The cancer can cause ‘referred pain’ – where you feel discomfort in one area even though the source of the pain is elsewhere
The NHS has issued a warning that nerve pain in your right shoulder could be an indication of liver cancer. Despite the physical distance between the right shoulder and the liver, ‘referred pain’ can sometimes occur due to cancer in this organ.
Referred pain is a phenomenon in which discomfort is felt in one part of the body even though the actual source of the pain is located elsewhere. This is due to the complex interconnections within the nervous system.
Examples of referred pain include experiencing a headache due to a sore neck or knee pain due to a hip issue. Shoulder pain could potentially signal liver cancer because when the liver becomes enlarged, it can exert pressure on nerves connected to the shoulder. A tumour or its spread can impact these nerves, leading your brain to perceive pain in the shoulder blade, even though the origin of the pain is the liver, reports Surrey Live.
Cancer Research UK further explains: “A swollen abdomen might cause discomfort or pain, and a loss of appetite or feeling full quickly. A swollen (enlarged) liver can cause pain in your right shoulder. This is because the enlarged liver stimulates nerves that connect to nerves in the shoulder. This is called referred pain.”
According to the British Liver Trust, approximately 6,200 people succumb to liver cancer every year in the UK – equating to 17 individuals per day. The trust adds: “Having liver disease is one of the main risk factors for liver cancer. Around 30% of people with bile duct cancer have underlying liver disease.”
Liver cancer ranks differently in prevalence among males and females in the UK, with around 2,200 new cases each year, making it the 20th most common cancer in females. For males, there are about 4,300 new cases annually, positioning it as the 13th most common cancer.
The liver is a substantial organ in the upper right of the abdomen, pivotal for food digestion and toxin filtration. Liver cancers are categorised as primary, originating within the liver, or secondary, spreading from elsewhere in the body. The severity of liver cancer depends on various factors, including its precise location, size, whether it has spread (metastasised), and the overall health of the individual.
Signs of liver cancer can be non-existent or present with subtle symptoms challenging to pinpoint. Primary and secondary liver cancers typically share similar symptoms. Patients with pre-existing liver conditions, like cirrhosis, should promptly report new or aggravating symptoms to their doctors. Indicative signs of liver cancer may include:
- the whites of your eyes turning yellow or your skin turning yellow, which may be less obvious on brown or black skin (jaundice) – you may also have itchy skin, darker pee and paler poo than usual
- loss of appetite or losing weight without trying to
- feeling tired or having no energy
- feeling generally unwell or having symptoms like flu
- a lump in the right side of your tummy
Digestive-related symptoms might also surface, such as:
- feeling or being sick
- pain at the top right side of your tummy or in your right shoulder
- symptoms of indigestion, such as feeling full very quickly when eating
- a very swollen tummy that is not related to when you eat
The NHS advises: “Many of these symptoms are very common and can be caused by different conditions. Having them does not definitely mean you have liver cancer. But it’s important to get them checked by a GP. This is because if they’re caused by cancer, finding it early may mean it’s easier to treat.”
Cancer Research UK has urged vigilance: “See your GP if you have any of these symptoms. Remember primary liver cancer isn’t common in the UK and these symptoms can be caused by other conditions. But it’s important to get them checked by a doctor.”
Pain from liver cancer can be managed with pain medicines, radiation therapy, or a nerve block. Seek medical advice if you experience:
- Pain and other symptoms of liver cancer that persist or worsen after two weeks.
- Significant weight loss in the last 6–12 months without trying.
- A lump in the abdomen.
If your GP sends you to a specialist, various tests may be conducted to diagnose liver cancer. Potentially required assessments include blood tests, imaging tests like ultrasound, CT scans, or MRIs, and possibly a biopsy to check liver cells for signs of cancer.
For those with a history of cancer elsewhere, specialists might also opt for a PET scan should there be suspicion of secondary liver cancer affecting the liver. These diagnostics can also detect bile ducts, pancreas, or gallbladder problems.
The NHS advises that while completely avoiding liver cancer is not always feasible, lifestyle alterations can diminish your risk. This involves trying to lose weight if you’re overweight, wearing protective clothes and masks if you work in a job where you’re exposed to harmful chemicals, trying to cut down on alcohol and quitting smoking.
Above all, getting any liver cancer symptoms evaluated by a healthcare professional is crucial. Everyone should remain vigilant as liver cancer can affect anyone, regardless of their perceived risk.
Macmillan Cancer Support has a free helpline that’s open every day from 8am to 8pm. They’re there to listen if you have anything you want to talk about. Call 0808 808 00 00.
