Hepatoma (also called hepatocellular carcinoma) is the most common cancer of the liver. It’s a primary tumor, meaning the tumor started growing in the liver and did not spread from someplace else in the body.
In the United States, about 6000 new cases occur each year. Hepatomas are more common in men than women, usually occurring in people 50 to 70 years old. Unfortunately, many hepatomas are found late. Early diagnosis gives the best hope for cure.
Hepatoma occurs most often in people with cirrhosis (liver scarring), chronic hepatitis B, or chronic hepatitis C or after severe liver damage from chronic alcohol abuse. Hepatomas aren’t contagious or passed from parents to children.
One third of people do not have any symptoms. Symptoms may include pain in the abdomen (belly), an abdominal mass, abdominal fluid (ascites), and jaundice (yellow skin color). Later, weakness, loss of appetite, weight loss, and fatigue can occur.
Diagnosis is difficult because hepatomas often don’t have many early symptoms. To help diagnosis, the health care provider may initially do blood tests called alpha-fetoprotein and liver function tests for people with cirrhosis or hepatitis B or C. However, these tests are not diagnostic because not everyone with a hepatoma has abnormal blood tests, so the health care provider may want imaging studies called ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). If these imaging studies show a probable tumor, a liver biopsy will be done. In a biopsy, liver tissue is taken with a needle and looked at with a microscope.
Untreated people have a rapid downhill course. Surgery offers the best chance for cure, but most people cannot have surgery because of cirrhosis or tumor spread. Smaller tumors (less than 5 cm, or about 2 inches) that haven’t spread and with remaining liver working well are less likely to recur after surgery.
People who cannot have surgery may have other treatments, including injecting chemotherapy drugs into the artery that feeds the tumor or injecting ethanol (alcohol) directly into the tumor to destroy it.
People with very large tumors or with too much liver damage may be candidates for liver transplantation. A team of doctors and other health care workers must work together to manage care.
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