A doctor explaining a liver model to a woman in a clinic

Kanser Hati (Liver Cancer): Tanda, Punca & Tahap 4

十月 25, 2026 Drann Editorial Team

Kanser hati (liver cancer) is the 5th most common cancer in Malaysia and the 4th most common cause of cancer death. It often causes no symptoms at first; later signs include yellow skin or eyes (jaundice), weight loss, tiredness, a swollen tummy and pain in the upper right tummy or right shoulder. Most primary liver cancer develops in a liver damaged by long-term hepatitis B or C, cirrhosis, heavy drinking or fatty liver disease. Hepatitis B vaccination, treating hepatitis, limiting alcohol and keeping a healthy weight lower the risk. Liver cancer found early may be treated with surgery, a liver transplant or ablation; stage 4 means it has spread, and treatment then aims to control it and ease symptoms. This guide explains the signs, causes, tests, stages and treatment.

Apa itu kanser hati?

Liver cancer is cancer found anywhere in the liver (NHS). There are 2 main kinds:

primary liver cancer, which starts in the liver; the most common type is hepatocellular carcinoma (HCC) (MedlinePlus);
secondary liver cancer (liver metastases), which starts in another organ, such as the breast or bowel, and spreads to the liver (MedlinePlus). See our guides to kanser payudara and kanser usus.

This guide is mainly about primary liver cancer. According to GLOBOCAN 2024 estimates from the International Agency for Research on Cancer, Malaysia had 2,367 new cases of liver cancer in 2024, making it the 5th most common cancer, and 2,226 deaths, making it the 4th most common cause of cancer death. Among men, it was the 4th most common cancer.

Tanda dan simptom kanser hati

The NHS says liver cancer may not have any symptoms, or they might be hard to spot. Symptoms can include:

the whites of your eyes or your skin turning yellow (jaundice), which may be less obvious on brown or black skin; you may also have itchy skin, darker pee and paler poo than usual;
loss of appetite or losing weight without trying;
feeling tired or having no energy, or feeling generally unwell with flu-like symptoms;
a lump in the right side of your tummy.

Other symptoms can affect your digestion (NHS):

feeling or being sick;
pain at the top right side of your tummy or in your right shoulder;
indigestion, such as feeling full very quickly when eating;
a very swollen tummy that is not related to eating; MedlinePlus explains that this can be caused by fluid building up in the tummy (ascites).

MedlinePlus adds easy bruising or bleeding. Some of these symptoms, such as tiredness or discomfort under the right ribs, can also happen with hati berlemak or cirrhosis (NHS). Pain in the right shoulder is also commonly caused by the shoulder itself; see our guide to sakit bahu dan leher.

When to see a doctor

The NHS says many of these symptoms are very common and can be caused by different conditions. Having them does not mean you have liver cancer, but finding it early may make it easier to treat.

Ask for an urgent appointment (NHS) if:

your skin or the whites of your eyes turn yellow;
you have been sick (vomiting) for more than 2 days.

See a doctor (NHS, MedlinePlus) if you have:

a lump in your tummy;
lost a lot of weight without trying;
symptoms that get worse or do not get better after 2 weeks;
ongoing tummy pain, especially if you have a history of liver disease.

Stomach cancer can cause some similar symptoms, such as loss of appetite and pain at the top of the tummy; see our guide to kanser perut.

Punca dan faktor risiko kanser hati

MedlinePlus says that in most cases, hepatocellular carcinoma is caused by long-term damage and scarring of the liver, called cirrhosis. The main risk factors are:

Risk factor	What the sources say
Hepatitis B	Long-term hepatitis B infection is the leading cause of liver cancer in Asia and Africa (NCI). People with hepatitis B or C are at high risk even if they do not have cirrhosis (MedlinePlus).
Hepatitis C	Spread mainly through blood; can cause cirrhosis that may lead to liver cancer (NCI).
Cirrhosis	Healthy liver tissue is replaced by scar tissue; common causes include long-term heavy drinking and hepatitis (NCI). The NHS lists liver cancer among the complications of cirrhosis.
Heavy alcohol use	Can cause cirrhosis, and liver cancer can also occur in heavy drinkers without cirrhosis (NCI).
Fatty liver disease	The inflammatory form (steatohepatitis) can lead to cirrhosis and liver cancer; MedlinePlus says it is linked with obesity, diabetes and other metabolic disorders.
Diabetes and other conditions	The NHS lists diabetes, gallstones, liver flukes (a parasite) and HIV among conditions that raise the risk.
Aflatoxin B1	A poison from a fungus that can grow on foods such as corn and nuts stored in hot, humid places; it is most common in sub-Saharan Africa, Southeast Asia and China (NCI).
Smoking	Linked to a higher risk, which rises with how much and how long you smoke (NCI).
Age, sex and family	More likely over 60, in men, and if a parent, brother or sister has had primary liver cancer (NHS).

Not everyone with these risk factors develops liver cancer, and some people with no known risk factors do (NCI). For more on diabetes and gallstones, see kencing manis and batu karang dan batu hempedu.

Kanser hati di Malaysia: hepatitis B and fatty liver

Hepatitis B: a 2016 review estimated that about 1 million people in Malaysia live with chronic hepatitis B, that the main route of infection is from mother to baby, and that chronic hepatitis B accounted for more than 80% of liver cancer (HCC) cases seen in Malaysia. Hepatitis B vaccination for children was introduced in Malaysia in 1989 (Raihan, 2016).
Fatty liver is becoming important: a study of 190 people newly diagnosed with HCC at University Malaya Medical Centre (2011 to 2014) found that chronic hepatitis B was the most common cause (43.7%), but 41.6% had liver cancer of unknown cause or linked to fatty liver inflammation (Karuthan et al., 2021).
Late diagnosis: in the same study, only 11.1% were diagnosed at an early stage, and most (53.7%) were diagnosed at an intermediate stage.

Many people with fatty liver or hepatitis B have no symptoms. Our guide to hati berlemak explains how fatty liver is found and managed.

Cara mengurangkan risiko

You cannot always prevent liver cancer, but these steps lower the risk (NHS, NCI, MedlinePlus, WHO):

hepatitis B vaccination: the WHO says the vaccine is safe and effective and offers nearly 100% protection; it is usually given soon after birth. Babies born to mothers with hepatitis B get extra protection (NHS). Ask your doctor whether you need the vaccine or a blood test if you are unsure of your status;
treating chronic hepatitis B or C: treatment for chronic hepatitis B may reduce the risk of liver cancer (NCI); do not share razors, toothbrushes or needles (NHS);
cutting down on alcohol: the NHS advises not drinking more than 14 units a week;
losing weight if you are overweight, which also helps fatty liver;
stopping smoking;
avoiding nuts and corn that may have been stored badly in hot, humid conditions, to reduce exposure to aflatoxin (NCI);
wearing protective clothing and masks if your job exposes you to harmful chemicals (NHS).

Surveillance for people at high risk: MedlinePlus says some people at risk for liver cancer may have regular blood tests and ultrasound scans to look for tumours early. Ask your doctor whether this applies to you.

Ujian: how liver cancer is diagnosed

The doctor may feel your tummy and look for an enlarged, tender liver or signs of cirrhosis (NHS, MedlinePlus). Tests can include:

Test	What it is for
Blood tests	Including liver function tests and a blood test for alpha-fetoprotein (AFP)
Ultrasound, CT or MRI scan	To look at the liver and any lumps in detail
Liver biopsy	A small sample of cells from the liver is checked for cancer
PET scan	Sometimes used if you have had another cancer and it may have spread to the liver
Laparoscopy	A small operation to look inside your tummy, to help work out the stage

Sources: NHS and MedlinePlus. The NHS says it can take several weeks to get the results, and a delay does not mean anything is wrong.

Where to go in Malaysia: start at a klinik kesihatan or a GP. If needed, they can refer you to a hospital for scans and to a gastroenterology, hepatology or surgical clinic, or you can see a private specialist.

Tahap kanser hati, including tahap 4

The stage of liver cancer describes how big it is and whether it has spread. Cancer Research UK explains the number staging system:

Stage	What it means
Stage 1	A single tumour in the liver that has not grown into the blood vessels
Stage 2	The cancer might have grown into blood vessels of the liver, or there might be 2 or more tumours
Stage 3	There might be 2 or more tumours, or the cancer might have grown into nearby blood vessels or organs
Stage 4 (tahap 4)	4A: the cancer has spread to lymph nodes but not to distant parts of the body. 4B: it has spread to another part of the body, such as the lungs or bones

Because many people with liver cancer also have cirrhosis, doctors also look at how well the liver is working and your general health, often using the Barcelona Clinic Liver Cancer (BCLC) system, to plan treatment (Cancer Research UK).

Kanser hati tahap 4: Cancer Research UK says that when liver cancer is advanced, treatment will not be able to cure it. Treatment for stage 4 aims to control the cancer, relieve symptoms and give a good quality of life, often with targeted medicines and immunotherapy, together with treatments for symptoms such as pain and sickness. A palliative care team can help people and their families with symptoms and support (NHS).

Rawatan kanser hati

The NHS says liver cancer is often treatable, but it can be difficult to treat. Treatment depends on the size and type of the cancer, where it is, whether it has spread and your general health. Options include (NHS, MedlinePlus):

surgery to remove part of the liver, if the cancer is found early, is small and has not spread, or a liver transplant;
ablation, which destroys the cancer using heat (microwaves or an electric current) or other methods;
chemoembolisation, where chemotherapy is given into the blood vessels feeding the cancer to make it smaller or control symptoms;
selective internal radiation therapy (SIRT), where tiny radioactive beads are injected into the liver's blood supply;
targeted medicines and immunotherapy; MedlinePlus says newer immunotherapy medicines are now the most common treatment for advanced liver cancer.

Recovery from liver surgery can take a long time. A diagnosis of liver cancer can feel overwhelming; the NHS suggests bringing someone with you to appointments and asking your care team any questions you have.

Frequently asked questions (FAQ)

Apa tanda kanser hati (what are the signs of liver cancer)?

Liver cancer may not cause any symptoms at first, or the symptoms can be hard to spot. The NHS lists yellowing of the skin or the whites of the eyes (jaundice), itchy skin, dark pee and pale poo, loss of appetite or weight loss without trying, tiredness, feeling generally unwell, a lump or pain in the upper right side of the tummy or right shoulder, feeling sick, feeling full quickly and a very swollen tummy. These symptoms can have many other causes, but they should be checked.

Apa punca kanser hati (what causes liver cancer)?

Most primary liver cancer develops in a liver that has been damaged for a long time. Long-term hepatitis B or C infection, cirrhosis (scarring of the liver), heavy alcohol use and fatty liver disease linked to obesity and diabetes are the main risk factors. Smoking, aflatoxin (a poison from mould on badly stored foods such as nuts and corn), a family history and being older or male also raise the risk.

Apa maksud kanser hati tahap 4 (what does stage 4 liver cancer mean)?

Cancer Research UK says stage 4 liver cancer has spread into lymph nodes (stage 4A) or to distant parts of the body such as the lungs or bones (stage 4B). At this stage, treatment cannot cure the cancer, but it aims to control the cancer, relieve symptoms and give the person a good quality of life, often with targeted medicines or immunotherapy and support from a palliative care team.

Adakah hepatitis B menyebabkan kanser hati (does hepatitis B cause liver cancer)?

Long-term (chronic) hepatitis B infection is the leading cause of liver cancer in Asia, according to the US National Cancer Institute. People with hepatitis B are at high risk of liver cancer even if they do not have cirrhosis. A Malaysian review estimated that about 1 million people in Malaysia live with chronic hepatitis B. Treatment for chronic hepatitis B may lower the risk, so ask your doctor for a blood test if you are unsure of your status.

Bolehkah hati berlemak jadi kanser (can fatty liver turn into liver cancer)?

It can, but this is not common. The NHS says most people with fatty liver only have the first stage, which does not usually cause problems, and a small number progress to cirrhosis, which can lead to liver cancer; and the National Cancer Institute says liver cancer has also been found in people with the inflammatory form of fatty liver who do not have cirrhosis. The NHS advises a healthy diet, regular exercise, losing weight if you are overweight and keeping alcohol within limits.

Bagaimana kanser hati dikesan (how is liver cancer diagnosed)?

A doctor will examine your tummy and may arrange blood tests, including liver function tests and a blood test for alpha-fetoprotein, and scans such as an ultrasound, CT or MRI scan. A small sample of liver tissue (a biopsy) may be taken. MedlinePlus says some people at risk for liver cancer may have regular blood tests and ultrasound scans to look for tumours early.

Boleh sembuh ke kanser hati (can liver cancer be cured)?

Liver cancer is often treatable but can be difficult to treat. If it is found early, is small and has not spread, it may be removed with surgery, or treated with a liver transplant or ablation. MedlinePlus says that when the cancer cannot be removed or has spread outside the liver, there is usually no chance of a long-term cure, and treatment aims to improve and extend the person's life.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.

References

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