Primary Liver Cancer (hepatocellular carcinoma)
Primary liver cancer usually develops in people with chronic liver disease or cirrhosis. It may cause no symptoms in early stages and is often detected through surveillance imaging. Early diagnosis significantly improves treatment options and outcomes.
Read more about primary liver cancer, risk factors, surveillance, and treatment options.
What is primary liver cancer (hepatocellular carcinoma)?
Primary liver cancer (hepatocellular carcinoma HCC) is a cancer that originates in the liver itself. It most commonly develops in people with long-standing liver disease or cirrhosis, regardless of the original cause of liver injury. Common risk factors include fatty liver disease, chronic hepatitis B or C infection , and alcohol-related liver disease. In people living with hepatitis B liver cancer can develop in the absence of cirrhosis.
Primary liver cancer is different from secondary (metastatic) liver cancer, which refers to cancer that has spread to the liver from another organ.
Why does liver cancer often develop silently?
In its early stages, primary liver cancer usually causes no symptoms. Many cases are detected through routine surveillance imaging in people known to be at increased risk. This is why regular monitoring is important in individuals with cirrhosis or chronic liver disease.
When symptoms do occur, they may include weight loss, reduced appetite, abdominal discomfort, fatigue, or jaundice (yellowish eyes or skin), but these often appear later in the disease.
How is primary liver cancer diagnosed?
Diagnosis typically involves:
- Imaging studies such as ultrasound, CT, or MRI scans
- Blood tests, including tumour markers in some cases
- Assessment of liver function and overall health
- In some patient confirmation with biopsy is required
How is primary liver cancer treated?
Treatment depends on several factors, including tumour size and number, liver function, and overall health. Options may include:
- At an early stage, liver cancer:
- Can be surgically removed
- Tumour tissue destroyed with radiofrequency ablation (RFA)
- At more advanced stages treatment comprises:
- Localised treatments blocking the blood supply to the tumour (transarterial embolisation or TAE)
- Systemic therapies for advanced disease
- Liver transplantation in selected cases
Management is individualised and coordinated through specialist liver and cancer teams.
Why early detection matters
When primary liver cancer is detected early, a wider range of treatment options is available, including curative options, and outcomes are significantly improved. Regular surveillance in at-risk individuals plays a crucial role in early diagnosis.
Ongoing care and follow-up
Even after treatment, ongoing follow-up is essential to monitor liver health and detect recurrence or new disease early. Specialist care ensures treatment decisions are appropriate and coordinated over time.