Hepatocellular Carcinoma: Symptoms, Causes, Treatment
سرطان الكبد (سرطان الخلايا الكبدية)
Hepatocellular carcinoma is a major form of primary liver cancer, often arising in chronic liver disease. Treatment considers both tumour stage and liver reserve. Not every liver mass is hepatocellular carcinoma.
What is Hepatocellular Carcinoma?
It begins in liver cells and differs from bile-duct cancer and cancer that has spread from another organ. Surveillance in selected people with cirrhosis can identify disease before symptoms and allow discussion of more treatment options.
Related reading: What is the difference between cancer stage and grade?.
Symptoms
Early disease may be silent. Possible features include right-upper abdominal pain, early fullness, weight loss, swelling or jaundice. New deterioration in someone with cirrhosis can prompt further investigation.
Causes
Chronic liver injury and cellular changes contribute. Associations include hepatitis B or C and cirrhosis from several causes. Hepatocellular carcinoma can also occur without cirrhosis, requiring assessment of each person’s risks.
Risk factors
Cirrhosis, chronic viral hepatitis and certain metabolic or inherited disorders increase risk. Several factors together can warrant tailored surveillance. Risk factors do not establish cancer but help determine an appropriate monitoring plan.
Diagnosis
Assessment includes appropriately performed contrast CT or MRI, liver-function tests and selected markers. Characteristic imaging can establish the diagnosis in particular risk groups; other cases need biopsy. A raised tumour marker alone cannot confirm cancer.
Treatment
Selected cases may benefit from resection, transplantation or local ablation. Other options include liver-directed arterial procedures, radiation, immune or targeted medicines. A liver and oncology team considers spread, liver function, bleeding risk and general health.
Complications
Cancer may coexist with liver failure, fluid retention or bleeding, and can invade blood vessels or spread elsewhere. Effects of tumour, cirrhosis and treatment may overlap. Pain relief and nutritional support matter at every stage.
Prevention
Appropriate hepatitis B vaccination, treatment of liver infections, avoiding alcohol and managing liver disease can reduce risk. Some high-risk patients need periodic imaging arranged by their clinician. Treating infection does not always remove the need for surveillance.
When to see a doctor
Seek review for unexplained deterioration, jaundice or persistent weight loss, particularly with liver disease. Vomiting blood, black stools, confusion or painful swelling with fever needs urgent care, whether caused by cancer or another liver complication.