Get Treatment For Hepatocellular Carcinoma

Great Surgical Care at Marina del Rey Hospital

Why Choose Cedars-Sinai Marina del Rey Hospital for Hepatocellular Carcinoma Treatment?

Hepatocellular carcinoma has become a common form of cancer over the last 20 years in the United States and its rate of incidence is expected to increase in the following decade. The liver is critical to the body's immune system and metabolic functions. These systems cannot work without the liver's functions of filtering impurities and producing bile, which helps the body digest food and process fats. Illness or disease causes damage to the liver and may increase the risk of hepatocellular carcinoma and impact treatment options for the disease.

At Cedars-Sinai Marina del Rey Hospital, our specialists have years of experience delivering the range of cancer treatments available to treat hepatocellular carcinoma. Our care model is also designed to support patients throughout their treatment journey and includes supportive care services to help you manage side effects and maintain your quality of life.

A hepatocellular carcinoma (HCC), also known as hepatoma, is the most common type of primary cancer that starts in the liver. HCC accounts for about 75 percent of all liver cancers. It starts in the main type of liver cells: the hepatocellular cells. Most cases of HCC result from cirrhosis or infection with hepatitis B (HBV) or C (HCV.) However, up to 25 percent of patients have no risk factors for it or a history of cirrhosis.

A multidisciplinary setting provides the best management of hepatocellular carcinoma. HCC can be cured through surgical resection and liver transplantation. Unfortunately, these have limited applicability. Only about 5% of hepatocellular carcinoma patients are suitable for transplantation and the supply of good-quality deceased-donor organs is limited. Thus, other treatments have to be used to bridge patients to transplant or to delay recurrence if possible. Treatment options include:

  • Liver transplantation 
  • Resection 
  • Radiofrequency ablation (RFA)
  • Potentially systemic therapy with sorafenib
  • Alternatives to sorafenib are regorafenib, lenvatinib, nivolumab, pembrolizumab, ramucirumab, or cabozantinib
  • Chemotherapy: Several trials are being conducted to develop a drug for HCC treatment

The presentation of hepatocellular carcinoma has developed significantly over the past few decades. Currently, patients with known cirrhosis are undergoing routine screening. Thus, while in the past patients presented at an advanced stage, now the disease is increasingly recognized at a much earlier stage.

In general, patients with hepatocellular carcinoma present with the following signs and symptoms of advancing cirrhosis:

  • Pruritus
  • Jaundice
  • Splenomegaly
  • Variceal bleeding
  • Cachexia
  • Increasing abdominal girth 
  • Hepatic encephalopathy
  • Right upper quadrant pain 
  • Weight loss
  • Signs of decompensated liver disease 
  • Large mass in the upper-right section of the abdomen
  • Sudden feeling of illness
  • Fever
  • Sudden abdominal pain
  • Shock caused by a rupture or bleeding of the tumor

At first, symptoms may not offer clues HCC is present. However, the doctor will suspect HCC when the person has had cirrhosis for a long time and a tumor can be felt in the abdomen.

The diagnosis of HCC can often be established based on noninvasive imaging, without biopsy confirmation. Even when a biopsy is needed, imaging is usually required for guidance. Detection of the disease includes:

  • CBC
  • Electrolytes
  • Liver function tests
  • Coagulation studies
  • AFP determination
  • Ultrasound
  • Imaging tests (CT and MRI scans)
  • Liver biopsy

Risk factors for hepatocellular carcinoma include:

  • Severe cases of cirrhosis (severe scarring of the liver.) Major causes of cirrhosis in the United States are nonalcoholic fatty liver disease and alcohol abuse.
  • Hepatitis B virus infection
  • Hepatitis C virus infection
  • Certain food fungi (aflatoxin)
  • Obesity and diabetes, most likely through the development of nonalcoholic steatohepatitis
  • Hemochromatosis

The use of herbs and extracts made from plants and plant sources in the treatment of liver cancer has a long tradition. 

  • Herbal compounds. Some compounds have been proven to be effective against HCC by targeting various drivers of HCC. 
  • Herbal composite formula. Herbalists prescribe many herbal complex formulas in the form of capsules, tablets, and injections. Clinical trials are being conducted to assess their curative potential in hepatocellular carcinoma.

Primary prevention approaches include:

  • Vaccination strategies for HBV virus 
  • The management of HCV infections
  • HCV antiviral medication
  • Hepatitis C testing for people born between 1945 and 1965 
  • Screening of donated organs, blood, and tissues for transmissible diseases
  • Safe infection control practices during medical and dental procedures
  • Needle-exchange programs for injection drug users
  • Practicing safe sex
  • Decreasing harmful use of alcohol
  • Management programs for obesity and type 2 diabetes

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