What is Liver Cancer: Risks, Detection, and Treatment?

Liver cancer often follows long-standing liver disease, including chronic hepatitis B or C and cirrhosis. Learn symptoms, tests, treatment, and prevention.

Cancer

Liver Cancer: Risks, Detection, and Treatment

2025-09-17

Overview

Liver cancer (most often hepatocellular carcinoma, HCC) usually develops after years of liver damage from chronic hepatitis B or C, alcohol-related liver disease, or metabolic disease that leads to cirrhosis. Preventing the underlying liver damage—and catching cancer early—are the biggest levers for better outcomes.

Liver Cancer by the Numbers

4th leading cause of cancer death worldwide (WHO, 2024).
900,000 new cases and 830,000 deaths each year globally.
>80% of cases occur in regions with high hepatitis B or C prevalence (Asia, sub-Saharan Africa).
Up to 90% of hepatocellular carcinoma arises in patients with underlying cirrhosis.
5-year survival: ~18% overall, but >50% if detected early and treated with surgery or transplant.

Key Points

Chronic hepatitis B is a major global cause of liver cancer; vaccination prevents many cases.
Risk rises sharply with cirrhosis, regardless of cause.
Surveillance (ultrasound ± AFP every 6 months) for at-risk people finds tumors earlier.
Early-stage tumors may be cured with surgery, ablation, or transplant.
Advanced disease is managed with embolization and systemic therapies (targeted agents, immunotherapy).

Symptoms & Signs

Many patients have no symptoms early on. Possible signs include:

Right upper abdominal pain or fullness
Unexplained weight loss or fatigue
Jaundice, dark urine, pale stools
Abdominal swelling (ascites)

Causes & Risk Factors

Chronic HBV or HCV infection
Cirrhosis from any cause (alcohol, metabolic, viral)
Heavy alcohol use
Aflatoxin exposure (certain food contaminants)
Family history of liver cancer
Metabolic dysfunction (obesity, type 2 diabetes)

Diagnosis

Imaging: Ultrasound, CT, or MRI to identify and stage lesions.
Blood tests: Alpha-fetoprotein (AFP) and liver function tests.
Biopsy: Sometimes needed when imaging is inconclusive.

Treatment Options

Surgery: Resection for localized tumors with adequate liver reserve.
Liver transplant: For eligible patients within transplant criteria.
Local therapies: Ablation (radiofrequency, microwave) or transarterial embolization/chemoembolization (TACE).
Systemic therapy: Targeted agents and immunotherapy for advanced disease.
Supportive care: Symptom control, nutrition, and management of liver failure complications.

Treatment depends on tumor stage, liver function (e.g., Child-Pugh), performance status, and transplant eligibility.

Prevention & Surveillance

Vaccinate against hepatitis B.
Treat chronic HBV/HCV to reduce progression to cirrhosis and cancer.
Reduce alcohol and manage metabolic risks (weight, diabetes).
Surveil high-risk groups every 6 months with ultrasound ± AFP.

Prognosis

Outcomes vary widely by stage at diagnosis and underlying liver function. Early detection via surveillance offers the best chance of curative treatment.

FAQ

Q: What causes most liver cancers?
A: Most primary liver cancers develop on a background of chronic hepatitis B or C and cirrhosis.

Q: How is it detected?
A: Imaging tests (ultrasound, CT, MRI) plus AFP blood tests; at-risk people should have 6-monthly surveillance.

Q: Is liver cancer curable?
A: Early-stage liver cancer can be cured with surgery, transplant, or ablation. Advanced stages are treated with embolization or systemic therapy.

Q: How can I reduce my risk?
A: Vaccinate against hepatitis B, treat HBV/HCV, avoid heavy alcohol, maintain healthy weight, and manage diabetes.