Liver Cancer

Liver structure and function

The liver is the largest solid organ in the body. It is located under your right ribcage. It is pyramid-shaped and has two sections called lobes.

The liver has two blood sources. The hepatic artery brings in oxygen-rich blood, while the portal vein supplies nutrient-rich blood from the intestines.

The liver plays an important role in many of the body’s processes. Some of its functions are to:

• Break down and store nutrients from the intestine
• Create clotting factors that stop bleeding
• Make bile that helps the intestine absorb nutrients
• Help the body get rid of waste

Liver cancer types

Primary liver cancer

Cancers that begin in the liver are called primary liver cancers. They are named after the types of cells where the cancer begins. These include:

Hepatocellular carcinoma (HCC): HCC is the most common primary liver cancer. This tumor begins in the liver’s hepatocyte cells. Sometimes HCC begins as a single tumor. Other times, it starts in multiple spots in the liver (multifocal). Multifocal HCC is more common in people with liver inflammation, such as cirrhosis.

• Fibrolamellar HCC: This rare HCC subtype doesn’t typically have underlying liver inflammation or known risk factors. Fibrolamellar HCC is more common in younger patients. It often has a higher chance for successful treatment than HCC.

Angiosarcomas and hemangiosarcomas: These rare, fast-growing liver cancers begin in blood vessels in the liver. They are usually not diagnosed until advanced stages.

Hepatoblastoma: This is a very rare type of liver cancer most often found in children. The survival rate is more than 90% if caught early.

Some tumors in the liver are benign, or non-cancerous. These may be difficult to diagnose or grow large and cause problems. They sometimes require surgery.

Secondary (metastatic) liver cancer

Tumors that start elsewhere in the body and spread to the liver are called metastatic liver tumors. The liver is a common place where cancer spreads. Its large size and high blood flow make it a target for tumor cells moving through the bloodstream. Any tumor can spread to the liver but it is more common in colorectal, breast and lung cancers.

Liver Cancer Risk Factors

Anything that increases your chance of getting liver cancer is a risk factor. Risk factors for primary liver cancers are detailed below. For liver metastases risk factors, please refer to the cancer of origin website.

Cirrhosis of the liver: Cirrhosis, or scarring or damage to the liver, is the leading cause of HCC. Certain conditions or activities can cause cirrhosis. This also makes them risks for liver cancer. These include: 

• Nonalcoholic steatohepatitis (NASH): Obesity, diabetes and high cholesterol can increase your risk of developing nonalcoholic steatohepatitis (NASH), a form of fatty liver disease. NASH causes fat to infiltrate your liver and can lead to cirrhosis.
• Chronic Hepatitis B or C virus infection: These infections are the most common risk factors for liver cancer worldwide.
• Alcohol use: Drinking excessive amounts of alcohol can lead to cirrhosis.

Age: Most individuals who get liver cancer are over 55. However, some rare types of liver cancer like fibrolamellar HCC and hepatoblastomas are almost always found in younger patients.

Ethnicity: Liver cancer rates in the United States are higher for Asian/Pacific Islanders and American Indian/Alaska Natives. Hispanic communities, including in South Texas, have one of the highest rates of HCC in the United States.

Geography: Liver cancer is more common in developing countries in sub-Saharan Africa and Southeast Asia than in the United States.

Gender: Primary liver cancers are more common in men than women. This may be because of differences in hepatitis carrier rates, environmental exposures, estrogen effects, or a combination of these factors.

Medical conditions: Any of the following may increase your risk for liver cancer:

• Obesity
• Diabetes
• High cholesterol
• Hereditary hemochromatosis
• Alpha-1 antitrypsin deficiency
• Acute intermittent porphyria
• Wilson disease
• Primary sclerosing cholangitis (PSC)
• Liver fluke infection

Exposure to chemicals and toxins: Exposure to certain chemicals and toxins may increase the risk of liver cancer. This is especially true when other risk factors are present. These include:

• Aflatoxins, a family of poisons produced by fungi found on some crops
• Betel nut chewing
• Arsenic
• Thorotrast
• Vinyl chloride

Tobacco: Using tobacco can increase your risk of liver cancer.

Anabolic steroids: Anabolic steroid use has been linked to benign (non-cancerous) liver tumors called adenomas. Some adenomas progress to HCC.

Family history: In rare cases, liver cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.

Learn more about liver cancer:

• Liver cancer symptoms
• Liver cancer diagnosis
• Liver cancer treatment

Why choose MD Anderson for your liver cancer treatment?

At MD Anderson, you're surrounded by the strength of one of the nation's largest and most experienced comprehensive cancer centers. Here, you’ll find support and wellness services that treat the whole person – not just the disease.

Personalized care

A team of experts work together to diagnose and treat your specific case. Your individualized liver cancer treatment plan includes the most advanced therapies while focusing on your quality of life. This includes the use of tumor mutational analysis and biomarkers to plan and guide your treatment.

Experience, innovation

Treatment for liver cancer can be complex. As one of the nation's most active cancer centers, MD Anderson has become a pioneer in the field of liver cancer staging and treatment. We have developed techniques and benchmarks that have been adopted by other cancer centers across the country and the world. These advances include immunotherapy, advanced surgical techniques, operations for liver disease that isn’t otherwise able to be treated with surgery, and embolization.

The goal? To make sure you are treated safely and effectively, recover quickly and can return to daily activities as soon as possible.

Pioneering the future of liver cancer care

MD Anderson researchers are devoted to learning more about liver cancer. MD Anderson’s Specialized Programs of Research Excellence (SPORE) grant is the only HCC SPORE grant funded by the National Institute of Health. Teams are studying the use of immunotherapy for earlier stages of HCC. They are also developing ways to screen high-risk patients for liver cancer and studying prevention strategies. Their goal is to improve patient outcomes and reduce death rates through early intervention.

MD Anderson offers clinical trials of new treatments for liver cancer. These include systemic therapy, radioembolization, chemoembolization, microwave ablation, SBRT, proton therapy, and more.