Daniel Pratt, MD, of the Massachusetts General Hospital Hepatocellular Carcinoma Clinic, answers frequently asked questions (FAQ) for patients about hepatocellular carcinoma (HCC).

Frequently Asked Questions About Hepatocellular Carcinoma

What is hepatocellular carcinoma (HCC)?

HCC, or primary liver cancer, is a cancer that starts in the liver from the abnormal growth of liver cells. This is often confused with metastatic liver cancer, which starts elsewhere in the body and spreads to the liver. The number of HCC cases is on the rise in the United States.

What causes HCC?

The most important risk factor for HCC is the presence of cirrhosis (advanced scarring of the liver), regardless of what caused the cirrhosis. Alcohol and chronic hepatitis C are the most common causes of cirrhosis in the United States. Hepatitis B is the only condition associated with HCC even in people who don’t have cirrhosis.

How is HCC diagnosed?

HCC is most often diagnosed through screening tests performed in high-risk populations, such as patients with cirrhosis or chronic hepatitis B. Typical screening tests include ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) scan. Patients diagnosed with HCC using one of these methods usually have no symptoms because their tumors are very small.
Your doctor may also want to perform a liver biopsy to verify the diagnosis. During a biopsy, a small piece of liver tissue is removed and studied by pathologists. Symptoms can occur as the tumor enlarges; these include right-sided abdominal pain, weight loss, fever and jaundice.

How is HCC treated?

Determining the best treatment for HCC is based on a number of factors, including:

  • Size and number of tumors
  • Tumor’s location in the liver
  • Whether the tumor has spread outside the liver
  • General condition of the liver and the patient

Treatment options include:

  • Liver resection: Removal of the part of the liver that contains cancer
  • Locoregional therapies to destroy the tumor cells, including radiofrequency ablation (RFA), transarterial chemoembolization and ethanol ablation
  • Radiation or proton beam therapy
  • General condition of the liver and the patient

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