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Hepatocellular Carcinoma (HCC)

Contact the UPMC Center for Liver Diseases

To make an appointment with a hepatologist at the UPMC Center for Liver Diseases, call 412-647-1170 or fill out our contact form.


What Is Hepatocellular Carcinoma (HCC)?

HCC is a type of liver cancer. It's a primary liver cancer and is the most common form of cancer that starts in the liver.

HCC differs from cancers that start elsewhere in the body and spread to the liver.

Between 2000 and 2016, there were a total of 119,078 cases of HCC in the U.S. It's more common in parts of Asia and Africa.

HCC is about 3 times more common in men than in women.

HCC causes

Doctors don't know for sure what causes HCC. But the disease is more common in people who have other liver conditions.

Environment factors may play a role in causing HCC. This includes eating food contaminated with aflatoxin, a fungal poison.

Hepatocellular carcinoma risk factors and complications

Some conditions and infections damage the liver over time. This damage may make the liver at risk for developing HCC.

Liver conditions that may put you at greater risk for HCC include:

  • Alcoholic liver disease
  • Hepatitis B
  • Hepatitis C
  • Fatty liver disease
  • Nonalcoholic steatohepatitis (NASH)
  • Primary biliary cholangitis

How to prevent HCC

There's no sure way to prevent HCC.

But you can take actions to lower your risk, such as:

  • Getting the hepatitis B vaccine.
  • Limiting the amount of alcohol you drink.
  • Quitting smoking or avoiding tobacco.
  • Treating any liver conditions you may have.

Why choose the Center for Liver Diseases for HCC care?

Our doctors at the UPMC Center for Liver Diseases are experts in diagnosing and treating all liver conditions, including HCC.

And we work closely with experts in the UPMC Liver Cancer Center and the Liver Transplant Program to design customized treatment plans.

Hepatocellular Carcinoma (HCC) Symptoms and Diagnosis

Some people with HCC don't have any symptoms, especially when the disease first starts.

Sometimes, people notice a lump or feel pain on the right side of their body.

Other HCC symptoms include:

  • Bruising.
  • Swelling or pain in the stomach.
  • Jaundice (a yellow color of the skin and eyes).
  • Lack of appetite.
  • Dark urine.
  • Light, or clay-colored, stools.
  • Unexplained weight loss.

Diagnosing HCC

Doctors diagnose HCC in a few ways.

Along with a physical exam, other diagnostic techniques include:

  • Blood tests: To measure levels of alpha-fetoprotein (AFP), a substance in the blood. Higher levels of AFP may be a sign of liver cancer. Doctors also use blood draws to test your liver function.
  • Imaging: CT scans, MRI scans, and ultrasounds to look for signs of liver damage or enlargement.

Experts don't always require liver biopsy to confirm HCC. With a liver biopsy, doctors remove a small piece of liver tissue and study it under a microscope.

After diagnosing HCC, doctors stage the disease. Staging helps them make treatment decisions based on how advanced the cancer is.

In staging HCC, experts look at:

  • The location and size of tumors in the liver.
  • Whether cancer is only in the liver or has spread to other places in the body.
  • If cancer has spread to lymph nodes near the liver.

Doctors also take into account the overall condition of your liver when making treatment plans.

Hepatocellular Carcinoma (HCC) Treatment

Experts at the Center for Liver Diseases use different treatment options to tailor care to your needs.

Lifestyle changes to treat HCC

Doctors might suggest making certain lifestyle changes to support your liver's overall health, such as:

  • Avoiding alcohol.
  • Being more active.
  • Eating a healthy diet.
  • Quitting smoking.

Medical treatments for HCC

Medicine and other medical therapies to fight HCC include:

  • Chemo: Doctors prescribe sorafenib, lenvatinib, atezolimumab – bevacizumab, or other PD-1 checkpoint inhibitors to treat HCC.
  • Radiofrequency ablation: Doctors use imaging technology -- such as a CT scan or ultrasound -- to guide a thin wire into the tumor. Using this wire, doctors apply heat produced by high-frequency electrical currents to destroy cancerous tissue.
  • Trans-arterial chemoembolization: Surgeons insert a thin tube, or catheter, into an artery in the thigh to deliver chemo directly to the tumor. They then shrink the tumor by adding a special drug, or embolization agent, that blocks blood flow to the tumor.

Surgery to treat HCC

Sometimes, surgeons will operate to remove tumors in treating HCC.

In a partial hepatectomy, surgeons remove the tumor and some of the nearby tissue, leaving the liver's healthy tissue intact.

If cancer has advanced, your liver doctor may talk to you about a transplant. In a liver transplant, surgeons take out the entire diseased liver and replace it with a healthy donor liver.