General description
What is hepatocellular carcinoma (HCC)?
Hepatocellular carcinoma is the most common form of liver cancer. It is a serious illness that can be fatal. If caught early, hepatocellular carcinoma can be treated with surgery to remove the cancerous growth or with a liver transplant. Other treatments can shrink the tumor or slow its growth and ease symptoms. Hepatocellular carcinoma is associated withHepatical cirrhosisyNon-alcohol-related fatty liver disease (NAFLD). People with cirrhosis or NAFLD should have regular tests for signs of hepatocellular carcinoma.
How does hepatocellular carcinoma affect my body?
Over time, hepatocellular carcinoma can causeliver failure. However, before this happens, hepatocellular carcinoma can prevent the liver from handling vital body functions. Among other things, your liver:
- It keeps track of your body's nutrients, turning them into substances your body can use, storing them, and delivering them to your cells as needed.
- It gathers toxic substances, making sure they are harmless or released from your body.
- It supports healthy blood flow by producing substances that help blood to clot and kill bacteria that cause infections.
Who is affected?
Men age 60 and older are more likely to develop hepatocellular carcinoma than younger women and men.
How common is hepatocellular carcinoma?
With approximately six new cases per 100,000 people per year in the United States, hepatocellular carcinoma is considered a relatively rare form of cancer. Hepatocellular carcinoma makes up about 85% to 90% of all primary liver cancers, meaning cancers that start in the liver and not elsewhere in the body.
Is hepatocellular carcinoma the same as liver cancer?
There are several types ofliver cancer. Hepatocellular carcinoma is the most common form of liver cancer.
Can hepatocellular carcinoma be cured?
Surgery to remove the tumor or a liver transplant are the best cure options. If surgery isn't an option, there are other treatments to relieve symptoms, slow tumor growth, and help you live longer.
Is hepatocellular carcinoma a fast-growing cancer?
At first, hepatocellular carcinoma grows very slowly. It can take years before you notice any symptoms. The growth of hepatocellular carcinoma accelerates as it progresses.
What is the life expectancy of a person with hepatocellular carcinoma?
Each case of hepatocellular carcinoma is different. Your prognosis, or expected outcome, depends on several factors. Talk to your doctor about your individual situation. They will have specific information about your condition and what to expect.
Symptoms and Causes
What are the symptoms of hepatocellular carcinoma?
There are many conditions with the same symptoms as hepatocellular carcinoma. Having one or more of these symptoms doesn't mean you have hepatocellular carcinoma. But talk to your doctor if you have these symptoms. They will identify and treat the condition that caused your symptoms. Possible hepatocellular symptoms include:
- You are losing weight without trying.
- You feel very full after a small meal or you don't have much of an appetite.
- You have nausea and vomiting.
- Note a fullness or bulge under the ribs on the right side. This could indicate that your liver is enlarged.
- Note the fullness under the ribs on the left side. This could be a sign that your spleen is enlarged.
- You have an upset stomach or pain near your right shoulder blade.
- Your stomach feels bloated, as if it's filled with fluid.
- Your skin itches.
- Your eyes and skin are turning pale or yellow. This could be a sign that you havejaundice.
What causes hepatocellular carcinoma?
Liver cirrhosis is the most common cause of hepatocellular carcinoma. Increasingly, healthcare professionals are seeing cases of hepatocellular carcinoma in people with non-alcohol-related fatty liver disease (NAFLD). There are other medical conditions and activities that increase your risk of developing hepatocellular carcinoma.
- Hepatitis B.
- Hepatitis C
- Type 2 diabetes.
- From smoking.
- Terobesity.
- Excessive alcohol consumption.
If you have or have had any of these conditions, talk to your doctor about screening for hepatocellular cancer. If you smoke, are obese, or drink a lot of alcohol, your doctor can help you improve your health and lower your risk of developing hepatocellular carcinoma.
Diagnosis and Tests
How is hepatocellular carcinoma diagnosed?
Health professionals will perform a medical exam and ask about your medical history, including past illnesses and activities that may increase your risk.
They may also take the following tests:
- X ray.
- Magnetic resonance imaging (MRI).
- ultrasound.
- Computed tomography (CT).
- Angiography.
- bone scintigraphy.
- Biopsy.
- Blood, blood chemistry and blood clotting.
- liver function.
- Kidney function (blood tests to see how well your kidneys get rid of waste).
Management and Treatment
How is hepatocellular carcinoma treated?
There are several ways to treat hepatocellular carcinoma. Your healthcare professionals will develop a treatment plan that takes into account your overall health, liver function and tumor size.
In addition, they will talk with you about treatment goals, options, and possible side effects. They want you to have a complete picture of your situation so you can feel confident in your decisions. After sharing the information, they will ask about your personal preferences. Your final treatment plan will reflect your provider's recommendations and your preferences.
What are the surgical treatments for hepatocellular carcinoma?
Surgical treatments are hepatectomy andLiver transplant. Hepatectomies are usually done when the liver is working well and the tumor is limited to one part of the liver.
What are the other treatments for hepatocellular carcinoma?
Other treatments are:
- ablation therapy. Your doctor uses a special needle to burn your tumors.
- Embolization therapy or chemoembolization therapy. Health professionals inject chemotherapy drugs into the main artery of the liver, which carries the drugs to the tumor. They then temporarily block your artery so the drugs stay in your tumor longer.
- Targeted therapy. This treatment blocks the growth of cancer cells and limits damage to healthy cells by attacking genes in cancer cells.
- Immunotherapy.
- Radiotherapy.
Prevention
How can I reduce the risk of developing hepatocellular carcinoma?
Fortunately, there are several ways to reduce your risk of developing hepatocellular carcinoma:
- Get your hepatitis B vaccine. There is no vaccine for hepatitis C.
- Talk to your doctor if you think you may have hepatitis B and hepatitis C.
- Reduce the amount of alcohol you drink.
- Maintain a healthy weight for you.
Can I have an infection that increases my risk and not realize it?
Having hepatitis C is a risk factor for hepatocellular carcinoma. You can have hepatitis C without showing symptoms or knowing you've been infected. Some activities and medical conditions increase your risk of hepatitis C infection. Talk to your doctor if:
- Had unprotected sex in the past six months, shared drug needles in the past six months, or ever injected drugs.
- TerHIV.
- Was or is it long termhemodialysis.
- He was born between 1945 and 1965. Most people in the United States with hepatitis C were born in these years.
- He had a blood clotting problem before 1987 which was treated with medication.
- You received a blood transfusion or organ transplant before July 1992. That's when healthcare professionals started testing blood and organ donations for hepatitis C.
Outlook / Forecast
Can hepatocellular carcinoma be cured?
Researchers continue to look for ways to cure hepatocellular carcinoma. If your condition was caught early, you may be treated with surgery to remove the tumor. You can have a liver transplant. People whose condition was diagnosed later can still receive treatment and support to help them live longer and have a good quality of life.
living with
How do I take care of myself?
It's very hard to hear that you have a life-threatening disease like hepatocellular carcinoma. It's completely normal to feel overwhelmed, anxious, and even fearful. Give yourself and your loved ones time to work through your initial emotions. Share your feelings with your doctor. They will have suggestions to help you deal with your cancer diagnosis. Here are some steps you can take:
- Keep a record of your questions and concerns about your condition and your treatment. Asking questions helps you understand what to expect and what you can do to help yourself.
- Cancer is stressful. Activities such as meditation, relaxation exercises, or deep breathing can help relieve stress.
- Your treatments may affect your appetite. Try to follow a healthy diet and talk to a nutritionist if you have trouble eating.
- Get enough rest.
- Cancer can be lonely. Sometimes it's difficult to talk to your loved ones about your condition. Your doctor can refer you to support groups and programs where you can share your thoughts and feelings with people who understand what you're going through.
When should I see my doctor?
Contact your doctor if existing symptoms get worse or if you notice new symptoms.
When should I go to the emergency room?
Hepatocellular carcinoma can cause unusual or excessive bleeding. Go to the emergency room or seek immediate medical attention if you start bleeding from bumps and bruises or from your rectum.
What questions should I ask my doctor?
You will have different questions throughout your diagnosis and treatment. Some initial questions you might want to ask are:
- How well is my liver working?
- Has my cancer spread beyond my liver?
- Can my cancer be cured?
- What are my treatment options?
- Why do you suggest these options?
- What are the side effects of each treatment?
- How will each treatment affect my daily life?
- How quickly should we decide on treatment?
- How will we know if the treatment is working?
- What are my options if the initial treatments don't work?
Common questions
A note from the Cleveland Clinic
There is no ideal way to deal with a life-threatening condition like hepatocellular carcinoma. But there are things you can do to help yourself and your loved ones during this difficult time. To feel more confident about your options, take the time to understand your treatment options and side effects. To feel less anxious, try meditation, deep breathing, or light exercise. To avoid feeling isolated, share your experience with others who are going through the same thing; these conversations can help you and they can help them.
FAQs
What is the prognosis for HCC cancer? ›
Overall prognosis for survival is poor, with a 5-year relative survival rate of 18.4%. By stage, the relative 5-year survival is 32.6% in patients diagnosed with localized disease, 10.8% with regional disease, and 2.4% with distant disease.
Is HCC liver cancer curable? ›Since HCC usually grows slowly in its early stages, it can often be cured if discovered early enough.
What is the most common cause of HCC? ›The most common type of liver cancer in adults, hepatocellular carcinoma (HCC), typically develops in people with chronic (long-lasting) liver disease caused by hepatitis virus infection or cirrhosis.
What is the best treatment for HCC liver cancer? ›Surgery to remove your tumor or a liver transplant are the best options for a cure. If surgery is not an option, there are other treatments to ease your symptoms, slow the tumor's growth and help you to live longer.
What is the life expectancy of someone with HCC? ›| SEER stage | 5-year relative survival rate |
|---|---|
| Localized | 35% |
| Regional | 12% |
| Distant | 3% |
| All SEER stages combined | 20% |
Unfortunately, HCC is typically diagnosed late in its course, with a median survival following diagnosis of approximately 6 to 20 months. In the United States, 2 years survival is less than 50% and 5-year survival is only 10%.
How fast does HCC spread? ›The rationale behind the frequency of imaging is that HCC has an average 6-month doubling time. For example, a 1-cm tumor not detected on ultrasound imaging will double in size to a 2-cm tumor in 6 months.
Is HCC cancer terminal? ›Definition of terminal Hepatocellular Carcinoma
Among HCC patients, 15–20% present with end stage or terminal stage HCC. Their median survival is less than 3–4 months.
Overall, the BCLC staging system identifies early, intermediate, advanced, and end stage HCC patients who may benefit from curative therapies, palliative treatments or best supportive care.
How does HCC make you feel? ›Although HCC often does not cause symptoms, some people will develop mild to moderate pain in the upper abdomen and may feel full despite eating less food than usual (early satiety). Some may experience fatigue, unintended weight loss or have a mass that can be felt (palpable) in the upper abdomen.
How can HCC be treated? ›
Hepatocellular carcinoma treatments include: Surgery. Surgery to remove the cancer and a margin of healthy tissue that surrounds it may be an option for people with early-stage liver cancers who have normal liver function. Liver transplant surgery.
How painful is HCC? ›Pain has long been a significant concern for HCC patients and their clinicians; it may manifest as abdominal pain, metastatic bone pain, or in some cases, pain related to LRT.
What is first line treatment for HCC? ›In patients with advanced HCC, the United States Food and Drug Administration (US-FDA) approved systemic therapies include the combination of atezolizumab–bevacizumab, sorafenib, and lenvatinib in the first line setting while cabozantinib, regorafenib, ramucirumab (in patients with alfa-fetoprotein [AFP] > 400 ng/mL), ...
What causes HCC liver cancer? ›Hepatocellular Carcinoma (HCC) is the major form of liver cancer. Risk factors for HCC include chronic HBV (hepatitis B virus) and HCV (hepatitis C virus) infections, autoimmune hepatitis, chronic alcohol use, obesity and diabetes mellitus etc [2].
Can you fully recover from liver cancer? ›If your cancer is at stage A when diagnosed, a complete cure may be possible. The 3 main ways this can be achieved are: removing the affected section of liver – known as a resection. having a liver transplant – an operation to remove the liver and replace it with a healthy one.
What is early stage HCC? ›According to the BCLC staging system, very early stage HCC is defined as a single tumor with the largest diameter of 2 cm or less, well-preserved liver function without vascular invasion or metastasis [10].
Is there chemotherapy for HCC? ›Chemotherapy is one of the most important treatment modalities for advanced hepatocellular carcinoma (HCC). On the basis of the results of two pivotal Phase III placebo-controlled studies, sorafenib is currently acknowledged worldwide as the standard therapeutic agent for advanced HCC.
Can HCC burst? ›Ruptured HCC occurs in 3% to 15% of patients with HCC. With earlier detection of HCC, the incidence of ruptured HCC is decreasing. However, the mortality rate of ruptured HCC in the acute phase remains high (25%-75%) . Liver failure occurs in 12% to 42% of patients during the acute phase.
How long can you live with HCC without treatment? ›Without treatment, the median survival for stage 0 liver cancer is more than 3 years. With treatment, between 70 and 90 out of 100 people (between 70 – 90%) will survive for 5 years or more.
Can you get a liver transplant if you have HCC? ›The only potentially curative treatment options are resection and liver transplantation. Among patients who are not candidates for liver resection, some who have cirrhosis and HCC are candidates for potentially curative liver transplantation.
Is HCC a terminal for cancer? ›
Definition of terminal Hepatocellular Carcinoma
Among HCC patients, 15–20% present with end stage or terminal stage HCC. Their median survival is less than 3–4 months.
Hepatocellular carcinoma (HCC) is an aggressive tumor that frequently occurs in the setting of chronic liver disease and cirrhosis (see "Epidemiology and risk factors for hepatocellular carcinoma").
What is the difference between liver cancer and hepatocellular carcinoma? ›Liver cancer begins in the cells of the liver. The most common form of liver cancer begins in cells called hepatocytes and is called hepatocellular carcinoma. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer.
Is hepatocellular carcinoma a death sentence? ›Most HCC patients without treatment die within 6 months of diagnosis [1–5]. The fibrolamellar variant in non-cirrhotic liver of young adults are less aggressive and prolonged survival has been reported even in patients with advanced tumour stage and metastatic spread [10].
How does HCC cause death? ›Background: Most cases of HCC are associated to liver cirrhosis. Tumor extension and liver failure may be competing causes of death in these patients.
Is HCC liver cancer painful? ›Pain has long been a significant concern for HCC patients and their clinicians; it may manifest as abdominal pain, metastatic bone pain, or in some cases, pain related to LRT. More than 80% of patients who develop HCC have underlying liver disease or cirrhosis,5 creating special challenges for pain management.
Can HCC go into remission? ›Achieving radiological complete response can be associated with long-term remission and excellent outcome. However, despite recent advancements in the medical treatment of advanced stage HCC, complete remission with available systemic treatment options still remains a rare event.
What is the 5 year survival rate for HCC? ›The 5-year survival rate of persons with HCC is less than 20%(2); however, survival varies by stage at diagnosis and treatment.