Nerve pain in the right shoulder could be an early warning sign of liver cancer, according to the . Despite the shoulder and liver being situated in entirely different parts of the body, damage or growth within this organ can trigger what is known as “referred pain.”
Referred pain occurs when a problem in one area causes discomfort elsewhere, due to shared pathways within the body’s nervous system. Other well-known examples include neck problems causing headaches, or hip issues leading to knee pain.
NHS guidance states that shoulder discomfort can arise from an enlarged liver placing pressure on nearby nerves. As a tumour grows, it can affect these surrounding nerves, leading the brain to interpret the signal as pain close to the shoulder blade.
Cancer Research UK explains that a swollen liver can irritate nerves connected to the shoulder, generating referred pain. Abdominal swelling may also bring about discomfort, early fullness when eating, shortness of breath, or swollen feet.
The charity notes that growing tumours can cause swelling on the right side of the abdomen. This expansion increases pressure in the liver veins, resulting in fluid building up in the abdominal cavity, a condition known as ascites, reports .
Elevated pressure can cause surface veins in the abdomen to become swollen. Fluid accumulation can also develop if the liver ceases to produce adequate amounts of albumin, a vital blood protein.
Cancer Research UK emphasises liver disease as an increasingly prevalent condition, resulting in more than 11,000 deaths each year in the UK—approximately 31 daily. Mortality rates from liver disease have increased fourfold over the last half-century.
Around 6,200 people in the UK succumb to liver cancer annually. Pre-existing liver disease continues to be a major risk factor, present in 80% to 90% of hepatocellular carcinoma cases and roughly 30% of bile duct cancers.
Liver cancer has one of the poorest five-year survival rates in the UK at merely 13%. Since symptoms frequently emerge late, only 30% of cases are identified at early stages.
Situated in the upper right abdomen, the liver performs a crucial function in processing nutrients and filtering toxins from the body. Liver cancer can begin in the organ itself (primary) or migrate from another location (secondary).
Prognosis and severity depend on tumour size, location, spread, type, and general health. It is essential to have any potential liver cancer symptoms assessed by a doctor without delay, as the condition can impact anyone irrespective of known risk factors.
Liver cancer may not display any signs initially, or it could present symptoms that are difficult to spot and interpret. Both forms of liver cancer, the type that originates in the liver and the type that spreads there from elsewhere, typically share the same kinds of symptoms.
If you are already living with a liver condition, such as cirrhosis, it is crucial to inform your doctor immediately if you develop new symptoms or if your existing symptoms deteriorate. Some indicators that could suggest you have liver cancer 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 says: “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 adds: “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.”
Liver cancer is commonly called a “silent killer” because it rarely causes early warning signs or symptoms in its initial stages. Most patients with primary liver cancer (such as hepatocellular carcinoma) have no abnormal signs or discomfort while the tumour is small.
The liver itself does not have pain receptors, meaning a tumour or severe inflammation/fibrosis can grow for a long time without causing localised pain.
Because early symptoms are absent or mimic other common, less serious conditions (like general fatigue or mild stomach bloating), the majority of cases are diagnosed at an advanced stage