Liver cancer develops when abnormal cells grow uncontrollably in the liver, an organ that plays a vital role in digestion, metabolism, and detoxification. The most common type of primary liver cancer is hepatocellular carcinoma (HCC), which arises from liver cells (hepatocytes). Less common types include intrahepatic cholangiocarcinoma and rare tumors such as angiosarcoma.

Liver cancer often develops in the setting of chronic liver disease and is frequently diagnosed at an advanced stage. At OncoClinic, we support you with appropriate diagnostics, clear explanations, and a personalized care plan tailored to your diagnosis, overall health, and goals.

Signs and symptoms

• Abdominal pain or discomfort, especially in the upper right abdomen
• Unintended weight loss
• Loss of appetite
• Fatigue or weakness
• Abdominal swelling due to fluid buildup (ascites)
• Nausea or vomiting
• Other symptoms may include jaundice, dark urine and pale stools, itching, worsening liver function, and easy bruising or bleeding

Persistent or worsening symptoms should be evaluated by a healthcare professional.

Risk factors

• Genetic conditions: Inherited metabolic diseases, such as hemochromatosis
• Infections: Chronic hepatitis B or hepatitis C infection, the most important risk factors worldwide
• Chronic liver disease: Cirrhosis, regardless of cause
• Alcohol consumption: Alcohol-related liver disease
• Fatty liver disease: Nonalcoholic fatty liver disease (NAFLD) and NASH
• Metabolic conditions: Diabetes and obesity
• Environmental exposure: Exposure to aflatoxins (contaminated foods in some regions)
• Tobacco use: Smoking

Most liver cancers develop in patients with underlying chronic liver disease.

Screening

Routine screening is not recommended for people without liver disease.

Common screening methods include:

• Abdominal ultrasound every 6 months
• Blood test for alpha-fetoprotein (AFP) may be used as an adjunct in some settings

Screening recommendation

Liver cancer screening is recommended in high-risk individuals such as:

• Patients with cirrhosis, regardless of cause
• Patients with chronic hepatitis B, even without cirrhosis (depending on age and risk factors)
• Selected patients with advanced chronic liver disease

Diagnosis

Liver cancer may be diagnosed through surveillance imaging or after symptoms prompt evaluation.

Diagnostic evaluation typically includes:

• Imaging studies, such as contrast-enhanced CT scan or MRI of the liver
• Blood tests, including liver function tests and AFP
• In many cases, imaging findings are sufficient to diagnose HCC without biopsy
• Biopsy may be performed when imaging is inconclusive or for non-HCC tumors

Assessment of underlying liver function is a critical part of diagnosis.

Staging

Staging of liver cancer considers both tumor extent and liver function.

Evaluation may include:

• CT or MRI of the liver and chest
• Assessment of liver function (Child-Pugh score)
• Liver cancer is commonly staged using systems such as BCLC (Barcelona Clinic Liver Cancer), which classifies disease into early, intermediate, advanced, and terminal stages

Liver cancer staging

Staging describes how large the tumor is, how far the cancer has spread, and helps guide treatment selection:

• Stage I: Single tumor confined to the liver
• Stage II: Cancer limited to the liver, with more than one tumor or invasion of nearby blood vessels
• Stage III: More advanced cancer involving major blood vessels or nearby organs, without distant
• Stage IV: Cancer that has spread to lymph nodes and/or distant organs such as the lungs or bones

Treatment and procedures

At OncoClinic, liver cancer care is delivered through a multidisciplinary, patient-centered approach, integrating hepatology, oncology, surgery, and interventional radiology.

Surgery: Surgical removal of part of the liver may be an option for selected patients with early-stage disease and preserved liver function. When surgery is indicated, procedures are performed at our accredited partner hospitals under the direct coordination and supervision of our medical team, ensuring continuity and quality of care.

Liver transplantation: In selected patients with early-stage liver cancer and advanced liver disease, liver transplantation may offer the best chance for cure.

Locoregional therapies:

• Radiofrequency or microwave ablation
• Transarterial chemoembolization (TACE)
• Radioembolization

Systemic therapy: Systemic treatments include targeted therapy and immunotherapy and are used for advanced or unresectable disease.

Combined treatment strategies: Many patients benefit from a combination of locoregional and systemic therapies.

Palliative and supportive care: Supportive care focuses on symptom control, management of liver disease complications, nutritional support, and quality of life at all stages.

References

Liver cancer overview
American Cancer Society, 2026

Liver cancer – patient version
National Cancer Institute (NCI), 2026

NCCN clinical practice guidelines in oncology: hepatobiliary cancers
National Comprehensive Cancer Network (NCCN), latest version

Clinical practice guidelines: management of hepatocellular carcinoma
European Association for the Study of the Liver (EASL), 2018

Hepatocellular carcinoma
Llovet JM et al. – Nature Reviews Disease Primers, 2021