Cancer and liver failure: what you should know

The liver has considerable reserve, so function depends on how much healthy tissue remains, whether bile or blood flow is obstructed, and whether another liver disease is present. Blood tests, scans, symptoms and a physical examination help the care team judge how well the liver is working.

Liver failure means the liver can no longer perform essential jobs adequately, such as clearing waste, making proteins needed for blood clotting and processing medicines. Primary liver cancer begins in the liver, while cancers from other organs can spread there. Either can impair function if a large amount of liver tissue is affected or if a tumour blocks bile ducts or important blood vessels.

Some people with liver cancer already have scarring or chronic liver disease, which reduces the liver's reserve. Infection, dehydration, bleeding, medicines or cancer treatment may then trigger a sudden decline. Possible signs include yellowing of the skin or eyes, abdominal swelling, easy bleeding, marked sleepiness or confusion. These signs can have other causes, so the clinical assessment matters.

Contact the oncology or liver team promptly if jaundice, swelling, reduced appetite, vomiting, increasing weakness or changes in alertness appear or worsen. Keep a current list of prescription medicines, non-prescription products and herbal supplements; a damaged liver may process them differently, and the team may need to adjust or stop some products. Do not change prescribed treatment without medical guidance.

Treatment is tailored to both the cancer and the remaining liver function. The team may address a reversible trigger, relieve a blocked bile duct, manage fluid build-up or bleeding, and consider cancer-directed treatment. Liver resection or tumour ablation may suit selected localised tumours when enough functioning liver can be preserved. Immunotherapy or targeted therapy may be considered in some settings, but liver function influences whether and how these medicines are used. Supportive and palliative care can be provided alongside cancer treatment to control symptoms and help with decisions.

Seek emergency medical help for new confusion, inability to stay awake, vomiting blood, black tar-like stools, severe shortness of breath, collapse or a seizure. These can signal brain effects from toxin build-up, significant bleeding or another serious complication.

Arrange prompt medical assessment for new or rapidly worsening jaundice, a swollen or painful abdomen, fever, repeated vomiting, much less urine than usual, or bleeding that is difficult to stop. Bring the medicine list and details of recent cancer treatment, because both can guide immediate testing and management.

Ask whether the current problem is caused by the cancer, an underlying liver condition, a blocked bile duct, treatment effects or another reversible trigger. Useful follow-up questions include which changes in blood tests or scans matter, whether any medicines or supplements should be avoided, how treatment could affect liver reserve, which symptoms require emergency care, and who to contact if symptoms worsen outside clinic hours.