Doctors describes  liver cancer either as a primary or  secondary cancer. Liver cancer usually occurs as a secondary spread from another cancer in a remote site. Primary liver cancer is common in Africa and Southeast Asia but relatively uncommon in the United States. Primary cancers are six to 10 times more prevalent in men than in women, develop most often in the sixth decade of life, and are associated with cirrhosis of the liver in 70% of the cases.

Contributory risk factors include diseases like hemochromatosis, hepatitis, schistosomiasis, exposure to vinyl chloride or arsenic, and possibly nutritional deficiencies. Alcoholism may be a predisposing factor, but nonalcoholic cirrhosis is a greater risk than alcoholic cirrhosis. Aflatoxins in moldy grain and peanuts appear to be linked to high rates of hepatocellular carcinoma in parts of Africa.

Features of liver cancer are abdominal bloating, anorexia, weakness, dull upper abdominal pain, ascites, mild jaundice, and a tender enlarged liver; in some cases cancer nodules are palpable on the liver surface. Diagnostic procedures include radioisotope scan, needle biopsy, and various laboratory studies of liver function. An elevated level of alkaline phosphatase, increased retention of sulfobromophthalein, and the presence of alpha fetoprotein in the blood suggest liver cancer.

All primary liver tumors are adenocarcinomas, classified as hepatomas when derived from hepatic cells, and cholangiomas if they originate in cells of the bile duct. They form large single nodules or satellite nodules surrounding a central lesion and are found more often in the right lobe than in the left. Primary lesions spread centrifugally in the liver, invade the portal vein and lymphatic vessels, and spread to lymph nodes, the lungs, brain, and other sites.

Total hepatic lobectomy is the treatment of choice for primary tumors; because the liver is able to regenerate, 80% of it may be resected. Systemic chemotherapy such as methotrexate, cyclophosphamide, and 5-fluorouracil infused through a catheter in the hepatic artery may result in temporary cancer regression. Irradiation is less effective. It is very destructive to liver cells and not very toxic to tumor cells in the liver.