liver cancer is often called a “silent killer” because it seldom produces early warning signs. Many patients have no symptoms when tumours are small. Since the liver lacks pain receptors, tumours or severe damage can grow for a long time without causing local pain.
Early symptoms may be absent or resemble less serious issues like fatigue or mild stomach bloating, which contributes to most cases being detected at a late stage.