Complications of liver cancer can be extensive and affect more than just the liver. They often involve many other body systems and arise from both tumour progression and the underlying liver disease. These complications influence survival, quality of life, and how well treatment works.
A clear understanding of the complications of liver cancer helps clinicians, caregivers, and patients prepare for problems, act early, and deliver well-rounded care.
Liver Failure and Hepatic Encephalopathy
One of the most serious complications of liver cancer is liver failure. As the tumour grows, it replaces or compresses healthy liver tissue. This damages essential liver functions, such as making proteins, removing toxins, and producing bile.
When the liver fails, patients may develop jaundice, bleeding problems (due to reduced clotting factors), low blood sugar, and hepatic encephalopathy. The latter is a brain condition caused by toxins like ammonia building up in the blood.
Hepatic encephalopathy often starts with forgetfulness, irritability, or disturbed sleep. It can progress to confusion, disorientation, or even coma. Gastrointestinal bleeding, infections, and high protein intake can make it worse. Treatment may include lactulose, rifaximin, diet changes, and addressing triggers.
Portal Hypertension and Related Complications of Liver Cancer
Portal hypertension occurs when blood flow through the liver is blocked by cirrhosis or tumour growth. This raises pressure in the portal vein, creating enlarged veins (varices) in the oesophagus and stomach. If varices rupture, severe gastrointestinal bleeding can follow, often showing as vomiting blood or passing black stools.
Ascites — fluid build-up in the abdomen — is another frequent result of portal hypertension. It causes bloating, discomfort, and breathing difficulty. It can also increase the risk of spontaneous bacterial peritonitis (SBP), a dangerous infection. Management includes reducing salt in the diet, using diuretics, draining fluid (paracentesis), or in some cases, a transjugular intrahepatic portosystemic shunt (TIPS).
Jaundice, Malnutrition, and Infections
Jaundice may result from blocked bile ducts or liver dysfunction. It causes yellow skin and eyes, itching, dark urine, and pale stools. While not always life-threatening, it signals advanced disease and may limit treatment options.
Cancer cachexia — muscle and weight loss due to the tumour’s metabolic demands — is common. Poor appetite, nausea, and digestive problems make it worse. Nutritional support, high-protein supplements, appetite stimulants, and anti-nausea medications can help.
Liver cancer patients are also prone to infections, especially if liver function is poor or they are on immune-suppressing treatments. Pneumonia, urinary tract infections, and sepsis are frequent risks and can worsen other complications.
Bone, Lung, and Blood-Related Complications of Liver Cancer
In advanced disease, liver cancer can spread to the bones or lungs. Bone metastases may cause pain, fractures, and high calcium levels. Lung spread can cause cough, breathlessness, or chest pain.
Blood clotting issues are common. Patients may both bleed easily and be prone to blood clots. Portal vein thrombosis is a serious complication that worsens portal hypertension and limits treatment choices.
Rare and Psychological Complications
In rare cases, liver tumours may rupture and bleed internally. This is a medical emergency that causes sudden, severe abdominal pain, low blood pressure, and shock. Urgent surgery or embolisation may be needed.
Psychological effects — including anxiety, depression, and fear — are common and can be as challenging as physical symptoms. Emotional support, counselling, and medication for mood disorders can make a big difference.
Treatment-Related and End-Stage Complications of Liver Cancer
Cancer treatment itself can cause side effects. Chemotherapy, targeted therapy, and immunotherapy may lead to fatigue, nausea, diarrhoea, skin problems, or inflammation in organs. Managing these requires balancing tumour control with quality of life.
In late stages, the build-up of multiple complications often signals a shift toward palliative care. The focus becomes comfort, symptom control, and emotional well-being. Hospice care may allow patients to spend their final days in a preferred setting.
Final Thoughts on the Complications of Liver Cancer
The complications of liver cancer are diverse, often linked, and can affect nearly every part of the body. From liver failure to infections, malnutrition, and emotional distress, these problems require early recognition and proactive management. With a holistic approach, it is possible to preserve dignity and comfort, even in advanced illness.
