The news of “coughing for a long time is actually liver cancer” has aroused people’s attention. Is coughing really an early symptom of liver cancer? Experts said, “The most obvious symptoms of liver cancer are not wanting to eat, yellow face, upper abdominal pain, abdominal distension, etc.”, while coughing is not a common symptom of liver cancer.
Symptom 1: Pain in liver area
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The majority of patients with mid- to late-stage liver cancer have pain in the liver area as the first symptom, and the incidence rate is over 50%. Pain in the liver area is usually located in the right rib area or under the fenestra, and the nature of pain is intermittent or continuous hidden pain. Dull pain or stabbing pain, the patient may feel discomfort in the right upper abdomen for a period of time before the pain. The pain may be mild and severe or may be relieved by itself for a short period of time. The pain is mainly caused by the rapid enlargement of the tumor, which compresses the peritoneum of the liver and produces pulling pain.
In a few patients, the sudden onset of severe pain in the liver area spontaneously or after liver puncture is mostly due to the rupture and bleeding of cancer nodules located on the surface of the liver. If there are also signs of blood pressure drop and shock, and bloody fluid in the abdominal cavity, it means that the rupture and bleeding of cancer nodules are serious. In this case, emergency resuscitation is needed. If there is no accompanying symptom as mentioned above and the pain is more limited, it indicates that the bleeding is located in the subhepatic peritoneum. Pain may vary according to the location of tumor growth. Tumors located in the left lobe often cause pain in the middle and upper abdomen; tumors located in the right lobe have pain in the right quarter rib area; when tumors involve the transverse septum, pain radiates to the right shoulder or right back, which is easily mistaken for shoulder arthritis; when tumors are located in the posterior part of the right lobe, sometimes they may cause lumbar pain; if tumors are located deep in the liver parenchyma, they usually rarely feel pain.
Symptom 2: Gastrointestinal symptoms
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According to incomplete statistics, about 37% of liver disease patients mistook “stomach disease” for “stomach disease” at the early stage of the disease and missed the treatment. Decreased appetite, upper abdominal fullness after meals. Ambiguous gas, indigestion and nausea are common digestive symptoms of liver cancer, among which loss of appetite and abdominal distension are the most common. Diarrhea is also a common GI symptom of hepatocellular carcinoma, which has been reported both at home and abroad with high incidence and is easily mistaken for chronic enteritis. Portal hypertension and intestinal dysfunction caused by portal vein or hepatic vein thrombosis can lead to abdominal distension and increased stool frequency, and abdominal distension can also be caused by ascites. Gastrointestinal dysfunction can also lead to indigestion, ambiguous gas, nausea and other symptoms.
Symptom three: fever
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A considerable number of liver cancer patients will have sweating and fever. Most of the fever is low to moderate fever, and a few patients may have high fever, above 39℃, which is usually not accompanied by chills. Most of the fever in liver cancer is cancer fever, which is caused by the release of pyrogen into the blood circulation after the necrosis of tumor tissue. Due to low resistance, tumor patients are easily combined with infections, and fever may also appear, which is sometimes not easily distinguished from cancer fever of liver cancer.
Symptom 4: Wasting and weakness
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Patients with liver cancer often feel more weak than patients with other tumors, which is similar to patients with chronic hepatitis. The causes of weakness are unknown. It may be due to digestive disorders, lack of energy due to impaired nutrient absorption, or liver cell damage and decreased liver function, which makes metabolic disorders, inactivation of certain toxins in time, or release of toxic substances due to liver cancer tissue necrosis. Wasting is also a common symptom of liver cancer patients, which is due to impaired liver function. It is caused by the decrease of digestion and absorption function. With the development of the disease, the degree of wasting can be aggravated, and in serious cases, cachexia can appear.
Symptom 5: Bleeding tendency
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Patients with liver cancer often have bleeding tendency such as gum bleeding and subcutaneous bruises, which are mainly due to impaired liver function and abnormal coagulation function, and it is especially common in patients with liver cancer combined with cirrhosis. Gastrointestinal bleeding is more common and is mainly due to varices in the esophagogastric fundus due to portal hypertension. In fact, gastrointestinal bleeding is also the most common cause of death in patients with hepatocellular carcinoma.
Symptom 6: Lower limb edema
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Patients with hepatocellular carcinoma with ascites often have lower limb edema, which occurs in the ankle in mild cases and may spread to the whole lower limb in severe cases. In clinical practice, we have seen some patients with highly edematous lower limbs, and the water can ooze out from the skin of thighs. The main cause of lower limb edema is the obstruction of venous return by ascites compression of lower limb veins or cancer thrombus. Mild edema can also be caused by low plasma albumin.
Symptom 7: Acute abdomen
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The rupture of cancer nodules usually causes pain in the liver area and obvious pressure pain in the liver area during physical examination, which is a symptom of liver peritoneal irritation. After rupture of cancer nodules, some patients show acute abdominal pain with peritoneal irritation symptoms, which can be easily misdiagnosed as acute peritonitis. The abdominal pain caused by rupture of cancer nodules is usually accompanied by a drop in blood pressure or even shock.