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Digestive cancers · free patient guide
Liver cancer
Hepatocellular carcinoma, HCC
GI & hepatobiliary clinic
What it is
Liver cancer usually develops on a background of cirrhosis. Treatment decisions therefore depend on two things at once: the tumour, and how much working liver remains.
People with known chronic liver disease can be enrolled in surveillance, regular ultrasound and blood tests, which is how this disease is most often caught while treatment options are widest.
Most liver cancer arises in a liver already damaged by chronic hepatitis B or C, alcohol, or fatty liver disease. That makes it one of the few cancers with a clearly identifiable at-risk group who can be watched.
Warning signs worth acting on
- Known hepatitis B or C, or cirrhosis, without regular surveillance
- Worsening jaundice, swelling of the abdomen or confusion in someone with liver disease
- Unexplained weight loss with right upper abdominal discomfort
- A new mass on a routine abdominal ultrasound
How it is diagnosed
- Ultrasound, then multiphase CT or MRI, liver cancer is often diagnosed on imaging characteristics
- Alpha-fetoprotein and liver function blood tests
- Biopsy in selected cases only
- Assessment of underlying liver function, which is as important as the tumour assessment
Molecular profiling is considered in advanced disease. Underlying viral status is established in every case because treating it is part of managing the disease.
Is it inherited?
Uncommonly inherited. Family clustering usually reflects shared hepatitis exposure rather than genetics, which means testing relatives for hepatitis is often the useful step.
Genetic counselling & family risk →
Prevention & early detection
Hepatitis B vaccination prevents a major cause of liver cancer. Anyone with chronic hepatitis or cirrhosis should be in a surveillance programme, ask whether you are.
Treatment options
What may form part of a plan
Which of these apply to you depends on your stage, your pathology, your other health and what you want from treatment. That decision belongs at a tumour board, not on a website.
Surgery
Operability assessment and planning here; the operation at the appropriate partner centre.
Targeted therapy
Medicines matched to a specific alteration found in your tumour.
Immunotherapy
Treatment that works on the immune system rather than directly on the tumour.
Radiotherapy
Targeted radiation to a defined area, planned in millimetres.
Conservative management & active surveillance
Sometimes the right decision is to watch carefully and treat nothing yet.
Clinical trials
Most Indian patients never learn a trial exists, because nobody is looking.
At KPCIRC
The pathway for this disease
- Joint assessment of tumour and liver function before any treatment decision
- Hepatitis status established and treated where present
- Transplant-assessment referral where appropriate
- Nutrition, which in cirrhosis is a treatment rather than a comfort
Support that matters most here
Take this with you
Questions to ask your own doctor
These work wherever you are treated. Print the page or take a photograph of this list.
- How well is my liver working, and does that limit my options?
- Do I have hepatitis, and is it being treated?
- Am I a candidate for transplant assessment?
- If I have cirrhosis, what surveillance should I be on?
This page is not an emergency service. Severe breathlessness, chest pain, uncontrolled bleeding, a high fever during chemotherapy, or a sudden change in alertness means going to your nearest emergency department now, not reading further.