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Hepatocellular Carcinoma


What Is Hepatocellular Carcinoma?

Hepatocellular carcinoma (HCC) is a type of liver cancer. It causes a tumor to grow in the liver

Hepatocellular carcinoma may spread (metastasize) to other parts of the body, usually to the lungs and to nodes in the belly.

What Are the Signs & Symptoms of Hepatocellular Carcinoma?

Hepatocellular (hep-uh-toe-SEL-yuh-ler) carcinoma usually affects adults. 

A child who has it might have these symptoms:

  • a large belly that sticks out
  • belly pain, most often on the right side
  • belly mass (something solid in the belly that can be felt through the skin)
  • jaundice (yellow skin or eyes)
  • back pain
  • a fever
  • itching
  • loss of appetite
  • weight loss
  • nausea and vomiting 
  • anemia (low red blood cell count)

What Causes Hepatocellular Carcinoma?

Doctors don't know the exact cause of hepatocellular carcinoma. Children who have viral infections or other conditions that cause liver inflammation (swelling and irritation) and cirrhosis (scarring of the liver) get HCC more often than other children. But only a few who have these conditions get hepatocellular carcinoma.

Who Gets Hepatocellular Carcinoma?

Some conditions have a higher chance of leading to hepatocellular carcinoma: 

  • incomplete growth of the parts of the liver 
  • problems with the flow of bile from the liver into the intestine
  • infections like hepatitis B or hepatitis C 
  • liver diseases that cause blocking or scarring (cirrhosis) in the liver
  • use of anabolic (muscle-building) steroids
  • any liver disease causing blockage or cirrhosis (scarring) of the liver

How Is Hepatocellular Carcinoma Diagnosed?

When a child has hepatocellular carcinoma, the doctor will do a physical exam. Tests done may include:

How Is Hepatocellular Carcinoma Treated?

Surgery is the best way to treat hepatocellular carcinoma. Chemotherapy can't get rid of it all. Sometimes chemo is done to shrink a large tumor before surgery.

If possible, children with cancer should go to a medical center specializing in the treatment of pediatric cancers.

A child's treatment depends on:

  • the child's age
  • the size of the tumor
  • whether the cancer has spread from the liver

Treatment may include:

  • surgery to remove the tumor along with some or all of the liver
  • chemotherapy
  • chemoembolization (injecting chemotherapy drugs into the tumor to block its blood vessels)
  • radioembolization (using radiation and embolization to treat the tumor and block the blood supply to the cancer cells)
  • radiofrequency (RFA; using radio waves to shrink the tumor)
  • radiation therapy

The liver is a vital organ. So a child will need a liver transplant if the entire liver is removed to treat the cancer.

HCC is treated by a health care team, including specialists in:

  • oncology (cancer)
  • hematology (blood diseases)
  • surgery
  • gastroenterology (digestive tract) and hepatology (liver)
  • pathology (diagnosing diseases by examining body tissues, fluids and organs)
  • genetics (genetic counseling and testing)
  • radiology (medical imaging)
  • radiation oncology (radiation treatment)
  • interventional radiology (image-guided minimally invasive procedures)
  • behavioral health (psychology and psychiatry)
  • nutrition
  • oncologic nursing (nurses specialized in treating people with cancer)

Looking Ahead

Hepatocellular carcinoma is challenging to treat, even before it spreads beyond the liver. Clinical trials are underway to help find better treatments in children and adults.

The cancer also can return after surgery. After treatment, a child will have frequent checkups with the care team.

If your child is being treated for HCC, you don't have to go it alone. The care team is there to support your child and the whole family. They also can recommend websites, groups, and organization that help families dealing with a cancer diagnosis.

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