Liver Cancer: Causes & Symptoms


Our Approach to Treatment

Houston Methodist’s specialists are among the nation’s best in treating liver and bile duct cancers. We tightly coordinate your care with consultations involving surgeons, medical and radiation oncologists, gastroenterologists and hepatologists.


Patients travel across the country to receive treatment because we offer each patient the best possible care, resulting in exceptional outcomes and high survival rates. Our specialized team, including renowned transplant surgeons, often treats patients who have sought care elsewhere.


We are committed to ensuring each patient receives exceptional and personalized expert care in a compassionate, collaborative and innovative environment — care we would provide our families.

Bile Duct Cancers

  • Intrahepatic — develop in the smaller bile duct branches inside the liver
  • Perihilar — develop where the left and right hepatic ducts join and leave the liver
  • Distal — found closer to the small intestine and start outside of the liver

Causes And Risk Factors

  • Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection
  • Cirrhosis
  • Certain inherited liver diseases, including hemochromatosis and Wilson's disease
  • Diabetes
  • Nonalcoholic fatty liver disease — fat accumulation in the liver
  • Aflatoxin exposure — poisons produced by molds that grow on poorly stored crops, including corn and peanuts
  • Excessive alcohol consumption
  • Primary sclerosing cholangitis — bile ducts inflammation (cholangitis) leads to scar tissue formation (sclerosis)
  • Bile duct stones
  • Choledochal cysts — bile-filled sacs connected to the bile ducts
  • Liver fluke infections — occur in some Asian countries after people eat raw or poorly cooked fish infected with these parasite worms. These flukes live in the bile ducts and can cause bile duct cancer
  • Abnormalities where the bile and pancreatic ducts meet
  • Polycystic liver disease (PLD or PCLD) — a rare condition causing cysts to grow throughout the liver
  • Caroli syndrome — dilation of the intrahepatic bile ducts at birth
  • Inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease
  • Aging
  • Obesity
  • Smoking
  • Pancreatitis
  • HIV infection
  • Exposures to asbestos, radioactive chemicals or dioxin, nitrosamines or polychlorinated biphenyls (PCBs)


  • Blood tests
  • Imaging:
    • Ultrasound
    • Conputerized tomography (CT) scan
    • Magnetic resonance imaging (MRI)
  • Liver biopsy

Liver Cancers

  • Hepatocellular carcinoma (HCC) — begins in the hepatocytes, cells that make up the liver’s main tissue. HCC sometimes starts as a single tumor and spreads to other parts of the liver, or it may develop as nodules at several different places in the liver
  • Angiosarcoma — rare cancer of cells that line the walls of blood vessels or lymphatic vessels


  • Unexplained weight loss
  • Appetite loss
  • Upper abdominal pain
  • Nausea and vomiting
  • Abdominal swelling
  • Yellow discoloration of skin and whites of eyes (jaundice)
  • Stool discoloration
  • Itching
  • Dark urine
  • Fever

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