What is Liver Cancer?

Liver cancer is a type of cancer that originates in the liver, which is responsible for filtering toxins from the blood. It can be classified as primary, developing on the liver itself; or secondary, in which cancer that originates from another part of the body has metastasised or spread to the liver. There are many things that can cause liver cancer, from alcohol abuse to health conditions such as hepatitis B or C. Liver cancer is also one of the most common reasons why an individual may need to undergo liver surgery in Singapore.

What is the Function of the Liver?

The liver is considered one of the largest organs in the body with a size similar to a football. It is situated in the upper right area of the abdomen, below the ribs and above the stomach. Filtering blood, producing bile that aids in digesting vitamins, fats, and other nutrients, and regulating blood levels of amino acids are some of the bodily functions that the liver performs.

What are the Types of Primary Liver Cancer?

Hepatocellular carcinoma

This is the most common type of primary liver cancer that occurs in individuals with cirrhosis or intense scarring of the liver due to repetitive damage caused by having hepatitis B or C. Other causes include too much alcohol consumption and fatty liver diseases. Liver cancer surgeons in Singapore diagnose this condition through imaging tests or blood tests. Some of the common indicators of this condition are pain in the abdomen, weight loss, and a feeling of having a large mass in the upper part of the abdomen.


Also called "bile duct cancer", cholangiocarcinoma affects the bile ducts, which carries bile from the liver and gallbladder to the small intestine. This more frequently afflicts individuals who are above 65 years old. Some of the symptoms of this condition include jaundice or yellowing of the skin and eyes, fatigue, abdominal pain, weight loss, and fever.

Fibrolamellar carcinoma

A rare form of liver cancer, fibrolamellar carcinoma usually occurs in adults who are younger than 40 years old and teenagers. This form of liver cancer is unique in that it develops in people who have healthy livers.


This is the most common type of liver cancer that affects children younger than 3 years old. This form of cancer occurs more commonly in children who were either born very prematurely or were born with very low weights at birth.

What are the Symptoms of Liver Cancer?

  • Jaundice or yellowing of the skin and eyes
  • Loss of appetite
  • Swelling or build-up of fluid in the abdomen
  • Weight loss
  • Fatigue or feeling tired
  • Feeling full after eating even a small meal
  • Abdominal swelling
  • Abdominal pain

What are the Risk Factors of Liver Cancer?

The following can increase one’s likelihood of developing liver cancer:

  • Long-term infection with hepatitis B or hepatitis C
  • Cirrhosis or scarring of the liver
  • Excess consumption of alcohol
  • Obesity
  • Diabetes
  • Non-alcoholic fatty liver disease

What are the Diagnostic Tests for Liver Cancer?

In order to check if patients have liver cancer, a liver surgeon may prescribe certain diagnostic tests, such as:


An ultrasound generates images that can indicate a possible tumour or mass in the liver.

Blood Test

A tumour marker blood test will check whether an individual has a higher level of AFP (alpha-fetoprotein), which may be a sign of liver cancer.

CT Scan

A type of x-ray test that creates detailed images of the abdomen. This can help liver cancer surgeons find out the size, shape, and location of growing tumours in the liver, if any.


By removing a sample of liver tissue for laboratory testing, a biopsy can help doctors check if a patient has liver cancer.

What are the Treatments for Liver Cancer?

There are various treatments for patients with liver cancer, and these include:


Patients who have liver cancer usually undergo liver cancer surgery (liver resection), especially if it is still small and has not spread outside of the liver. By doing so, the surgeon will remove damaged parts of the liver or all of the liver. If the entire liver is removed, the patient will need a liver transplant to replace it with a healthy one.


Chemotherapy uses drugs to destroy cancer cells, and are often used for patients whose cancer cannot be treated via surgery. These drugs are usually administered intravenously – directly into the blood vessel that carries blood into the liver.

Radiofrequency Ablation

Ablation refers to treatment that aims to destroy tumours in the liver without having to remove them. First, a thin probe is inserted into the skin to reach the tumour. Then, high-energy radio waves are passed through the tip of the probe, which heats the tumour and kills the cancer cells in the liver.


During this treatment, radiation (such as x-rays) is used to destroy cancer cells. This can be done externally, where the radiation used to destroy cancer cells comes from a machine outside the body, or internally, wherein radioactive beads are injected into the blood supply of the liver to prevent cancer cells from developing.
Headed by Dr Wong Jen San, the Hepatobiliary & Pancreatic Surgery Centre offers liver cancer surgery in Singapore and other non-surgical therapies to manage the condition as effectively as possible. For more information, call 6235 4088.
Dr Wong Jen San
Consultant Hepatobiliary & Pancreatic Surgeon
MBChB (UK), MMed (S’pore), Msc (S’pore), FRCS (Edin), FAMS

Upon graduating from the University of Leicester and completing his basic surgical training in the United Kingdom, Dr Wong went on to complete advanced training in Singapore before embarking on his HMDP clinical fellowship in Japan—specializing in living donor liver transplantation.

Prior to establishing his own practice, Dr Wong was previously a consultant with the Department of Hepatopancreatobiliary & Transplant Surgery at SGH, an adjunct assistant professor at the Duke-NUS Graduate Medical School and a visiting consultant at the National Cancer Centre Singapore.

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The Hepatobiliary-Pancreatic System
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