The NHS has warned experiencing nerve pain in your right shoulder could be a sign of liver cancer. Although the right shoulder and liver aren’t very close to each other in the body, cancer in the vital organ can sometimes cause ‘referred pain’.
Referred pain occurs when you feel discomfort in one area of your body, even though the source of the pain is located somewhere else. This happens due to the intricate connections within the body’s nervous system. Examples of referred pain include a headache from a sore neck and knee pain caused by a hip problem.
Shoulder pain might indicate liver cancer. When the liver enlarges, it can put pressure on the nerves linked to the shoulder. Additionally, a tumour or its spread can affect the nerves, causing your brain to perceive pain in the shoulder blade, even though the source is the liver.
Cancer Research UK adds: “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 around 6,200 people die from liver cancer every year in the UK – that’s 17 people a day. It 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.”
In females in the UK, liver cancer is the 20th most common cancer, with around 2,200 new cases every year. In males in the UK, liver cancer is the 13th most common cancer, with around 4,300 new cases every year.
The liver is a sizable organ located in the upper right part of your abdomen. It plays a crucial role in digesting food and filtering out toxins. Liver cancer can either originate in the liver itself (primary) or spread from another part of the body (secondary). The severity of liver cancer varies based on its location within the liver, its size, whether it has metastasised, whether it is primary or secondary, and your overall health condition.
Main symptoms of liver cancer:
Liver cancer can sometimes be asymptomatic, or its symptoms may be subtle and difficult to detect. Whether the cancer originates in the liver itself (primary liver cancer) or has spread from another area of the body (secondary liver cancer), the symptoms tend to be similar.
If you have a liver condition like cirrhosis, make sure to inform your doctor about any new or worsening symptoms you may experience. Symptoms of liver cancer can 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
Other symptoms can affect your digestion, 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 said: “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 also said: “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.”
Main tests for liver cancer:
If your general practitioner refers you to a specialist, you will undergo various tests and scans to assess for liver cancer. These may involve blood tests, imaging tests such as an ultrasound, CT scan, or MRI, and a biopsy, which is a procedure to take a small sample of liver cells for cancer analysis. Not all of these tests may be necessary.
If you have a history of another type of cancer and the specialist suspects it may have spread to your liver (known as secondary liver cancer), you might also receive a PET scan. Additionally, these tests can help identify issues with your bile ducts, pancreas, or gallbladder.
Reducing your chances of primary liver cancer:
The NHS says that although you cannot always prevent liver cancer, making healthy changes can lower your chances of getting it.
- try to lose weight if you’re overweight
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wear protective clothes and masks if you work in a job where you’re exposed to harmful chemicals
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try to cut down on alcohol – avoid drinking more than 14 units a week
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try to quit smoking
Getting any symptoms of liver cancer checked by a GP is important. Anyone can get liver cancer, even if you do not think you have a higher chance of getting it.
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.