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</div><div><span>Liver cancer - hepatocellular carcinoma</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Liver cancer - hepatocellular carcinoma</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Hepatocellular carcinoma is cancer that starts in the liver.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Hepatocellular carcinoma is the most common type of liver cancer. It occurs more often in men than women. It is most often diagnosed in people age 50 or older.</p><p>Hepatocellular carcinoma is not the same as <a test="test" href="./000277.htm">metastatic liver cancer</a>. Metastatic liver cancer starts in another organ (such as the breast or colon) and spreads to the liver.</p><p>In most cases, the cause of hepatocellular liver cancer is long-term damage and scarring of the liver (<a test="test" href="./000255.htm">cirrhosis</a>). Cirrhosis may be caused by:</p><ul><li>Alcohol overuse</li><li><a test="test" href="./000816.htm">Autoimmune diseases</a> of the liver</li><li><a test="test" href="./000279.htm">Hepatitis B</a> or <a test="test" href="./000284.htm">hepatitis C</a> virus infection</li><li>Inflammation of the liver that is long-term (chronic hepatitis)</li><li>Iron overload in the body (<a test="test" href="./000327.htm">hemochromatosis</a>) </li></ul><p>People with hepatitis B or C are at high risk for liver cancer, even if they do not develop cirrhosis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms of liver cancer may include any of the following:</p><ul><li><a test="test" href="./003120.htm">Abdominal pain</a> or tenderness, especially in the upper-right part</li><li>Easy bruising or bleeding</li><li>Enlarged abdomen due to fluid in the abdomen (<a test="test" href="./000286.htm">ascites</a>)</li><li>Yellow skin or eyes (<a test="test" href="./000210.htm">jaundice</a>)</li><li>Unexplained weight loss</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam and ask about your symptoms. The physical exam may show an enlarged, tender liver or other signs of cirrhosis.</p><p>If your provider suspects liver cancer, tests that may be ordered include:</p><ul><li><a test="test" href="./003789.htm">Abdominal CT scan</a></li><li><a test="test" href="./003796.htm">Abdominal MRI scan</a></li><li><a test="test" href="./003777.htm">Abdominal ultrasound</a></li><li><a test="test" href="./003895.htm">Liver biopsy</a></li><li><a test="test" href="./003436.htm">Liver function tests</a></li><li><a test="test" href="./003573.htm">Serum alpha fetoprotein</a></li></ul><p>Some people at risk for liver cancer may get regular blood tests and ultrasounds to see if tumors are developing.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Treatment depends on how advanced the cancer is.</p><p>Surgery may be done if the tumor has not spread. Before surgery, the tumor may be treated with <a test="test" href="./002324.htm">chemotherapy</a> to reduce its size. This is most often done by delivering the medicine straight into the liver with a tube (catheter).</p><p><a test="test" href="./001918.htm">Radiation treatments</a> in the area of the cancer may also be helpful.</p><p>Ablation is another method that may be used. Ablate means to destroy. Types of ablation include using:</p><ul><li>Radio waves or microwaves</li><li>Ethanol (an alcohol) or acetic acid (vinegar)</li><li>Extreme cold (cryoablation) </li></ul><p>A <a test="test" href="./003006.htm">liver transplant</a> may be recommended.</p><p>If the cancer can't be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment instead focuses on improving and extending the person's life. Treatment in this case may use <a test="test" href="../patientinstructions/000902.htm">targeted therapy</a> with drugs that can be taken as pills. Newer immunotherapy drugs may also be used.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Support Groups</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>You can ease the stress of illness by joining a <a test="test" href="./002166.htm">cancer support group</a>. Sharing with others who have common experiences and problems can help you not feel alone.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>If the cancer can't be completely treated, the disease is usually fatal. But survival can vary, depending on how advanced the cancer is and how successful treatment is.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if you develop ongoing abdominal pain, especially if you have a history of <a test="test" href="./000205.htm">liver disease</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Preventive measures include:</p><ul><li>Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk for liver cancer in the future.</li><li>Not drinking alcohol in excess.</li><li>Screening for liver cancer in people with certain types of hemochromatosis (iron overload).</li><li>Screening for liver cancer in people who have hepatitis B or C or cirrhosis.</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma </p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1102t.jpg" alt="Liver biopsy" title="Liver biopsy" class="side-img"/><a href="../imagepages/1102.htm">Liver biopsy</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1167t.jpg" alt="Hepatocellular cancer - CT scan" title="Hepatocellular cancer - CT scan" class="side-img"/><a href="../imagepages/1167.htm">Hepatocellular cancer - CT scan</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Abou-Alfa GK, Jarnagin W, El Dika I, et al. Liver and bile duct cancer. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. <em>Abeloff's Clinical Oncology</em>. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 77.</p><p>Di Bisceglie AM, Befeler AS. Hepatic tumors and cysts. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 96.</p><p>National Cancer Institute website. Adult primary liver cancer treatment (PDQ) - health professional version. <a href="https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq" target="_blank">www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq</a>. Updated August 22, 2023. Accessed September 8, 2023.</p><p>National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: hepatocellular carcinoma. Version 2.2023. <a href="https://www.nccn.org/professionals/physician_gls/pdf/hcc.pdf" target="_blank">www.nccn.org/professionals/physician_gls/pdf/hcc.pdf</a>. Updated September 4, 2023. Accessed September 28, 2023.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 8/28/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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