Unlike other organs or tissues in the body, most nerves in the liver are located on the surface and relatively few inside the liver. Therefore, when there is a tumor in the liver, there are no specific symptoms or pain in the early stages, and it is usually not easily detected without regular screening. Eight common end-stage liver cancer symptoms are described below:
1. Pain in the liver
Some patients with liver cancer may experience mild liver pain in the early stage of the disease, and the pain will be more pronounced in the middle and late stages. This pain is mainly due to the enlargement of the tumor, which presses on the liver pericardium, or involves other tissues; it may also be due to the irritation of the liver pericardium by the tumor necrosis.
2. Weight loss and weakness
Patients with advanced hepatocellular carcinoma may experience wasting and generalized weakness, and in severe cases, they may show signs of cachexia. Cachexia, commonly known as cachexia, manifests as a syndrome of extreme wasting, anemia, difficulty taking care of oneself, and then systemic failure.
3. Jaundice
Jaundice is a common symptom of advanced liver cancer. Diffuse liver cancer and cholangiocarcinoma are most likely to develop jaundice. Jaundice is mostly due to bile duct compression or bile duct obstruction caused by tumor invasion of bile ducts. The main manifestation is yellowing of the skin and sclera.
4. Fever
Late stage hepatocellular carcinoma often bleeds fever, mainly afternoon fever, which may have no obvious symptoms and may subside on its own or after taking medication. If tumor compression or invasion of bile duct can be complicated by biliary tract infection, it may cause high fever.
5. Bleeding
Advanced hepatocellular carcinoma is prone to bleeding, including ruptured liver bleeding, upper gastrointestinal bleeding and subcutaneous bleeding.
Ruptured hepatic bleeding: High malignancy of hepatocellular carcinoma, rapid growth and excessive volume increase, and the inability of the tumor tegument to stretch, can lead to ulceration of the tumor surface and cause bleeding. When the tumor is located in the superficial position of liver, it is easy to be impacted by external force to cause bleeding. Therefore, patients with liver cancer should avoid receiving impact on the right upper abdomen in their daily life.
Upper gastrointestinal bleeding: A common complication of advanced hepatocellular carcinoma, mainly hepatocellular carcinoma patients are often accompanied by esophagogastric fundic varices, whose clinical manifestations are mainly vomiting blood and black stools, often accompanied by clinical manifestations of decreased blood pressure and insufficient blood volume, which are common emergencies. Once the bleeding and vomiting symptoms, should pay great attention and seek medical attention in time.
Subcutaneous bleeding: Patients with hepatocellular carcinoma, especially those with combined cirrhosis, have abnormal coagulation routine and lack of coagulation factors, and are prone to symptoms such as gingival and subcutaneous bleeding. The subcutaneous bleeding spots can be seen on examination. Daily attention should be paid to using a soft-bristled toothbrush and regular monitoring of blood and coagulation routines.
6. Ascites and lower limb edema
Patients with hepatocellular carcinoma develop ascites and edema mainly due to chronic impaired liver function, which reduces albumin synthesis and causes ascites due to hypoproteinemia. Patients with hepatocellular carcinoma ascites often show symptoms such as dry throat and mouth and thirst. In addition, lower limb edema is also related to the compression of lower limb veins by ascites or obstruction of cancer emboli, which block the venous return, and clinical attention should be paid to supplemental albumin and diuresis.
7. Hepatorenal syndrome
Hepatorenal syndrome refers to acute renal failure that occurs in the setting of severe liver disease. Hepatorenal syndrome is easily complicated by hepatocellular carcinoma cirrhosis or severe hepatitis with massive peritoneal effusion. It is characterized by decreased or absent urine output, azotemia, dilutional hyponatremia, and decreased sodium content in the urine without severe lesions on renal examination, which is a serious complication of severe liver disease.
8. Hepatic encephalopathy
Hepatic encephalopathy may occur in patients with advanced hepatocellular carcinoma, especially with cirrhosis. Additional complications of hepatocellular carcinoma, such as upper gastrointestinal bleeding, massive potassium drainage diuresis, and discharge of ascites, may also lead to hepatic encephalopathy. Clinical manifestations include abnormal behavior, sleep inversion with daytime drowsiness and nighttime excitement, drowsiness, liver odor, etc. Fluttering wing-like tremor can also be found on physical examination. If any of these abnormalities occur, attention should be paid to rechecking blood ammonia.
*Fluttering tremor is caused by basal ganglia lesions and cerebellar ataxia. When the patient extends the fingers and wrists flat, the wrists suddenly flex and then straighten rapidly, resembling the wings of a bird flapping, hence the name.