Hepatocellular Carcinoma
(Liver Cancer)

Medical Author: Tse-Ling Fong, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD

• What is liver cancer (hepatocellular carcinoma, HCC)?
• What is the scope of the liver cancer problem?
• What are the population characteristics (epidemiology) of liver cancer?
• What are the risk factors for liver cancer?
• What are the symptoms of liver cancer?
• How is liver cancer diagnosed?
  • Blood tests
  • Imaging studies
  • Liver biopsy or aspiration
  • Patient Discussions: Liver Cancer - Describe Your Experience
• What is the natural history of liver cancer?
• What are the treatment options for liver cancer?
  • Chemotherapy
  • Chemoembolization (trans-arterial chemoembolization or TACE)
  • Ablation techniques
  • Proton beam therapy
  • Surgery
• Is there a role for routine screening for liver cancer?
• What is fibrolamellar carcinoma?
• What's in the future for the prevention and treatment of liver cancer?
• Liver Cancer At a Glance
• Related liver cancer articles:
  Liver cancer - on WebMD

The Relationship of Chronic Viral Hepatitis, Alcoholism, and Cirrhosis to Liver Cancer Medical Author: Jay W. Marks, MD Medical Editor: Leslie J. Schoenfield, MD, PhD Cancer can start within the liver (primary liver cancer or hepatocellular cancer) or spread to the liver (metastatic liver cancer) from other sites, such as the colon. Cancer that starts in the liver, which I will refer to simply as liver cancer, is the fifth most common cancer in the world. In the U.S., it is among the 10 most common cancers. This cancer is more frequent among Native Americans, Asians, Pacific Islanders, and Hispanics than among Caucasians. Liver cancer is a bad cancer. It has frequently spread beyond the liver by the time it is discovered, and only 5% of patients with liver cancer that has begun to cause symptoms survive even five years without treatment. The only hope for patients who are at risk for liver cancer is regular surveillance so that the cancers can be found early. Early cancers can be treated by surgical removal (resection), destruction of the individual tumors, or liver transplantation. Although the current techniques for surveillance are not very good at detecting early liver cancer, newer techniques are being tested and appear to be better. The most common diseases associated with liver cancer are chronic viral hepatitis, alcoholism, and cirrhosis (scarring of the liver). Moreover, chronic viral hepatitis is common in alcoholism, and both viral hepatitis and alcoholism cause cirrhosis which usually precedes the development of cancer. Therefore, the contributions and interrelationships of alcohol abuse, viral hepatitis, and cirrhosis in the development of liver cancer are complex. Despite the complexity, it is important to try to understand the contributions of each disease so that patients at highest risk for liver cancer can be targeted for surveillance. Theoretically, they also might be targeted with treatments that prevent the development of liver cancer, when such treatments are developed. Learn what puts you at risk for liver cancer » Top Searched Liver Cancer Terms: symptoms, tumor, transplant, treatment

What is liver cancer (hepatocellular carcinoma, HCC)?

Liver cancer (hepatocellular carcinoma) is a cancer arising from the liver. It is also known as primary liver cancer or hepatoma. The liver is made up of different cell types (for example, bile ducts, blood vessels, and fat-storing cells). However, liver cells (hepatocytes) make up 80% of the liver tissue. Thus, the majority of primary liver cancers (over 90 to 95%) arises from liver cells and is called hepatocellular cancer or carcinoma.

When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. Thus, the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer. The subject of this article is hepatocellular carcinoma, which I will refer to as liver cancer.

What is the scope of the liver cancer problem?

Liver cancer is the fifth most common cancer in the world. A deadly cancer, liver cancer will kill almost all patients who have it within a year. In 1990, the World Health Organization estimated that there were about 430,000 new cases of liver cancer worldwide, and a similar number of patients died as a result of this disease. About three quarters of the cases of liver cancer are found in Southeast Asia (China, Hong Kong, Taiwan, Korea, and Japan). Liver cancer is also very common in sub-Saharan Africa (Mozambique and South Africa).

The frequency of liver cancer in Southeast Asia and sub-Saharan Africa is greater than 20 cases per 100,000 population. In contrast, the frequency of liver cancer in North America and Western Europe is much lower, less than five per 100,000 population. However, the frequency of liver cancer among native Alaskans is comparable to that seen in Southeast Asia. Moreover, recent data show that the frequency of liver cancer in the U.S. overall is rising. This increase is due primarily to chronic hepatitis C, an infection of the liver that causes liver cancer.

Liver Cancer - Describe Your Experience

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