Shoulder Pain Caused by Liver Cancer: What Stage Does It Indicate?

Liver cancer that causes shoulder pain is typically associated with the middle or late stages of the disease. This symptom often occurs when the tumor is located near the diaphragm, especially in the upper part of the liver. The liver is situated in the upper abdomen and is closely connected to the diaphragm, particularly on the right side. When a tumor develops near the diaphragm, especially if it's larger than 5 cm, it can stretch the liver capsule and irritate the diaphragm, leading to referred pain in the right shoulder or back.

This type of pain is commonly seen in stage II or III liver cancer according to clinical staging systems. At this point, the primary treatment option is surgical resection, especially if the cancer hasn't spread beyond the liver. Surgery may be combined with systemic therapies to improve outcomes. If the tumor cannot be removed surgically, alternative treatments such as transarterial chemoembolization (TACE), chemotherapy infusion, or radiation therapy may be considered.

Shoulder pain may also be a sign of metastatic liver cancer, particularly when the disease has spread to the bones. In such cases, the cancer is considered to be in an advanced or late stage. Systemic treatments like targeted therapy or immunotherapy are often prioritized to manage the disease. If the pain is severe, radiation therapy can be used to help alleviate discomfort and improve quality of life.