Nerve pain in the right shoulder could be an early indicator of liver cancer, according to the NHS. Even though the shoulder and liver are located in different areas of the body, damage or growth in this organ can cause "referred pain."
Referred pain occurs when an issue in one area triggers discomfort somewhere else due to shared pathways in the body's nervous system. Other common examples include neck problems causing headaches or hip issues causing knee pain.
How liver cancer causes shoulder pain
NHS guidance notes that shoulder discomfort can stem from an enlarged liver putting pressure on adjacent nerves. As a tumour develops, it can affect these surrounding nerves, leading the brain to interpret the signal as pain near 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 cause discomfort, early fullness during meals, 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, causing fluid to accumulate in the abdominal cavity (ascites).
Liver disease statistics in the UK
Additionally, elevated pressure can cause surface veins in the abdomen to swell. Fluid accumulation can also occur if the liver stops producing sufficient albumin, a key blood protein.
Cancer Research UK highlights liver disease as an increasingly common condition, leading to over 11,000 deaths annually in the UK—roughly 31 per day. Death rates from liver disease have quadrupled over the past 50 years.
Approximately 6,200 people in the UK die from liver cancer each year. Pre-existing liver disease remains a significant risk factor, present in 80% to 90% of hepatocellular carcinoma cases and about 30% of bile duct cancers.
Symptoms and when to see a GP
Liver cancer has one of the lowest five-year survival rates in the UK at just 13%. Because symptoms often develop late, only 30% of cases are diagnosed at early stages.
Located in the upper right abdomen, the liver plays an essential role in processing nutrients and filtering toxins from the body. Liver cancer can originate in the organ itself (primary) or spread from another area (secondary).
Outlook and severity depend on tumour size, location, spread, type, and overall health. It is vital to have any potential liver cancer symptoms evaluated by a doctor promptly, as the condition can affect anyone regardless of known risk factors.
Liver cancer might not show any signs at first, or it could have symptoms that are hard to notice and figure out. Both types of liver cancer, the kind that starts in the liver and the kind that spreads there from somewhere else, usually have the same kinds of symptoms.
If you already have a liver problem, like cirrhosis, you need to tell your doctor right away if you get new symptoms or if your old symptoms get worse. Some signs that might mean 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."
