Overview
Liver cancer
Liver cancer
Liver cancer begins in the cells of the liver. The most common form of liver cancer begins in cells called hepatocytes. This type of cancer is called hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is a type of cancer that starts as a growth of cells in the liver. The liver is an organ that sits just under the rib cage on the right side of the belly. It helps the body digest food and get rid of waste products, among other tasks.
Hepatocellular carcinoma is the most common type of liver cancer. It starts in liver cells called hepatocytes. Hepatocellular carcinoma happens most often in people with chronic liver conditions, such as cirrhosis caused by hepatitis B or hepatitis C infection.
Hepatocellular carcinoma happens when liver disease or something else changes the cells in the liver. The changes cause the cells to make many more diseased cells that form a growth called a tumor. The tumor can hurt healthy liver tissue and grow into nearby blood vessels. The cells can break away and spread to other parts of the body.
Hepatocellular carcinoma is one of the most serious cancers. It may not cause symptoms right away, which means it can grow without being detected. It also tends to happen in people with serious liver disease, which may make treatment more difficult.
Treatment often depends on how advanced the cancer is and how well the liver is working. Hepatocellular carcinoma treatment may include surgery to remove the cancer or a liver transplant. Other treatments may include ablation, embolization, radiation therapy, immunotherapy and targeted therapy.
Hepatocellular carcinoma differs from another kind of liver cancer called intrahepatic cholangiocarcinoma. This other type starts in the bile ducts in the liver, rather than in the liver tissue. They are both kinds of liver cancer, but they have different risk factors and treatments. Another type of liver cancer called hepatoblastoma mostly affects young children. These are all types of malignant neoplasms of the liver, which is a medical term that means cancer in the liver.
Types
Hepatocellular carcinoma doesn't have types. Fibrolamellar carcinoma is sometimes described as a subtype or variant of hepatocellular carcinoma because both cancers are thought to start in hepatocytes. But fibrolamellar carcinoma acts differently than most hepatocellular carcinomas. Healthcare professionals don't agree on whether hepatocellular carcinoma and fibrolamellar carcinoma are related or not.
Fibrolamellar carcinoma happens most often in young adults who don't have liver disease. It's most often treated with surgery. Fibrolamellar carcinoma often doesn't cause high levels of alpha-fetoprotein (AFP) in the blood, as most hepatocellular carcinomas do.
Products & Services
Symptoms
Hepatocellular carcinoma might not cause symptoms that are noticed right away. This disease happens most often in people with liver scarring, called cirrhosis, caused by hepatitis B or hepatitis C infection. In these people, the cancer symptoms might be the same as the cirrhosis symptoms.
Hepatocellular carcinoma doesn't cause early symptoms. A healthcare professional might detect early signs of the disease, such as:
- Results that are higher than expected on a blood test that looks for alpha-fetoprotein (AFP), which might be done as part of liver cancer screening in someone with a high risk of the disease.
- Growths, called nodules, on the liver, which might be detected on an ultrasound imaging test that's done as part of liver cancer screening.
If signs and symptoms of hepatocellular carcinoma develop, it usually means the disease is advanced. Symptoms may include:
- Losing weight without trying.
- Loss of appetite.
- Upper abdominal pain.
- A growth in the abdomen.
- Yellowing of the skin and the whites of the eyes. This is called jaundice. It happens when a substance called bilirubin builds up in the blood.
When to see a doctor
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
Causes
The main causes of hepatocellular carcinoma are liver scarring, called cirrhosis, and infection with hepatitis B virus or hepatitis C virus. But not everyone with this type of cancer has a serious liver condition. It's not clear what causes hepatocellular carcinoma in people who don't have liver disease.
Hepatocellular carcinoma happens when cells in the liver called hepatocytes develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.
The cancer cells form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.
Risk factors
There are many factors that can increase the risk of hepatocellular carcinoma. The most common risk factors are liver scarring, called cirrhosis, and infection with the hepatitis B virus or hepatitis C virus. There are many other conditions that can hurt the liver and raise the risk of hepatocellular carcinoma.
Risk factors for hepatocellular carcinoma include:
- Older age. Hepatocellular carcinoma is more common in older adults.
- Infection with hepatitis B virus or hepatitis C virus. Ongoing or previous infection with the hepatitis B virus or hepatitis C virus increases the risk of hepatocellular carcinoma.
- Cirrhosis. Cirrhosis is a progressive and irreversible condition that causes scar tissue to form in the liver. It increases the chances of developing hepatocellular carcinoma.
- Certain inherited liver diseases. Some liver diseases that can run in families may increase the risk of hepatocellular carcinoma. Examples include hemochromatosis and Wilson's disease.
- Excess fat in the liver. Metabolic dysfunction-associated steatotic liver disease, which used to be called nonalcoholic fatty liver disease, happens when fat builds up in the liver. People with this condition are at an increased risk of hepatocellular carcinoma.
- Diabetes. People with this blood sugar condition have a greater risk of hepatocellular carcinoma than those who don't have diabetes.
- Obesity. People with obesity have a higher risk of cirrhosis and excess fat in the liver. These conditions increase the risk of hepatocellular carcinoma.
- Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with aflatoxins, which can end up in foods made of these products.
- Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase the risk of hepatocellular carcinoma.
- Smoking cigarettes. People who smoke cigarettes are at an increased risk of hepatocellular carcinoma.
Complications
Hepatocellular carcinoma can spread to other parts of the body. When it spreads, it most often goes to the:
- Lungs.
- Lymph nodes in the abdomen.
- Bones.
- Adrenal glands.
- Brain.
The medical term for spread is metastasize. When this cancer spreads, healthcare professionals call it metastatic hepatocellular carcinoma.
Prevention
Reduce your risk of cirrhosis
Cirrhosis is scarring of the liver, and it increases the risk of hepatocellular carcinoma. You can reduce your risk of cirrhosis if you:
- Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
- Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.
Get vaccinated against hepatitis B
Infection with the hepatitis B virus increases the risk of hepatocellular carcinoma. You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine. The vaccine can be given to almost anyone, including infants, children, adults and older adults.
Take measures to prevent hepatitis C
Infection with the hepatitis C virus increases the risk of hepatocellular carcinoma. No vaccine for hepatitis C exists, but you can reduce your risk of infection.
- Know the health status of any sexual partner. Don't engage in unprotected sex unless you're certain your partner isn't infected with hepatitis B, hepatitis C or any other sexually transmitted infection. If you don't know the health status of your partner, use a condom every time you have sexual intercourse.
- Don't use intravenous drugs, but if you do, use a clean needle. Reduce your risk of hepatitis C by not injecting legal or illegal drugs that may be sold on the streets. But if that isn't an option for you, make sure any needle you use is sterile, and don't share it. Contaminated needles are a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
- Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop won't answer your questions or don't take your questions seriously, take that as a sign that the facility isn't right for you.
Seek treatment for hepatitis B or C infection
Treatments are available for hepatitis B and hepatitis C infections. Research shows that treatment can reduce the risk of hepatocellular carcinoma.
Ask about liver cancer screening
For most people, screening for liver cancer hasn't been proved to reduce the risk of dying of liver cancer, and it isn't generally recommended. People with conditions that increase the risk of liver cancer might consider screening. People with an increased risk include those who have:
- Hepatitis B infection.
- Hepatitis C infection.
- Liver cirrhosis.
Talk about the pros and cons of screening with your healthcare team. Together you can decide whether screening is right for you based on your risk. Hepatocellular carcinoma screening typically involves a blood test and an abdominal ultrasound every six months.
Sept. 11, 2025