Symptoms that deserve attention
Possible symptoms of liver cancer include:
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Persistent discomfort or pain in the upper-right abdomen.
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A feeling of fullness or swelling in the abdomen.
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Unexplained weight loss.
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Reduced appetite or feeling full unusually quickly.
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Persistent fatigue or weakness.
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Nausea or general discomfort that does not resolve.
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Yellowing of the skin or whites of the eyes, known as jaundice.
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Dark urine or unusually pale stools.
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Swelling in the abdomen or legs.
These symptoms can also occur in many other conditions, including infections, gallbladder disease, digestive disorders, and noncancerous liver conditions.
Fatigue alone, bad breath alone, or occasional abdominal discomfort does not mean someone has liver cancer. There is no reliable basis for treating persistent bad breath as a specific early warning sign of the disease.
Nevertheless, unexplained symptoms that persist, worsen, or occur together should be evaluated by a healthcare professional.
Severe abdominal pain accompanied by fever, jaundice, confusion, or significant weakness warrants urgent medical assessment.
2. What Actually Causes Liver Cancer?
Liver cancer is not a single disease with one universal cause. Different types of tumors can develop in the liver, and their risk factors differ.
The most common primary liver cancer in adults is hepatocellular carcinoma, which develops from liver cells called hepatocytes.
Many cases occur in people who have chronic liver disease, particularly long-standing inflammation, fibrosis, or cirrhosis. However, liver cancer can also develop in people without a known diagnosis of cirrhosis.
According to the National Cancer Institute, established risk factors for liver cancer include chronic hepatitis B or hepatitis C infection, cirrhosis, heavy alcohol use, and exposure to aflatoxin. Certain metabolic conditions that affect the liver can also contribute to risk.
Understanding these factors is more useful than assuming that one everyday food explains a cancer diagnosis.
Chronic hepatitis B
Hepatitis B is a viral infection that affects the liver. Some people clear the infection, while others develop chronic hepatitis B, which can persist for many years.
Chronic infection can cause ongoing inflammation and liver damage, increasing the risk of cirrhosis and liver cancer.
A particularly important feature of hepatitis B is that a person may have no noticeable symptoms for a long time. Someone who feels healthy may not know that they carry the virus unless they have been tested.
Hepatitis B is especially important in many Asian countries, including Vietnam, where it remains a major public health concern.
The encouraging news is that hepatitis B can be prevented through vaccination. People with chronic infection can also benefit from medical assessment and antiviral treatment when indicated.
The World Health Organization's hepatitis B guidance explains the relationship between chronic infection, liver disease, and cancer.
Chronic hepatitis C
Hepatitis C is another viral infection that can cause long-term liver inflammation and scarring.
Unlike hepatitis B, there is currently no widely used vaccine against hepatitis C, but modern antiviral medicines can cure most infections.
Because chronic hepatitis C may remain undetected for years, testing is important for people with relevant exposure risks or other clinical indications.
Treating the infection can reduce the risk of progressive liver disease. People who already have advanced fibrosis or cirrhosis may still require ongoing liver cancer surveillance after successful treatment.
Cirrhosis
Cirrhosis occurs when prolonged liver damage leads to extensive scarring. The underlying causes can include chronic viral hepatitis, alcohol-related liver disease, and metabolic dysfunction-associated steatotic liver disease.
As healthy tissue is replaced by scar tissue, the liver's structure and function become increasingly impaired.
Cirrhosis is a major risk factor for hepatocellular carcinoma. However, not everyone with cirrhosis develops cancer, and not every person with liver cancer has cirrhosis.
The risk depends on several factors, including the underlying disease, its severity, and whether the cause can be treated.
Alcohol
Alcohol can damage liver cells and, with sustained heavy consumption, contribute to inflammation, fibrosis, and cirrhosis.
Alcohol is also a recognized carcinogen, and alcohol-related liver disease can substantially increase liver cancer risk.
The risk is influenced by the amount and pattern of consumption, duration of exposure, underlying liver health, and other factors.
For people with chronic hepatitis or existing liver disease, avoiding alcohol is often particularly important. People who are concerned about alcohol dependence should seek medical support rather than attempting to manage withdrawal alone.
Fatty liver and metabolic health
Fat can accumulate in the liver in people who consume little or no alcohol. This condition is now commonly described within the spectrum of metabolic dysfunction-associated steatotic liver disease, or MASLD.
MASLD is associated with factors such as insulin resistance, type 2 diabetes, abdominal obesity, and abnormal blood lipids.
Some people develop inflammation and progressive scarring, which can eventually increase the risk of liver cancer. Although many people with fatty liver never develop severe disease, it should not be dismissed simply because it causes no symptoms.
A balanced diet, regular physical activity, appropriate management of diabetes, and medical follow-up can help reduce the risk of progression.
Importantly, a person can have fatty liver or other metabolic risk factors even when their body weight appears normal.
3. Pickled Vegetables: When Preservation Methods Matter
Pickled vegetables are common in many culinary traditions. Cabbage, mustard greens, cucumbers, radishes, carrots, and other vegetables may be preserved using salt, vinegar, fermentation, or combinations of these methods.
Properly prepared pickled vegetables can contribute flavor and variety to meals. Some fermented products contain microorganisms produced during fermentation, although the types and amounts vary, and not every pickled food qualifies as a probiotic food.
The main concern is not that all pickled vegetables are toxic. It is that the safety and nutritional characteristics of preserved foods depend on their ingredients, processing, storage, and the quantities consumed.
What does research say about pickled vegetables and cancer?
The International Agency for Research on Cancer (IARC), part of the World Health Organization, has classified traditionally prepared Asian-style pickled vegetables as possibly carcinogenic to humans, a category known as Group 2B.
This classification was based on limited evidence in humans, including studies investigating associations with certain cancers. The evidence was not consistent across all studies, and it did not establish that all pickled vegetables cause cancer.