Hepatocellular carcinoma is a cancer that starts in your liver. It's different from "secondary" liver cancers, which have spread to the liver from other organs. If caught early, it can sometimes be cured with surgery or transplant. In more advanced cases it can’t be cured, but treatment and support can help you live longer and better.
To diagnose most types of cancer, doctors take a tissue sample (biopsy) and look at it under a microscope. This is not always necessary for HCC, though. We can usually use computerized tomography or magnetic resonance imaging scans with dye injection to make a diagnosis. If a person with cirrhosis has a mass in the liver with a characteristic-rich blood supply, we can diagnose HCC. Sometimes, though, we still need to perform a biopsy. We also use biopsies for genetic analysis, which may be necessary to develop personalized treatment plans.
There are many treatments for hepatocellular carcinoma. It's a big decision, so work closely with your doctor to make the right plan for you.
It may include:
Radiation: This uses high-energy rays to kill your cancer cells. Two types of radiation therapy can treat hepatocellular carcinoma:
External: You'll lie on a table while a large machine aims beams of radiation at specific spots on your chest or belly.
Internal: A doctor injects tiny radioactive particles into the artery that sends blood to your liver. These block or destroy the blood supply to the tumor in your liver.
Radiation therapy can cause side effects, including nausea, vomiting, or tiredness, but these symptoms go away when treatment is done.
Chemotherapy: To treat cancer, doctors often place chemotherapy drugs directly into your liver. It's a process called "chemoembolization."
Targeted therapy: The cancer is treated with drugs that target specific changes in cells that cause cancer. Some targeted therapies block new blood vessel growth in tumors. Others target certain proteins found on cancer cells that help tumors grow.
Immunotherapy: This treatment uses drugs that help stimulate your immune system to find and kill cancer cells. Immunotherapy drugs called immune checkpoint inhibitors are sometimes used to treat liver cancer.
Liver transplant: If your doctor can't remove your cancer through a partial hepatectomy, they may suggest a liver transplant.