Liver cancer - hepatocellular carcinoma
Hepatocellular carcinoma is cancer that starts in the liver.
Hepatocellular carcinoma is the most common type of liver cancer. It occurs more often in men than women. It is most often diagnosed in people age 50 or older.
Hepatocellular carcinoma is not the same as metastatic liver cancer. This type of cancer starts in another organ (such as the breast or colon) and spreads to the liver.
Metastatic liver cancer
Liver metastases refer to cancer that has spread to the liver from somewhere else in the body. Liver metastases are not the same as cancer that start...Read Article Now Book Mark Article
In most cases, the cause of hepatocellular liver cancer is long-term damage and scarring of the liver (cirrhosis). Cirrhosis may be caused by:
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.Read Article Now Book Mark Article
- Alcohol abuse
- Autoimmune diseases of the liver
- Hepatitis B or hepatitis C virus infection
Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...Read Article Now Book Mark Article
- Inflammation of the liver that is long-term (chronic)
- Iron overload in the body (hemochromatosis)
People with hepatitis B or C are at high risk for liver cancer, even if they do not develop cirrhosis.
Symptoms of liver cancer may include any of the following:
Exams and Tests
The health care provider will perform a physical exam and ask about your symptoms. The physical exam may show an enlarged, tender liver or other signs of cirrhosis.
If the provider suspects liver cancer, tests that may be ordered include:
- Abdominal CT scan
- Abdominal MRI scan
- Abdominal ultrasound
- Liver biopsy
- Liver function tests
- Serum alpha fetoprotein
Some people at risk for liver cancer may get regular blood tests and ultrasounds to see if tumors are developing.
A biopsy of the tumor must be done to diagnose hepatocellular carcinoma.
Treatment depends on how advanced the cancer is.
Surgery may be done if the tumor has not spread. Before surgery, the tumor may be treated with chemotherapy to reduce its size. This is most often done by delivering the medicine straight into the liver with a tube (catheter).
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancer Shrink the cancerPrevent the cancer from...Read Article Now Book Mark Article
Radiation treatments in the area of the cancer may also be helpful.
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.Read Article Now Book Mark Article
Ablation is another method that may be used. Ablate means to destroy. Types of ablation include using:
- Radio waves or microwaves
- Ethanol (an alcohol) or acetic acid (vinegar)
- Extreme cold (cryoablation)
A liver transplant may be recommended.
Liver transplant is surgery to replace a diseased liver with a healthy liver.Read Article Now Book Mark Article
If the cancer can't be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment instead focuses on improving and extending the person's life. Treatment in this case may use targeted therapy with drugs that can be taken as pills. Newer immunotherapy drugs may also be used.
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
If the cancer can't be completely treated, the disease is usually fatal. But survival can vary, depending on how advanced the cancer is and how successful treatment is.
When to Contact a Medical Professional
Contact your provider if you develop ongoing abdominal pain, especially if you have a history of liver disease.
Preventive measures include:
- Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk for liver cancer in the future.
- Not drinking alcohol in excess.
- Screening for liver cancer in people with certain types of hemochromatosis (iron overload).
- Screening for liver cancer in people who have hepatitis B or C or cirrhosis.
Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Abou-Alfa GK, Jarnagin W, El Dika I, et al. Liver and bile duct cancer. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 77.
Di Bisceglie AM, Befeler AS. Hepatic tumors and cysts. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 96.
National Cancer Institute website. Adult primary liver cancer treatment (PDQ) - health professional version. www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq. Updated August 23, 2021. Accessed November 16, 2021.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: hepatobiliary cancers. Version 5.2021. www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Updated September 21, 2021. Accessed November 16, 2021.