Hepatocellular carcinoma is a cancer that starts in your liver. It's different from "secondary" liver cancers, which have spread to the liver from other organs.

If caught early, it can sometimes be cured with surgery or transplant. In more advanced cases it can’t be cured, but treatment and support can help you live longer and better.

It's important to remember that you still have control over the decisions you make about your treatment and your life. Make sure you have people you can talk to about your plans, your fears, and your feelings. Ask your doctor about support groups, where you can meet people who know what you're going through.

Your doctor can help you understand your treatment options. Surgery, radiation, chemotherapy, immunotherapy, and target therapy may be some of your choices.

Causes

Doctors aren't sure exactly what causes all cases of hepatocellular carcinoma, but they've identified some things that may increase your risk for getting it:

Hepatitis B or hepatitis C. Hepatocellular cancer can start many years after you've had one of these liver infections. Both are passed through blood, such as when drug users share needles. Blood tests can show whether you have hepatitis B or C.

Cirrhosis: This serious disease happens when liver cells are damaged and replaced with scar tissue. Many things can cause it: hepatitis B or C infection, alcohol drinking, certain drugs, and too much iron stored in the liver.

Heavy drinking: Having more than two alcoholic drinks a day for many years raises your risk of hepatocellular cancer. The more you drink, the higher your risk.

Obesity and diabetes: Both conditions raise your risk of liver cancer. Obesity can lead to nonalcoholic fatty liver disease, which can lead to hepatocellular carcinoma. The higher risk from diabetes may be due to liver damage caused by the disease. Plus, people with diabetes are often overweight or obese.

Anabolic steroids. Drugs that mimic the male sex hormone testosterone are sometimes used by athletes to build muscle mass. Long-term use increases your risk.

Iron storage disease. This causes too much iron to be stored in the liver and other organs. People who have it may develop hepatocellular carcinoma.

Aflatoxin. This harmful substance, which is made by certain types of mold on peanuts, corn, and other nuts and grains, can cause hepatocellular carcinoma. The U.S. has safety measures that limit aflatoxin in the food supply.

Getting a Diagnosis

Your doctor will give you a physical exam and may ask you questions like:

Have you had any pain in your belly?

Are you feeling weak or tired?

Is your appetite down?

Have you lost weight?

Blood test. Your doctor takes a sample of your blood and checks to see if it has a protein called AFP. :  Unborn babies have high levels of AFP, but it decreases in most people right after birth. If your blood has a high amount of AFP, it could be a sign of liver cancer.

Imaging tests. Your doctor may ask you to get an ultrasound, CT scan, or MRI to look for tumors in your liver. An ultrasound creates images of your liver with sound waves. A CT scan is a powerful X-ray that makes detailed pictures inside your body. An MRI uses strong magnets and radio waves to make an image of your liver.

Liver biopsy. Your doctor may want to remove a sample of your liver tissue and check it under a microscope for cancer cells.

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