Hepatocellular Carcinoma: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hepatocellular Carcinoma?
A hepatologist, a liver doctor, and an oncologist, a cancer doctor, usually work together on care. A surgeon and a liver transplant team may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hepatocellular carcinoma?
Hepatocellular carcinoma is cancer that starts in the liver. It is the most common type of liver cancer. Most liver cancers in adults are hepatocellular carcinomas.
It is not the same as metastatic liver cancer. Metastatic liver cancer starts in another organ, such as the breast or colon, and spreads to the liver.
Symptoms
Symptoms of liver cancer may include any of the following:
- Abdominal pain or tenderness, especially in the upper right part.
- Easy bruising or bleeding.
- An enlarged abdomen from fluid in the abdomen, called ascites.
- Yellow skin or eyes, called jaundice.
- Weight loss for no known reason.
- Loss of appetite, or feeling full after a small meal.
- Unusual tiredness or weakness.
Other conditions can cause these signs too.
Causes and who gets it
In most cases, the cause is long-term damage and scarring of the liver. This is called cirrhosis. Cirrhosis may be caused by:
- Drinking too much alcohol.
- Autoimmune diseases of the liver.
- Infection with the hepatitis B or hepatitis C virus.
- Iron overload in the liver and body, called hemochromatosis.
- MASH, a liver disease linked to obesity and diabetes.
People with hepatitis B or C are at high risk for liver cancer, even if they do not develop cirrhosis. It occurs more often in men than women. It is most often diagnosed in people age 50 or older.
How doctors diagnose it
Your provider will do a physical exam and ask about your symptoms. The exam may show an enlarged, tender liver or other signs of cirrhosis. Tests may then include:
- An abdominal CT scan, MRI scan, or ultrasound.
- A liver biopsy.
- Liver function tests.
- A blood test for serum alpha fetoprotein.
Some people at risk for liver cancer may get regular blood tests and ultrasounds to see if tumors are developing.
Treatment
Treatment depends on how advanced the cancer is. Options include:
- Surgery to remove the part of the liver where cancer is found, called a partial hepatectomy. The rest of the liver takes over and may regrow.
- A liver transplant, which replaces the whole liver with a healthy donated liver. It may be done when the disease is only in the liver and a donor liver can be found.
- Ablation, which destroys tissue with radio waves, microwaves, alcohol, or extreme cold.
- Embolization, which blocks or lowers blood flow to the tumor. It is for people who cannot have surgery or ablation and whose tumor has not spread outside the liver.
- Radiation therapy, which aims high-energy x-rays at the cancer.
If the cancer can't be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment then focuses on improving and extending life. It may use targeted therapy medicines that can be taken as pills. Newer immunotherapy medicines are also used. They are now the most common treatments for advanced liver cancer.
When to see a doctor
Contact your provider if you have ongoing abdominal pain, especially if you have a history of liver disease. Check with your doctor about yellow skin or eyes, easy bruising or bleeding, or a swollen abdomen.
Call 911 or go to the emergency room for any of these. Bleeding that will not stop. Coughing up or vomiting blood. Severe abdominal pain or pressure. Fainting. A sudden change in mental status.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can check symptoms, order first blood tests, and follow people with liver disease. They can also refer you to a specialist and help coordinate care.
Common questions
Is hepatocellular carcinoma the same as liver cancer?
It is the most common type of liver cancer, but it is not the only type. Bile duct cancer, called cholangiocarcinoma, is the other main type of adult primary liver cancer.
Can liver cancer be prevented?
Some steps may lower the risk. They include preventing and treating viral hepatitis, not drinking too much alcohol, and controlling obesity and diabetes. Childhood vaccination against hepatitis B may reduce the risk for liver cancer in the future.
Can liver cancer be cured?
It depends on how advanced the cancer is. If it can't be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment then focuses on improving and extending life.
Sources
- MedlinePlus - Liver cancer - hepatocellular carcinoma
- National Cancer Institute - What Is Liver Cancer?
- National Cancer Institute - Liver Cancer Treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
