The liver is one of the most important organs in the body. As part of the digestive system, it’s estimated that the liver performs about 500 different tasks, such as filtering out toxins and regulating blood sugar. However, like any part of the body, the liver is susceptible to wear and tear. Over time, too much damage to the liver can result in a type of scarring called liver cirrhosis which in turn can lead to Hepatocellular Carcinoma (HCC), a type of cancer that is responsible for an estimated 500,000 deaths every year.
Reviewed by Luke Wilkins, MD
What Is Hepatocellular Carcinoma (HCC)?
Hepatocellular Carcinoma is a primary cancer of the liver, meaning it is a cancer that originates in the liver; it doesn’t spread to the liver from other parts of the body. HCC is one of the most common liver cancers and is often caused by long-term damage or scarring of the liver (liver cirrhosis).
Liver cirrhosis is usually a result of alcohol abuse, Hepatitis B, or Hepatitis C. Other causes of HCC include: autoimmune disease of the liver, long-term liver inflammation, iron overload, obesity, and diabetes. In order to understand HCC better, we need to first understand the liver and liver cirrhosis.
The liver is the only body part that can regenerate. This means that when it is damaged, it can replace damaged cells with healthy cells, resulting in little to no scar tissue. Unfortunately, the liver can still become scarred when it is damaged continually over a long period of time and doesn’t have a chance to fully heal. Hepatitis B or C, heavy alcohol use, and other conditions can cause liver cirrhosis because they damage the liver without giving it a chance to heal completely.
A scarred liver can’t function properly, and as a result, a liver with cirrhosis is more likely to have cells that mutate and then replicate, causing abnormal growths–cancer–to form. HCC, like other types of cancer, disrupts the normal functions of the affected organ and can spread to other parts of the body.
Because HCC is so closely related to liver health, it’s important to get screening for HCC if you have any risk factors for the disease since it can be treated much more effectively early on than later. It’s important to understand cancer and know your own health risks in order to know your options for preventing and treating this disease.
Symptoms and Risk Factors
Because the liver handles such a wide range of functions, HCC can have many different symptoms, including:
Abdominal pain or tenderness to the touch
Feeling there is a “lump” and/or pain in the stomach
Loss of appetite or feeling “full”
Nausea or vomiting
Pale, chalky bowel movements
Unexplained weight loss
Persistent fatigue or weakness
Fever unrelated to other conditions
There are many risk factors that can raise the probability of developing HCC. Some groups linked to higher instances of HCC include adults over the age of 60, males, people of asian or pacific islander descent, and those with a metabolic disease. However, other risk factors such as obesity, smoking, and drinking too much alcohol are all things we can and should control as a way to limit our chances of developing HCC.
There are a number of things you can do to reduce your risk of liver cancer, even if you have some of the risk factors listed above. Prevention methods include:
Guarding Against Hepatitis– Getting a vaccine against Hepatitis B and avoiding dirty needles are both ways to prevent contracting the Hepatitis virus.
Drinking in Moderation– Making sure you limit your alcohol intake can help keep your liver healthy and guard against liver cirrhosis.
Liver Cancer Screenings– If you have a condition that can damage the liver over time, you should have regular cancer screenings to catch liver cancer early if it appears.
Engaging in A Healthy Lifestyle– Exercising regularly, eating a healthy diet, and getting enough sleep have all been shown to reduce your risk of cancer and other diseases.
There are many different ways your health care professional may choose to test you for HCC. Some common testing options include:
In a biopsy, doctors will surgically remove a small tissue sample from the liver to test and determine whether or not HCC is present.
Blood may be drawn and tested. Abnormally high or low levels of certain components can signal the presence of liver cancer.
Your doctor may order an ultrasound, CT, or MRI scan of the liver to see whether or not HCC is present.
Treatment options vary from patient to patient and depend on how advanced the cancer is when treatment starts. Typical treatment options for HCC include surgery, chemotherapy, external radiation therapy, ablation, liver transplant, and radioembolization.
While all of these treatment options have their own merits, UVA interventional radiology offers radioembolization for patients who have otherwise untreatable liver cancer.
Radioembolization is an interventional radiology procedure that specially treats liver cancers like HCC. In a radioembolization procedure, an interventional radiologist uses tiny resin or glass beads containing the radioactive material yttrium, called microspheres, to block blood flow to the tumor and deliver a concentrated dose of radiation to the cancer cells.
Radioembolization is not a cure, but rather a palliative treatment. It reduces symptoms and extends the life expectancy of the patient, sometimes long enough for a liver transplant. Radioembolization is a good treatment option for patients who are not candidates for other treatments.
If you or a loved one has been diagnosed with HCC or is at risk for the disease, contact the UVA Cancer Center at 434-924-9333 to learn more about what your options are for dealing with or preventing this type of cancer.