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Liver Cancer

Liver cancer begins when abnormal cells in the liver grow and divide in an uncontrolled way. Because every patient’s situation is unique, our team at Illinois CancerCare focuses on timely diagnosis, accurate staging, and personalized treatment plans designed to give you the best possible outcome. In adults, the most common primary liver cancer is hepatocellular carcinoma (HCC); intrahepatic cholangiocarcinoma (bile duct cancer inside the liver) is the next most common. Cancers that spread to the liver from other organs are called metastatic (secondary) liver cancers and are treated based on where they started.  

Understanding the Liver  

Your liver sits in the upper right abdomen and performs critical tasks—filtering the blood, making bile to digest fats, and storing energy (glycogen). Because it’s essential for so many functions, a precise diagnosis and treatment plan are important to protect liver health while treating the cancer.  

Types of Liver Cancer

Hepatocellular carcinoma (HCC)

Arises from hepatocytes (the main liver cells) and is the most common primary liver cancer in adults. 

Intrahepatic cholangiocarcinoma (iCCA)

Starts in bile duct cells within the liver. (Bile duct cancers outside the liver are considered extra hepatic and are staged/treated separately.)  

Rare types

Angiosarcoma/hemangiosarcoma and others—these are uncommon and managed differently.  

Signs & Symptoms

Early liver cancer may cause no symptoms. As it grows, possible symptoms can include: 

  • Right upper abdominal pain or swelling
  • loss of appetite
  • unintended weight loss
  • nausea/vomiting
  • fatigue/weakness
  • jaundice (yellow eyes/skin)  

Many of these can be caused by non-cancer liver conditions. If you’re at higher risk (see below), ask your clinician about regular surveillance.  

Risk Factors

  • Chronic hepatitis B (HBV) and/or hepatitis C (HCV) infection  
  • Cirrhosis (from HBV/HCV, alcohol related liver disease, or other causes)  
  • Nonalcoholic steatohepatitis (NASH) / fatty liver disease (often linked to obesity, diabetes)  
  • Heavy alcohol use and tobacco use  
  • Aflatoxin exposure (certain mold contaminated foods; more common in parts of Africa/Asia)  
  • Inherited/rare disorders (e.g., hereditary hemochromatosis, alpha1 antitrypsin deficiency, Wilson disease, porphyria cutanea tarda, glycogen storage diseases)  

Good to know: HBV vaccination prevents new HBV infections and is part of global liver-cancer prevention strategies; effective antiviral treatments for HBV/HCV also reduce risk.  

Screening & Surveillance

There is no one-size-fits-all screening test for everyone. However, for people at high risk (e.g., chronic HBV, cirrhosis from any cause), regular ultrasound based surveillance about every 6 months—often with blood tests such as AFP—is recommended to find cancers earlier, when potentially curative options are most effective. Your clinician will personalize your plan.  

Diagnosis

If imaging or symptoms raise concern for liver cancer, your care team may use: 

Multi-phase CT or MRI to identify typical HCC patterns (some HCCs can be diagnosed by imaging without biopsy in the appropriate clinical setting). 

Liver function tests; AFP (alpha-fetoprotein) and other markers in selected cases.  

Sometimes needed—especially for atypical imaging findings or suspected cholangiocarcinoma—after weighing risks/benefits.

Staging & Treatment Planning 

Several systems exist to guide treatment. A commonly used approach is the Barcelona Clinic Liver Cancer (BCLC) system, which considers tumor burden, liver function, performance status, and symptoms to categorize disease from very early/early to intermediate, advanced, and end-stage. Your team uses this together with surgical/transplant criteria to plan care.  

Treatment Options 

Your plan is individualized based on cancer extent, liver function, overall health, and your goals. Care is coordinated by a multidisciplinary team (medical oncology, hepatobiliary surgery/transplant, interventional radiology, radiation oncology, hepatology). 

Potentially curative options (select patients)

  • Surgery (partial hepatectomy): removal of the tumor bearing portion of liver; remaining liver can regenerate.  
  • Liver transplant: for disease confined to the liver that meets transplant criteria; may offer cure when resection isn’t feasible. Bridge therapies can control disease while awaiting a donor.  
  • Ablation (e.g., radio frequency/microwave, ethanol injection, cryoablation): destroys small tumors, often used when surgery isn’t an option.  

Liver directed therapies (for unresectable, liver-confined disease)

  • Embolization (e.g., bland embolization, TACE, or radiation-based embolization in select settings) to block a tumor’s blood supply and control growth.  
  • External beam radiation (including SBRT) in carefully selected cases, or as part of a multi-modal plan.  

Systemic therapy (locally advanced/metastatic or recurrent disease)

Targeted therapies and immunotherapies are standard options depending on tumor type and patient factors; your oncologist will discuss the most appropriate, up to date regimens and combinations for your situation. Clinical trials may provide access to newer approaches.  

Your Illinois CancerCare physician will review benefits and potential side effects of each option and whether a clinical trial is right for you.  

Prognosis

Outcomes depend on tumor stage, liver function (e.g., presence of cirrhosis), overall health, and response to therapy. When found early and treated with resection, ablation, or transplant, some patients achieve long-term remission; for more advanced disease, liver directed and systemic therapies can help control cancer and improve survival. Your doctor will explain what your specific features mean.  

Follow-Up & Survivorship 

Follow-up typically includes: 

  • Regular visits with labs and interval imaging to monitor for recurrence or new lesions 
  • Managing liver health (hepatitis treatment, alcohol cessation, metabolic risk factors) 
  • Vaccinations and prevention counseling; nutrition support; referral to transplant/hepatology as needed 

Illinois CancerCare builds a personalized survivorship plan and coordinates supportive services—nutrition, counseling, financial navigation, and community resources.  

Why Choose Illinois CancerCare

  • Experienced multidisciplinary team with access to advanced diagnostics, liver-directed therapies, and systemic treatments 
  • Clinical trials close to home that may offer cutting edge options 
  • Compassionate, patient-centered care focused on your goals and quality of life  

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).