Hepatocellular Carcinoma (HCC)

Hepatocellular carcinoma is the most common type of liver cancer. It starts in the main type of liver cell, called a hepatocyte. HCC usually develops in people who have chronic liver disease or cirrhosis, which is severe scarring of the liver.

Your liver is a vital organ that filters toxins from your blood, makes proteins, and stores energy. When cancer cells grow in liver tissue, they can disrupt these important functions. HCC is the third leading cause of cancer deaths worldwide and affects more men than women.

Most cases develop slowly over years in livers that are already damaged by conditions like hepatitis B, hepatitis C, fatty liver disease, or alcohol use. Early detection is critical because small tumors can often be treated successfully. That is why screening blood tests matter so much for people at risk.

• Unexplained weight loss
• Loss of appetite or feeling full after eating small amounts
• Pain in the upper right side of the abdomen
• Swelling or bloating in the abdomen
• Yellowing of the skin and eyes, known as jaundice
• White or chalky stools
• Nausea and vomiting
• Weakness and fatigue
• Fever
• Easy bruising or bleeding

Many people with early stage HCC have no symptoms at all. That is why regular monitoring with blood tests and imaging is so important for people with chronic liver disease.

HCC almost always develops in livers that are already damaged. Chronic hepatitis B infection is the leading cause worldwide and can cause HCC even without cirrhosis. Hepatitis C infection also significantly increases risk, especially when it progresses to cirrhosis. Chronic heavy alcohol use damages liver cells over time and creates an environment where cancer can develop. Nonalcoholic fatty liver disease, often linked to obesity and diabetes, is becoming a more common cause in the United States.

Other risk factors include exposure to aflatoxins, which are toxins from mold on stored grains and nuts. Inherited liver diseases like hemochromatosis, which causes iron buildup, and Wilson disease also raise risk. Smoking, especially combined with alcohol use, increases your chances of developing HCC. Men are two to three times more likely to get HCC than women. Age matters too, as most cases occur in people over 60.

Doctors diagnose HCC using a combination of blood tests, imaging studies, and sometimes tissue biopsy. Blood tests like alkaline phosphatase, gamma-glutamyl transferase, and hepatitis screening help identify liver damage and infection that raise HCC risk. Rite Aid offers testing for these important biomarkers through our flagship panel at Quest Diagnostics locations nationwide.

If blood tests show concerning patterns, your doctor will order imaging like ultrasound, CT scan, or MRI to look for tumors. Alpha-fetoprotein, or AFP, is a tumor marker often elevated in HCC, though not all cases produce high AFP levels. In some cases, a liver biopsy is needed to confirm the diagnosis. Early detection through regular screening is the best way to catch HCC when treatment is most effective.

• Surgical removal of the tumor for early stage disease in patients with good liver function
• Liver transplant for select patients with small tumors and cirrhosis
• Ablation therapies that destroy tumors using heat, cold, or alcohol injection
• Embolization procedures that block blood flow to the tumor
• Targeted therapy medications like sorafenib or lenvatinib that attack cancer cells
• Immunotherapy drugs that help your immune system fight cancer
• Radiation therapy for tumors that cannot be surgically removed
• Treatment of underlying liver disease, including antiviral therapy for hepatitis
• Avoiding alcohol completely to protect remaining liver function
• Eating a balanced diet rich in fruits, vegetables, and lean protein
• Maintaining a healthy weight to reduce fatty liver disease
• Regular monitoring with imaging and blood tests every 3 to 6 months