What is hepatocellular carcinoma?

Hepatocellular carcinoma, also sometimes called hepatoma, is a form of cancer that begins primarily in the liver. It is the most common form of liver cancer, representing about 12,000 cases in the United States annually and 80% of all forms of liver cancers.

The cancer is more common in men, African-Americans, and people aged older than 50 years. Hepatocellular carcinoma often is the result of a hepatitis B or hepatitis C infection, cirrhosis of the liver, or chronic alcohol abuse. The presence of a viral hepatitis infection significantly increases the risk for liver cancer. Symptoms of hepatocellular carcinoma can include weight loss, abdominal pain (specifically around the liver), a swollen abdomen, fluid in the abdomen, fatigue, bloody stool, jaundice and easy bruising or bleeding.

Oncologists and hepatologists can diagnose hepatocellular carcinoma by conducting abdominal ultrasound, MRI and CT scan to identify a potential tumor or tumors. They may order serum samples to look for elevated alpha-fetoprotein, liver enzyme tests to analyze liver function, or a liver biopsy to identify the size of the tumor. Based on these results, the physician will recommend different treatment methods depending on the cancer’s severity.

If the cancer is caught early, chemotherapy to shrink the tumor may be followed by open or minimally invasive surgery as long as the tumor has not metastasized. Other treatment options include targeted radiation (if the patient does not have cirrhosis), or ablation. If the patient has cancer and cirrhosis, then a liver transplant is recommended.

Survival from hepatocellular carcinoma varies depending on whether the whole tumor was removed during surgery, and how advanced the cancer is when diagnosed. The prognosis if the cancer cannot be removed completely is fatal generally within 3 months to 6 months, but a physician will provide a treatment plan based on individual needs.

Vaccinating against hepatitis B and hepatitis C virus, and avoiding excessive alcohol consumption can reduce the risk for hepatocellular carcinoma. Screening for liver cancer regularly can help reduce the likelihood of a late-stage diagnosis.