Hepatocellular Carcinoma
(Liver Cancer)

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Medical Author:

Keith E. Stuart, MD

Keith E. Stuart, MD

Dr. Keith E. Stuart is a medical oncologist specializing in the study and treatment of cancers involving the gastrointestinal tract, with a special interest in tumors involving the liver. He was educated at Harvard University (graduating magna cum laude) and Albert Einstein College of Medicine and did his medical training at the New England Deaconess Hospital.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Liver cancer is the third most common cancer in the world, and the majority of patients with liver cancer will die within one year as a result of the cancer.
• In the U.S., patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, obesity or diabetes, and hemochromatosis are at the greatest risk of developing liver cancer.
• Patients with chronic liver disease (for example, hepatitis C virus, hepatitis B virus, or hemochromatosis) should avoid drinking alcohol, which can further increase their risk of developing cirrhosis and liver cancer.
• Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor. When the patient does develop symptoms, the prognosis is usually poor.
• The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein most effectively diagnoses liver cancer.
• A liver biopsy can make a definitive diagnosis of liver cancer, but the procedure requires an expert liver pathologist and is not necessary for all patients.
• The natural history of liver cancer is quite variable and depends on the stage of the tumor and the severity of the associated cirrhosis.
• Medical treatments for liver cancer such as chemotherapy are slowly becoming more effective, although still disappointing. The new drug sorafenib has shown that survival can be prolonged.
• Ablative and local techniques such as chemoembolization, radioembolization, radiofrequency or cryoablation, and stereotactic radiosurgery can by very useful in controlling individual cancers for an extended time.
• Surgical resection (removal) of the tumor may be curative for a select group of individuals with liver cancer, specifically for those with small tumors and healthy liver function.
• For patients with small liver cancer and significant associated liver disease, liver transplantation offers the only chance for cure.
• This is a disease that should be almost entirely preventable by societal and lifestyle changes.