Hepatocellular carcinoma is cancer that starts in the liver.
Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually seen in people age 50 or older.
Hepatocellular carcinoma is not the same as metastatic liver cancer, which starts in another organ (such as the breast or colon) and spreads to the liver.
In most cases, the cause of liver cancer is scarring of the liver (cirrhosis). Cirrhosis may be caused by:
- Alcohol abuse
- Autoimmune diseases of the liver
- Hepatitis B or C virus infection
- Inflammation of the liver that is long-term (chronic)
- Iron overload in the body (hemochromatosis)
Patients with hepatitis B or C are at high risk of liver cancer, even if they do not develop cirrhosis.
- Abdominal pain or tenderness, especially in the upper-right part
- Easy bruising or bleeding
- Enlarged abdomen
- Yellow skin or eyes (jaundice)
Exams and Tests
The doctor will perform a physical exam and ask about your symptoms. The physical exam may show an enlarged, tender liver.
If the doctor suspects liver cancer, tests that may be ordered include:
- Abdominal CT scan
- Abdominal ultrasound
- Liver biopsy
- Liver enzymes (liver function tests)
- Liver MRI
- Serum alpha fetoprotein
Some high-risk patients may get regular blood tests and ultrasounds to see whether tumors are developing.
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 done by delivering the medicine straight into the liver with a tube (catheter).
Radiation treatments in the area of the cancer may also be helpful. But many patients have liver cirrhosis or other liver diseases that make these treatments more difficult.
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 for certain persons who have both cancer and cirrhosis.
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 cannot be completely removed, the disease is usually fatal within 3 to 6 months. But survival can vary depending on how advanced the cancer is when diagnosed and how successful treatment is.
When to Contact a Medical Professional
Call your health care provider if you develop ongoing abdominal pain, especially if you have a history of any liver disease.
- Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future.
- Do not drink excessive amounts of alcohol.
- Persons with certain types of hemochromatosis may need to be screened for liver cancer.
- Persons who have hepatitis B or C or cirrhosis may be recommended for liver cancer screening.
Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma
National Cancer Institute: PDQ Adult Primary Liver Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified 09/20/2013. Accessed September 24, 2013.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. Version 2.2013. Accessed September 24, 2013.
Update Date 9/20/2013
Updated by: 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, Bethanne Black, and the A.D.A.M. Editorial team.