A Look at Hepatocellular Carcinoma

hepatocellular-carcinoma-doctor-patient-speaking-baltimore-md-1Liver cancer that originates in the liver, also referred to as hepatocellular carcinoma, is responsible for more than 12,000 deaths per year in the United States and those numbers continue to rise.

Unfortunately, there is not a lot of expertise when it comes to primary liver cancer.  That, paired with the often late detection of large tumors, make this disease very dangerous for a person diagnosed with liver cancer.  And although Baltimore has some of the leading hepatocellular carcinoma treatment facilities in the country, including The Liver and Pancreas Center, and some of the top physicians in the country, such as Dr. Mark Fraiman, the people of Maryland are not immune to possibility of getting this fatal disease.

With the hepatocellular cancer survival rate being so low, it is important to share knowledge about this deadly disease with the hopes that earlier diagnoses and higher survival rates can become the norm.

That being said, let’s take a look at the causes, symptoms, diagnosis, and treatment of hepatocellular carcinoma.


What is Hepatocellular Carcinoma?

Hepatocellular carcinoma is cancer that originates in the liver and is a result of normal cells that have become abnormal and have grown out of control into malignant tumors.  This cancer type differs from ‘secondary’ liver cancers, which are cancers that originated in other organs and spread to the liver.

Most often occurring in adults, hepatocellular carcinoma is the most common liver cancer in the United States.  It is seen most often in those with chronic liver damage, though there are several other suggested causes for the disease presenting itself.


Causes of Hepatocellular Carcinoma

Though doctors are not entirely sure what causes hepatocellular carcinoma, they have identified some common trends amongst those diagnosed:


Cirrhosis of the Liver

This is the most common suggested cause for liver cancer.


Approximately 80% of those diagnosed with hepatocellular carcinoma have experienced some sort of chronic liver damage that has resulted in scar tissue development.


Hepatitis B or C

Since these diseases can chronically damage your liver, it is not uncommon to see a diagnosis of liver cancer some years after contracting Hepatitis B or C.


Heavy Alcohol Use

Again causing significant damage to your liver over time, those drinking two alcoholic drinks or more a day increase their risk of hepatocellular cancer.  The more you drink, the higher the risk.


Obesity and Diabetes

Both conditions increase your risk of getting liver cancer.  Obesity has been known to cause fatty liver disease, among other diseases, which can cause normal cells to turn abnormal and potentially become cancerous.  Insulin use to treat diabetes can cause damage to the liver over long periods of time and heighten the chances of abnormal (and cancerous) cells forming.



When too much iron is stored in the liver and surrounding organs, irreparable damage can be caused leading to liver cancer.



Peanuts, corn, and other nuts and grains have been known to harbor a specific type of mold called aflatoxin.  This harmful substance, though controlled by the United States FDA, can still be consumed in small amounts and has been attributed to hepatocellular carcinoma.


Symptoms of Liver Cancer

Sometimes, unless a large tumor can be seen from the outside of you abdominal or you experience extreme pain, those with hepatocellular have no symptoms alerting them to a possible health issue that should be checked out by their physician.

However, those who do experience symptoms related to liver cancer often complain of the following:

  • Pain in the upper right part of the abdomen
  • A lump or feeling of heaviness in the upper abdomen
  • Nausea and vomiting
  • Yellow skin and eyes
  • Pale, chalky bowel movements and dark urine
  • Unexplained weight loss
  • Weakness or excessive fatigue
  • Bloating or swelling of the abdomen
  • Fever


Diagnosis of Liver Cancer

If you or your Baltimore physician feels you may be at risk for hepatocellular carcinoma, there are several tests that can be performed before an official liver cancer diagnosis is decided.


  • Blood Test. If a simple blood test reveals a protein called AFP, you may have liver cancer.  Found only in unborn babies (after which disappears once born) and those with liver cancer, AFP is a warning sign to conduct more thorough cancer screening tests.
  • Imaging Tests. Ultrasounds, CT scans, and MRIs are all used to look deep within the abdominal cavity, behind your rib cage, and into your liver for the presence of tumors.
  • Liver Biopsy. Your Baltimore physician may decide take a small sample of liver tissue and have it tested for cancerous cells.


Hepatocellular Carcinoma Treatment

Just as with any type of cancer, there are different treatment options that can be individualized for your specific treatment needs.  Discussing your options with a physician who specializes in liver cancer treatment is going to produce the best possible outcome for you.



Chemotherapy is when anti-cancer drugs used to destroy cancer cells are injected directly into your veins or are given orally.  This option is especially useful for treating cancers that may have spread to other parts of the body since the medicine enters your bloodstream and reaches all areas of your body.  Unfortunately, liver cancer resists most chemotherapy drugs and different combinations are often necessary to overcome this resistance.


Radiation Therapy

This treatment option uses high-energy rays to kill cancer cells.  There are two types of radiation therapy that can be used for treating liver cancer.

The first is external radiation therapy by which radiation beams are delivered to you from the outside using large machines aimed at the area on your body where cancer exists.

The second radiation therapy type is internal, whereby your physician will inject small radioactive particles into your bloodstream that can reach your liver and either destroy or block your tumor’s blood supply therefore killing it.


Alcohol Injections

Also called a percutaneous ethanol injection, this treatment option kills cancer cells by delivering ethanol (alcohol) directly into your liver via a needle guided by ultrasound waves that outline your internal organs.


Cryoblation and Radiofrequency Ablation

Cryoblation is performed by your physician using a thin, metal probe that is frozen.  Once placed directly inside the tumor, a cold gas is blasted onto the tumor in hopes of freezing it.

With radiofrequency ablation the same method is used however instead of cold gas, a hot electric current is applied to the tumor in hopes of killing it.



A liver specialist may decide to remove the part of your liver that has cancer.  Called a partial hepatectomy, this option can only be used on cancers that have not spread to blood vessels.  Unfortunately, most liver cancers cannot be fully removed using this procedure and can affect the prognosis of the patient.

Another option is a liver transplant whereby your entire liver is removed and is replaced by a healthy one.  Though this option comes with hopeful results, the problem is there are limited liver organs available and most are used for patients with liver diseases other than liver cancer.


Final Thoughts

In the end, hepatocellular carcinoma is a serious disease with a poor outcome for many patients.  The key to fighting this terrible disease is prevention and early detection.

Physicians like Dr. Fraiman are dedicated to patients at all stages of liver cancer.  Individualizing treatment options to gain the most favorable outcome is what Dr. Fraiman and his team of specialists strive for daily.

With over 20 years of experience dealing with liver diseases of all kind, you can trust that Dr. Fraiman is fully committed to helping diagnose liver cancer patients early and get them as healthy as possible in the shortest amount of time.

If you are in the Baltimore area and are looking for a reputable liver cancer treatment center, consider The Liver and Pancreas Center.  Don’t wait too long.  Get the help you need now so that you can enjoy your life later.


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