Hepatocellular Carcinoma
What is Hepatocellular carcinoma?
Hepatocellular carcinoma is the most common type of primary liver cancer. It starts in the main cells of the liver, called hepatocytes. This cancer usually develops in people who already have chronic liver disease or damage.
Most cases occur in people with cirrhosis, a condition where healthy liver tissue is replaced by scar tissue. Chronic viral hepatitis, particularly hepatitis B and C, are the leading causes worldwide. The liver is responsible for filtering toxins, producing proteins, and storing energy. When cancer develops, these vital functions become impaired.
Early detection matters because treatment options are most effective when the cancer is found at a smaller size. Regular monitoring with blood tests and imaging helps catch changes early, especially for people at higher risk.
Symptoms
- Pain or discomfort in the upper right abdomen
- Swelling or bloating in the abdomen
- Unexplained weight loss and loss of appetite
- Feeling very full after eating small amounts
- Nausea and vomiting
- Yellowing of skin and eyes, called jaundice
- Extreme tiredness and weakness
- Fever and night sweats
- Easy bruising or bleeding
Many people have no symptoms in the early stages. Symptoms often appear only after the cancer has grown larger. This is why screening is critical for people with chronic liver disease.
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Causes and risk factors
Chronic liver damage is the primary cause of hepatocellular carcinoma. Hepatitis B and hepatitis C infections cause ongoing inflammation that damages liver cells over decades. Cirrhosis from any cause raises cancer risk significantly. Heavy alcohol use over many years leads to cirrhosis and increases cancer risk. Nonalcoholic fatty liver disease, often linked to obesity and diabetes, is a growing cause.
Other risk factors include exposure to aflatoxins, toxins produced by mold on grains and nuts. Inherited liver diseases like hemochromatosis, where iron builds up in the liver, also increase risk. Men develop hepatocellular carcinoma more often than women. Age over 60, smoking, and diabetes are additional risk factors.
How it's diagnosed
Diagnosis typically combines blood tests, imaging studies, and sometimes a biopsy. Blood tests check for alpha fetoprotein, a protein that is often elevated in hepatocellular carcinoma cases. Hepatitis B core antibody testing helps identify chronic hepatitis B infection, a major risk factor. Imaging tests like ultrasound, CT scans, or MRI show suspicious liver masses and help determine cancer stage.
Rite Aid offers add-on blood testing for alpha fetoprotein and hepatitis B markers through our network of Quest Diagnostics locations. These tests help monitor people at high risk and support early detection efforts. If imaging or blood tests suggest cancer, a liver biopsy may be needed to confirm the diagnosis and guide treatment planning.
Treatment options
- Surgical removal of the tumor when cancer is caught early and liver function is preserved
- Liver transplantation for selected patients with early-stage cancer and cirrhosis
- Ablation therapy, which destroys tumors using heat, cold, or alcohol injection
- Embolization procedures that cut off blood supply to the tumor
- Targeted drug therapies that attack specific cancer cell pathways
- Immunotherapy medications that help the immune system fight cancer cells
- Radiation therapy for tumors that cannot be removed surgically
- Limiting alcohol consumption completely to protect remaining liver function
- Eating a nutrient-dense diet with plenty of vegetables, lean protein, and whole grains
- Managing underlying conditions like hepatitis, diabetes, and obesity with medical supervision
Need testing for Hepatocellular carcinoma? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Hepatocellular carcinoma starts in hepatocytes, the main liver cells. This makes it a primary liver cancer. Other liver cancers include cholangiocarcinoma, which starts in bile ducts, or metastatic cancers that spread from other organs. Hepatocellular carcinoma accounts for about 75 percent of all primary liver cancers.
People with cirrhosis from any cause should get screened every 6 months. Those with chronic hepatitis B infection also need regular screening, even without cirrhosis. Screening includes blood tests for alpha fetoprotein and imaging like ultrasound. Early detection through screening greatly improves treatment outcomes.
Many cases can be prevented by addressing risk factors. Getting vaccinated against hepatitis B prevents infection. Treating hepatitis C with antiviral medications reduces cancer risk significantly. Limiting alcohol intake, maintaining a healthy weight, and managing diabetes help protect the liver from damage that leads to cancer.
Alpha fetoprotein is a protein normally produced by a developing fetus. In adults, elevated levels can indicate hepatocellular carcinoma. However, AFP can also be elevated in chronic hepatitis, cirrhosis, and other liver conditions. High AFP levels require further testing with imaging to determine the cause.
Growth rate varies widely depending on the tumor type and individual factors. Some tumors double in size within 3 to 6 months. Others grow more slowly over years. This is why regular monitoring every 6 months is recommended for high-risk individuals.
Early-stage hepatocellular carcinoma can be cured with surgery or liver transplant. Cure rates depend on tumor size, number, and liver function. Small tumors found through screening have the best outcomes. Advanced-stage cancer is harder to cure but can be managed with treatments that extend life.
Stop drinking alcohol completely to preserve liver function. Eat a balanced diet rich in vegetables, fruits, and lean protein. Avoid supplements without doctor approval, as some can harm the liver. Stay physically active within your energy limits to maintain strength during treatment.
People with chronic hepatitis B should get blood tests every 6 to 12 months. Testing includes alpha fetoprotein and liver function tests. Ultrasound imaging is also recommended every 6 months. This schedule helps detect hepatocellular carcinoma early when treatment is most effective.
Yes, nonalcoholic fatty liver disease can progress to cirrhosis and hepatocellular carcinoma. The risk increases with obesity, diabetes, and metabolic syndrome. Weight loss through diet and exercise can reverse early fatty liver disease. Managing these conditions reduces your long-term cancer risk.
Survival depends heavily on the stage at diagnosis. Early-stage tumors treated with surgery or transplant have 5-year survival rates above 70 percent. Advanced-stage cancer has lower survival rates, often under 20 percent at 5 years. Early detection through screening makes the biggest difference in outcomes.