What is the most common presenting symptom in liver cancer?

The most common presenting symptom in liver cancer is often right upper quadrant (RUQ) pain. This symptom arises due to the liver's location in the body and its involvement in the disease process. As liver cancer progresses, it can lead to a range of structural changes, such as the formation of tumors or enlargement of the liver, both of which can create discomfort or pain in the RUQ. This pain may be persistent and can sometimes radiate to the back or shoulder, reflecting the irritation or stretching of the liver capsule or surrounding structures.

Although jaundice, fatigue, and ascites are also important symptoms associated with liver cancer, RUQ pain is frequently noted as an earlier and more direct symptom that prompts individuals to seek medical evaluation. Jaundice can develop as the cancer affects liver function and bile excretion, whereas fatigue is a common but nonspecific symptom that may arise from various factors, including overall health decline. Ascites, which is the accumulation of fluid in the abdominal cavity, generally occurs at a later stage in the disease process as portal hypertension develops, leading to increased pressure in the blood vessels of the liver. Therefore, RUQ pain stands out as a primary presenting symptom when assessing patients for liver cancer.