Hepatocellular Carcinoma: Causes, Symptoms, Diagnosis and Treatment


The liver is an organ with many functions, including the filtering of toxins that accumulate in the blood, the production of proteins and hormones, and the breakdown of complex molecules.

The liver is essential for survival. Hepatocellular carcinoma (HCC), also known as primary liver cancer, occurs when a tumor develops in the liver.

This type of cancer differs from metastatic liver cancer, which emerges in other body parts and spreads to the liver through the bloodstream. (Many more patients get liver cancer this way).

CHC is the fifth most common cancer in the United States, where its incidence has increased in recent years, a trend projected to continue through the next decade.

Worldwide, hepatitis B and C types are responsible for more than 80 percent of primary liver cancer.

In the United States, primary liver cancer is mainly caused by hepatitis C and chronic alcoholism, and related cirrhosis.

Research suggests that the recent increase in HCC is partly due to a more significant number of cases of obesity and diabetes.

Alcoholism, hepatitis, drug abuse, and other liver infections are associated with cirrhosis – the healing of advanced liver tissue.

Cirrhosis develops over decades, and the damage to the liver becomes significant over time. Often, this damage is not recognized since the symptoms are absent.

The mortality rate of primary liver cancer is high, and early detection is crucial. All patients with cirrhosis, regardless of their cause, should undergo screening for hepatocellular carcinoma.

The data suggest that the average survival rate is 11 months among all patients with HCC and 16 to 24 months for patients who received two pharmacological treatments.

Survival rates are improving as treatment modalities improve over time.

The symptoms

Hepatocellular carcinoma or liver cancer may grow unnoticed for years. When symptoms appear, jaundice – yellowing of the skin and eyes – is common.

This symptom is due to the inability of the liver to remove bilirubin, a waste product, from the blood.

HCC is also revealed through the following symptoms:

  • Loss of appetite or weight.
  • Fatigue.
  • Nausea.
  • Pain in the abdomen.
  • Inflated abdominal cavity of fluid accumulation.


Chronic hepatitis B and C virus infections occur in about 80 percent of the cases worldwide. In the United States, alcohol-related cirrhosis is another crucial cause of HCC.

Other causes include:

  • Cirrhosis related to drugs.
  • Hemochromatosis is a hereditary disease where the body can not adequately eliminate excess iron.
  • Fatty liver disease.

Risk factor’s

  • Hepatitis C, Hepatitis B.
  • The excessive consumption of alcohol.
  • Cirrhosis.
  • Hereditary hemochromatosis.
  • Obesity.
  • Diabetes.
  • Non-alcoholic fatty liver disease.


This disease is usually linked to hepatitis B or cirrhosis of any cause, and affected patients typically experience symptoms only after the disease has reached a later stage.

When the symptoms – abdominal pain, weight loss, jaundice – are recognized, the blood test can reveal abnormal levels of several proteins that mark the Hepatocellular Carcinoma (HCC) and the images of the liver may show a mass.

Two radiological methods reliably confirm the presence of the tumor:

  1. Formation of images of three phases through magnetic resonance, with dynamic contrast.
  2. Three-phase, helical computed tomography (CT)

The results are sufficient to generate a formal diagnosis of Hepatocellular Carcinoma with any method.

CT and MR imaging is very accurate with tumors of 2 cm or more but much less accurate in revealing smaller tumors.

Liver tumors can be solitary or multiple. They can invade the blood vessels of the liver and have spread out of the liver (metastasis).


The most appropriate treatment for Hepatocellular Carcinoma depends on the size of the tumor, the number and location, the involvement of the blood vessels, and the severity of the underlying liver disease.

Potential curative treatments include hepatectomy (surgical resection) and liver transplantation, but only a tiny percentage of patients are suitable candidates for these treatments.

The most common therapies are to kill tumor cells or slow their growth.

These include:

Radiofrequency ablation (destruction of the tumor by electric energy waves).

Percutaneous ethanol injection (ethanol injection needle into the tumor tissue, dehydration, and deactivation of the cellular structure).

Transarterial embolization (implantation of small particles, spheres – in the tumor tissue to stop its blood flow, causing the death of tumors. Often, these particles are coated with a chemotherapy drug)

Radiation (destruction of tumor cells with laser energy).

Chemotherapy (toxic chemicals introduced intravenously or in the form of pills to kill cancer cells and fight their spread).


Patients with Hepatocellular Carcinoma often experience weight loss and a change in eating interests and sensitivities.

Patients should try to maintain a healthy diet low in sodium and adequate protein intake.

Patients must:

  • Stop smoking.
  • Interrupting the consumption of alcohol.
  • Perform gentle exercise.
  • Find something to laugh about every day.