Liver cancer is a cancer that starts in the liver. It is sometimes called primary liver cancer. A cancer that starts somewhere else in the body and spreads to the liver is called secondary cancer in the liver.
Primary liver cancer is rare in the UK, but the number of people developing it is increasing. Around 5,700 people in the UK are diagnosed with primary liver cancer each year. In other parts of the world, such as parts of Africa and Asia, it is one of the most common cancers.
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Types of liver cancer
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It is sometimes called hepatoma. This information is about hepatocellular carcinoma (HCC). To make it simpler, we call it HCC.
We have more information about other types of cancer that start in the liver.
In the early stages of liver cancer (HCC), there are often no symptoms. If you have long-term (chronic) liver disease, you may have regular tests to check their liver. If you develop HCC, these tests may find it before you have any symptoms.
Symptoms may include:
- loss of appetite
- weight loss
- feeling sick
We have more information about these and other possible the symptoms of HCC.
You may have some of the following tests to diagnose HCC:
Liver ultrasound scan
We have more information about how liver cancer is diagnosed.
Waiting for test results can be a difficult time. We have more information that can help.
The stage of a cancer describes its size and whether it has spread from where it first started.
Knowing the stage helps you and your doctors to decide on the best treatment for you. For liver cancer, doctors also use the Child-Pugh score when planning treatment. This looks at how well the liver is working.
Your treatment will be planned by a team of specialists called a multidisciplinary team (MDT).
Your cancer doctor or specialist nurse will explain the different treatments and their side effects. If two treatments are likely to be equally helpful, your doctor may ask you to decide which one to have. They will also talk to you about certain things to think about when making treatment decisions.
The treatment you have will usually depend on:
- where the cancer is in the liver – there may be several areas of cancer in different parts of the liver
- the size of the tumour or tumours
- how many tumours there are
- whether the cancer has spread outside the liver
- whether any important blood vessels in the liver are affected
- how well your liver is working
- your general health.
Possible treatments include:
- surgery - a surgeon operates to remove the cancer
- tumour ablation – a doctor applies heat or alcohol to the cancer cells to destroy them
- embolisation – a doctor blocks blood vessels close to the cancer to try to shrink it. Chemoembolisation or radioembolisation may be used.
- targeted therapy – the most commonly used targeted therapy drugs for primary liver cancer (HCC) are sorafenib, lenvatinib and regorafenib.
- chemotherapy – this may be used to try to control advanced liver cancer
- radiotherapy – stereotactic radiotherapy (SABR) is sometimes used to treat liver cancer (HCC). Or radiotherapy may be used to help symptoms if the cancer has spread outside the liver.
For some people, treatment may be given with the aim of curing the cancer. For others it may be given to help control the cancer, prolong your life and improve symptoms. Your doctor or nurse will talk about what to expect.
We have more information about treatment for liver cancer.
Treatment to control symptoms
Treatments can also be used to control symptoms. This is sometimes called palliative treatment or supportive care. Your doctor may refer you to a palliative care team who are experts in controlling symptoms. They will support you and your family. The team often includes a doctor and nurses. They often work closely with a local hospice and can visit you and your family at home.
Follow-up after treatment
After your treatment finishes, you will have regular check-ups. Your specialist will do a physical examination. You will usually also have blood tests. Depending on the treatment you had, you may have regular CT scans to check that the tumour has not come back. After a liver transplant, you also have checks to make sure your body is not rejecting the new liver. Your doctor or nurse will talk to you about what to look out for.
If you have problems or new symptoms between check-ups, contact your doctor or nurse as soon as possible.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
Well-being and recovery
After treatment you are likely to feel very tired and you may still be coping with some side effects. It is important to take care of yourself to allow your body time to recover. Tiredness and feeling weak are also common in people with advanced liver cancer. Make sure you get enough rest and eat well.
After treatment, you may want to focus on making the most of your health.
Because the liver breaks down alcohol, your specialist may advise you not to drink for a period of time after treatment. They may ask you to reduce the amount of alcohol you drink, or to stop drinking completely. Your liver may not be able to cope with alcohol, so ask your specialist doctor or nurse for advice.
Below is a sample of the sources used in our primary liver cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Melloul E, Hübner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016; 40: 2425–2440. Available from: doi.org/10.1007/s00268-016-3700-1 [accessed Feb 2020]
NICE. Lenvatinib for untreated advanced hepatocellular carcinoma: Technology appraisal guidance (TA 551) [Internet]. 2018. Available from: www.nice.org.uk/guidance/TA551 [accessed Feb 2020]
NICE. Liver disease. Quality standard (QS 152) [Internet]. 2017. Available from: www.nice.org.uk/guidance/QS152 [accessed Feb 2020]
NICE. Liver cancers overview [Internet]. 2019. Available from: pathways.nice.org.uk/pathways/liver-cancers/liver-cancers-overview [accessed Feb 2020]
NICE. Regorafenib for previously treated advanced hepatocellular carcinoma. Technology appraisal guidance (TA555) [Internet]. 2019. Available from: www.nice.org.uk/guidance/ta555 [accessed Feb 2020]
Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018; 29 (S4): iv238–iv255. Available from doi.org/10.1093/annonc/mdy510 [accessed Feb 2020]
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.
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