What is Hepatocellular Carcinoma?
Hepatocellular Carcinoma (HCC) is the fourth most common cancer in the world, and the second most common cause of cancer deaths worldwide. It is also known as hepatoma, primary liver cell carcinoma or primary liver cancer. HCC is cancer that arises from hepatocytes, the major cell type of the liver.
What causes HCC?
The most common risk factors for HCC are hepatitis B, hepatitis C, cirrhosis, nonalcoholic fatty liver disease or exposure to aflatoxins.
What are the symptoms of HCC?
Symptoms include abdominal pain or tenderness (particularly in the right-upper part of the abdomen), an enlarged abdomen, right shoulder pain, bloating, decreased appetite, nausea, unexplained weight loss and unexplained fevers. Jaundice and swelling of the abdomen/legs can occur in more advanced liver cancer. Many patients with HCC do not develop symptoms until the advanced stages of the disease.
How is HCC diagnosed?
+A physical examination may show an enlarged, tender liver.
+Imaging tests such as ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI) may reveal a mass in the liver.
+Blood tests of liver enzymes or function may show abnormal variations, or tumor markers such as serum alpha-fetoprotein (AFP) may be elevated.
+A liver biopsy may reveal cancer after a tissue sample is removed during surgery and examined under a microscope by a pathologist.
What are the stages of HCC?*
Very Early Stage (0)
Single tumor less than 2 cm with preserved liver function
Early Stage (A)
Single tumor less than 5 cm that does not invade blood vessels or up to 3 tumors, all being less than 3 cm.
Intermediate Stage (B)
Multiple tumors that do not invade blood vessels or extend outside of the liver with preserved liver function.
Advanced Stage (C)
Tumor(s) that invade the blood vessels or a nearby organ (other than the gallbladder) with or without preserved liver function.
Terminal Stage (D)
The cancer has spread to other parts of the body (e.g., lungs, bones). Tumors can be any size or number, and nearby lymph nodes may or may not be involved. Liver function is compromised.
*While there are multiple staging systems for HCC, the one most commonly used is the Barcelona Clinic Liver Cancer (BCLC) staging and treatment system outlined here.
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