Hepatocellular Carcinoma: Signs and Symptoms, Diagnostic tools, and Treatment Options

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According to the American Cancer Society, in 2010, there have been 24,120 new cases and almost 20,000 new deaths due to liver cancer. Although this type of cancer is relatively minor or uncommon in the United States, incidences are rising because of the spread of the hepatitis C infection within the population. Hepatocellular carcinoma should be distinguished from other types of tumors that develop in the liver due to metastasis of other types of cancer. A hepatocellular carcinoma is a tumor that originates in the liver and not as the consequence of cancer spreading.

Signs and Symptoms of Hepatocellular Carcinoma

The following represent signs and symptoms of this type of carcinoma, according to the National Institute of Cancer:

  • A hard lump on the right side just below the rib cage.
  • Discomfort in the upper abdomen on the right side.
  • Pain around the right shoulder blade.
  • Unexplained weight loss.
  • Jaundice (yellowing of the skin and whites of the eyes).
  • Unusual tiredness.
  • Nausea.
  • Loss of appetite.

A doctor may order a variety of blood or other tests to accurately diagnose the presence of hepatocellular carcinoma in a suspected patient.

Diagnostic Methods for Hepatocellular Carcinoma

Since a hard lump is one of the characteristics of this type of liver cancer, a doctor may palpate the patient for the presence of lumps on the liver as a first sign of liver cancer. This is just exploratory and is easily done in the doctors office. Afterward a battery of blood tests will be ordered including: complete blood count (red blood cells, white blood cells, platelets, and amount of hemoglobin) and tests for hepatitis B and C. Also, a specific tumor marker is ordered (alpha-fetoprotein-AFP) which may indicate presence of liver cancer (although other cancers, cirrhosis, and hepatitis may also affect AFP blood level).

Laparoscopy (surgical procedure to look at the organs inside the abdomen), CT scans (computer x-ray for abdominal pictures), and/or MRI (magnetic resonance imaging) will be performed to confirm diagnosis.

Treatment of Hepatocellular Carcinoma

There are four standard treatments for hepatocellular carcinoma:

Surgery: This is the primary tool for treatment. Basically it is the removal of the part of the liver where the tumor is found. This treatment works well when the tumor is small. However, complete liver removal and transplant is also possible as a treatment procedure for liver cancer.

Radiation therapy: This refers to the use of radiation to kill cancer cells. It can be done from the outside with a potent X-ray machine or by making a small incision and radiating the affected zone of the liver with a small probe.

Chemotherapy: This refers to the use of chemical drugs to kill the liver tumor cells or to prevent the growth of the tumor. Recently, Sorafenib tosylate has been approved for hepatocellular carcinoma. Sorafenib tosylate is taken orally.

Percutaneous ethanol injection: This refers to a procedure in which a small needle is employed to inject ethanol directly into a tumor to kill cancer cells.


National Cancer Institute: https://www.cancer.gov/cancertopics/pdq/treatment/adult-primary-liver/Patient

American Cancer Society.: Cancer Facts and Figures 2010. Atlanta, Ga: American Cancer Society, 2010. Available online. Last accessed August 26, 2010. https://www.cancer.org/acs/groups/content/@nho/documents/document/acspc-024113.pdf