Hepatocellular Carcinoma or Liver Cancer


Anatomy and Function of Liver

The liver is the largest internal organ and is in the upper right-hand portion of the abdominal cavity. It approximately weights about 1.35 kgs. There are 2 distinct sources that supply blood to the liver, which are:

  • Oxygenated blood flows in from the hepatic artery
  • Nutrient-rich blood flows in from the hepatic portal vein

The liver is made up mainly of cells called hepatocytes. The liver regulates most chemical levels in the blood and excretes a product called bile. This helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic. [Hopkins Medicine]

Hepatocellular Cancer (HCC)

A cancer that starts in the liver is called primary liver cancer. This type of liver cancer develops from the main liver cells i.e., hepatocytes. Hepatocellular carcinoma (HCC) has become the most common primary hepatic malignancy, with average survival rates between 6 and 20 months and is ranked sixth in the world among all malignancies, contributing to the third leading cause of mortality attributed to cancer. [ncbi,2015]

HCC is more likely to develop in men than in women and becomes more common as you get older. [cancerresearchuk.org]. Patients with advanced fibrosis, predominantly cirrhosis and hepatitis B are predisposed to developing HCC. Individuals with chronic hepatitis B and C infections are most afflicted.

There is more than one kind of primary liver cancer. We can classify several subtypes of HCC.[cancer.org]


Types of Liver Cancer


More commonly known as bile duct cancer, develops in these small, tube-like bile ducts in the liver. It involves approximately 10 to 20 percent of all liver cancers. These ducts carry bile to the gallbladder to help with digestion. When the cancer begins in the section of the ducts inside the liver, it’s called intrahepatic bile duct cancer. When the cancer begins in the section of the ducts outside the liver, it is called extrahepatic bile duct cancer.

Liver Angio carcinoma

Liver angio carcinoma is a rare form of liver cancer that begins in the blood vessels of the liver. This type of cancer tends to progress very quickly, so it is typically diagnosed at a more advanced stage.


Hepatoblastoma is an extremely rare type of liver cancer. It is nearly always found in children, especially those under age 3. With surgery and chemotherapy, the prognosis can be incredibly good. When hepatoblastoma is detected in the early stages, the survival rate is higher than 90 percent.


  • Genetic & Congenital Abnormalities
  • Hepatitis Virus: Risk factors for HCC include chronic HBV (hepatitis B virus) and HCV (hepatitis C virus). Hepatitis B and C infections accounted for most of the morbidity and mortality since it leads to progressive hepatic damage in patients and ultimately causing cirrhosis and hepatocellular carcinoma. These viruses are usually transmitted through transfusion of infected blood, use of contaminated equipment during surgery, and sexual contact. HBV is also transmitted from mother to child during parturition. [ncbi, 2018]
  • Cirrhosis: It is a form of liver damage in which healthy tissue is replaced by scarred tissue. A scarred liver cannot function properly and may ultimately lead to numerous complications, including liver cancer.
  • Exposure to aflatoxin is a risk factor. Aflatoxin is a toxic substance produced by a type of mold that can grow on peanuts, grains, and corn. Diabetes and obesity are also risk factors. People with diabetes tend to be overweight or obese, which can cause liver problems and increase risk for liver cancer. [Healthline, 2020]
  • NASH (Non-alcoholic steatohepatitis): It is a type of non-alcoholic fatty liver diseases (NAFLD- a condition where fat builds up in the liver). NASH is closely related to the triple epidemic of obesity, pre-diabetes, and diabetes. But its symptoms are often silent or non-specific to NASH, making it difficult to diagnose. As a result, NASH patients canremain unaware of their condition until late stages of the disease. [niddk.nih.gov]

Diagnosis [cancer.org]

Tests and procedures used to diagnose liver cancer include:

Blood tests. Blood tests may reveal liver function abnormalities.

Imaging tests – tests include ultrasound, X-rays, CT, and MRI.

Removing a sample of liver tissue for testing or liver biopsy

Alpha-fetoprotein blood (AFP) test

Test for Viral Hepatitis

Liver Function Tests

Complete Blood Count (CBC)

Signs & symptoms

Symptoms may not be experienced in the early stage of HCC. When the symptoms do appear, it may include:

Abdominal discomfort, pain, and tenderness

Yellowing of the skin and the whites of the eyes, which is called jaundice

White, chalky stools

Nausea & vomiting

Bruising or bleeding easily

Weakness and fatigue

Enlarged liver

Enlarged spleen


  • Cancer.org
  • Mayoclinic.Org
  • Healthine.com
  • Gut.bmj.com
  • Ncbi.nlm.nih.gov