In some people, the liver cancer itself can cause pain, particularly in the upper right area of the abdomen (belly) and, sometimes, in the right shoulder. In advanced cancer, the liver may press on nerves that connect to the shoulder. This is called referred pain.
Pain associated with liver cancer can be managed with different types of pain medicines. These may be mild, like paracetamol, or strong and opioid-based, like morphine, hydromorphone and fentanyl. Some medicines, such as ibuprofen and aspirin, may not be suitable for pain caused by liver cancer, especially in people with a history of gastric ulcers or gastritis. Speak to your doctor about the best type of medicines to use to manage pain.
Radiation therapy may also provide relief by reducing the size of a liver tumour that is causing pain. Some people may have an injection of local anaesthetic to numb the nerve sending the pain signals (nerve block). People may also be referred to a palliative care or pain specialist, as this can be very helpful in managing pain caused by cancer.
How to cope with pain
- Keep track of your pain in a symptom diary. Try to describe what the pain feels like, how intense it is, exactly where it is, where it comes from and travels to, how long it lasts, and if it goes away with a specific pain medicine or with any other therapy, such as a heat pack.
- Allow a few days for your body to adjust to the dose of pain medicine and for any drowsiness to improve.
- Let your doctor know if you have vivid dreams, nausea or other side effects after taking a strong pain medicine such as morphine. The doctor can adjust the dose, which may help, or you can try other methods of pain relief.
- If you are taking an opioid-based drug like morphine, it is important to use a laxative regularly to prevent or relieve constipation.
- Take pain medicine as prescribed, even when you’re not in pain. Managing pain may become more difficult if pain medicine is not taken regularly – it’s better to stay on top of the pain.
For more on this, see Pain and cancer.
Podcast: Managing Cancer Pain
A/Prof Simone Strasser, Hepatologist, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital and The University of Sydney, NSW; A/Prof Siddhartha Baxi, Radiation Oncologist and Medical Director, GenesisCare, Gold Coast, QLD; Prof Katherine Clark, Clinical Director of Palliative Care, NSLHD Supportive and Palliative Care Network, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW; Anne Dowling, Hepatoma Clinical Nurse Consultant and Liver Transplant Coordinator, Austin Health, VIC; A/Prof Koroush Haghighi, Liver, Pancreas and Upper Gastrointestinal Surgeon, Prince of Wales and St Vincent’s Hospitals, NSW; Karen Hall, 131120 Consultant, Cancer Council SA; Dr Brett Knowles, Hepato-Pancreato-Biliary and General Surgeon, Royal Melbourne Hospital, Peter MacCallum Cancer Centre and St Vincent’s Hospital, VIC; Lina Sharma, Consumer; David Thomas, Consumer; Clinical A/Prof Michael Wallace, Department of Hepatology and Western Australian Liver Transplant Service, Sir Charles Gairdner Hospital Medical School, The University of Western Australia, WA; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT.
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