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Liver cancer (hepatocellular carcinoma)

Carcinoma hepatocellulare · Rakovina jater (hepatocelulární karcinom)

What it is

Nearly always on top of cirrhosis or chronic hepatitis.

Symptoms & signs

  • Right upper pain
  • weight loss
  • worsening jaundice
  • ascites
  • hard liver edge

🚩 Get help if…

  • call 112 / 911 now Sudden severe belly pain with fainting (tumour bleeding)
  • call 112 / 911 now Vomiting blood or confusion
  • see a doctor soon Yellow skin or eyes or a swelling belly
  • see a doctor soon Weight loss or pain under the right ribs with cirrhosis

Where it strikes

Medical treatment

  • Resection or transplant if early
  • ablation
  • TACE
  • atezolizumab + bevacizumab
  • lenvatinib
  • 6-monthly ultrasound surveillance in cirrhosis
  • histotripsy (non-invasive ultrasound destruction) — FDA-authorised 2023 for liver tumours
  • TARE with Y-90 (TheraSphere) — FDA-approved 2021

Natural & lifestyle

  • Alcohol abstinence
  • hepatitis B vaccination and antiviral therapy
  • coffee
  • weight control

Emerging & experimental

  • Neoadjuvant immunotherapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Coffee — observational data link it to lower risk early / small studies
  • Metformin in diabetics — observational data link it to lower risk early / small studies
  • Milk thistle — no evidence against cancer anecdotal / traditional

ICD codes