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Liver Cancer (Hepatocellular Carcinoma)

What is liver cancer?

Liver cancer is a primary cancer, meaning that it originated in the liver. (As opposed to liver metastases, or secondary liver cancers, which have spread to the liver from other organs.)

Liver cancer is responsible for more than 12,000 deaths a year in the United States and is being diagnosed more frequently. It is more common in men than women and in African Americans than whites.

It is commonly associated with cirrhosis and hepatitis. Other risk factors can include a history of alcohol use.

Learn more about liver cancer.

Cirrhotic liver with a focal tumor.
A, cirrhotic liver with focal tumor; B, histological appearance
Causes of hepatocellular carcinoma: hepatitis B, hepatitis C, hemochromatosis, anabolic steroids, alcohol, cirrhosis, and aflatoxins.
Causes of liver cancer (hepatocellular carcinoma)

What are the symptoms of liver cancer?

In the United States, hepatocellular carcinoma can be found during routine screening examinations or found incidentally on exams performed for other unrelated reasons. While some patients may not have symptoms, others may experience:

  • Weight loss
  • Blood in the stool
  • Jaundice
  • Fatigue
  • Fluid in abdomen

How is liver cancer diagnosed?

When you see your physician, you will have a routine examination. Your doctor will ask you questions about your general health and your family history of cancer and liver disease. You will also be asked about your lifestyle and habits, including drinking and smoking.

Your physician may order the following tests:

  • Blood work. Blood tests may include a complete blood count, hematocrit, platelet count, liver function tests, and alpha fetoprotein, which may be elevated in patients with liver cancer.
  • Abdominal ultrasound. This test helps the doctor see the tumor
  • CT scan. This test identifies the tumor(s) and pinpoints their size and location in the liver, as well as their relation to the vascular / biliary structures. It also helps the doctor to determine the overall health of the liver.
Computed tomography (CT) scan of hepatocellular carcinoma in the liver.
Computed tomography (CT) scan of
hepatocellular carcinoma
  • MRI. This test identifies the tumor(s) and pinpoints their size and location in the liver, as well as their relation to the vascular / biliary structures. It also helps the doctor to determine the overall health of the liver.  A doctor will determine whether to do a CT scan, an MRI or both.
  • Liver biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. The sample removed from the biopsy is analyzed by one of our expert pathologists. Depending on the size of the tumor or mass, your physician may recommend that the biopsy be taken in one of several ways:
    • By using a minimally invasive surgical technique known as laparoscopy
    • By fine needle or thick needle aspiration (a core biopsy), using a computed tomography (CT or CAT) scan or ultrasound to guide the needle placement.
    • Through an endoscope (a thin, lighted, flexible tube) inserted in the mouth, passed through the stomach, and into the first part of the intestine. A tool can be passed from the endoscope through the intestinal wall to remove a sample of tissue.
Biopsy of a focal tumor in the liver.
A, biopsy of focal tumor; B, histological appearance; C, percutaneous approach to the liver

What is the treatment for liver cancer?

Treatment for HCC includes a combination of the following:

What is the prognosis for liver cancer?

Your team of physicians will create an individualized treatment plan for you.

Additional Information

 

Traveling for care?

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Whether crossing the country or the globe, we make it easy to access world-class care at Johns Hopkins.

Maryland 1-877-LIVER99
(1-877-548-3799)

U.S. 1-410-464-6713 (toll free)
International +1-410-614-6424

 

 
 
 
 
 

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