Hepatocellular carcinoma is a type of liver cancer. Certain health conditions like cirrhosis, chronic viral hepatitis, or type 2 diabetes can increase your risk of developing this cancer.

Liver cancer is cancer that starts in the liver. The American Cancer Society (ACS) estimated 41,260 new diagnoses and 30,520 deaths from liver cancer in 2022.

There are different types of liver cancer. However, hepatocellular carcinoma is the most common.

In this article, we delve deeper into hepatocellular carcinoma. We look into the symptoms, how it’s diagnosed and treated, risk factors, and the outlook for people with this type of cancer.

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Researchers estimate that it makes up about 90% of all liver cancers.

Generally speaking, there are two different growth patterns of HCC. These are classified by how many tumors are present.

  • Growth pattern 1: In the first growth pattern, there’s only one tumor that continues to grow larger. In more advanced stages, this cancer may spread to other parts of the liver.
  • Growth pattern 2: The second growth pattern is more common. In this one, there are many small areas of cancer peppered throughout the liver. This is the growth pattern that tends to happen in people that have cirrhosis (severe scarring of the liver).

The potential symptoms of HCC can include:

Other potential signs of HCC may be:

See a doctor if you have symptoms consistent with HCC. Many of these symptoms are similar to those of other conditions affecting the liver, so they may not be due to HCC. Instead, they may be symptoms of another liver condition that also needs treatment.

Like other cancers, HCC happens when liver cells start to grow and divide uncontrollably. When this happens, cancer cells can further invade liver tissue and may eventually spread (metastasize) to other parts of the body.

Cancer cells behave as they do because of changes in their DNA. These can be inherited from your parents or acquired due to naturally occurring irregularities during cell division or exposure to other risk factors.

Risk factors are things that increase your risk of developing HCC. The known risk factors for HCC are:

Having risk factors for HCC doesn’t mean that you’ll definitely get it. It means that you’re at an increased risk compared with people without risk factors.

That said, if you do have one or more HCC risk factors, consider talking with your doctor about beginning surveillance for HCC. Surveillance can involve a liver ultrasound with or without a serum alpha-fetoprotein blood test every 6 months.

There are several tests that are involved in the diagnosis and staging of HCC. These are:

Staging of HCC

There are several staging systems for HCC. Generally speaking, staging of HCC takes the following factors into account:

  • the size of the tumor(s)
  • whether more than one tumor is present
  • if the cancer has spread to nearby tissues or lymph nodes
  • if the cancer has spread to more distant tissues, such as the bones or lungs
  • how well your liver is functioning
  • your overall health

Treatment options for HCC typically depend upon:

  • the stage of your HCC
  • how well your liver is functioning
  • your overall health

If your HCC is still in an early stage and your liver is functioning well, surgery may be recommended. A liver transplant is another potential treatment option if your HCC is in an early stage.

If surgery or a liver transplant aren’t recommended treatment options for your HCC, other treatment types may be used. These are:

  • ablation, which uses heat to destroy cancer cells
  • chemoembolization, which blocks blood flow to the cancer and also delivers chemotherapy to the area
  • targeted therapy, which uses drugs that specifically target certain aspects of HCC cells
  • immunotherapy, which works to help your immune system respond to HCC
  • chemotherapy, which uses drugs that disrupt the growth and division of cancer cells
  • radiation therapy, which uses high energy radiation to kill cancer cells

The outlook for HCC depends on many factors, such as:

  • the stage of your HCC
  • whether there’s one tumor or several tumors
  • how well your liver is functioning
  • the type of treatment(s) used
  • how the HCC responds to treatment
  • whether you’re being treated for an HCC recurrence
  • your age and overall health

5-year survival rates

The National Cancer Institute’s SEER database estimates 5-year survival for different types of cancer. This is the percentage of people that are alive 5 years after their diagnosis.

The 5-year survival rates for liver cancer are:

Stage of cancer5-year survival rate
If liver cancer remains localized to the liver36.1%
If liver cancer spreads to nearby tissues or lymph nodes12.8%
If liver cancer has spread to more distant tissues3.1%
Overall (combined)20.8%

These statistics don’t account for individual factors or recent advances in HCC diagnosis and treatment. While HCC can still be challenging to treat, a 2021 study noted that the outlook for HCC improved significantly from 1988 to 2015.

HCC is the most common type of liver cancer. It’s more likely to happen in people that have risk factors, many of which are associated with liver damage such as cirrhosis, chronic viral hepatitis, or NASH.

The outlook for HCC is generally poorer than many other cancers. However, early diagnosis and treatment can help to improve outlook.

Because of this, be sure to see your doctor for symptoms like abdominal pain, jaundice, or pale stools. While these symptoms may not be due to HCC, they may be signaling another liver condition that needs attention.