Carcinoma hepatocelular

El carcinoma hepatocelular es el tipo más frecuente de cáncer primario de hígado. Se desarrolla más comúnmente en personas que padecen enfermedades hepáticas crónicas, como cirrosis causada por hepatitis B o C.

Síntomas

Hepatocellular carcinoma might not cause symptoms that are noticed right away. This liver cancer happens most often in people with liver scarring, called cirrhosis, caused by hepatitis B or hepatitis C infection. In these people, the cancer symptoms might be the same as the cirrhosis symptoms.

If signs and symptoms of hepatocellular carcinoma develop, they may include:

  • Losing weight without trying.
  • Loss of appetite.
  • Upper abdominal pain.
  • A growth in the abdomen.
  • Yellowing of the skin and the whites of the eyes, known as jaundice.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causas

It's not always clear what causes hepatocellular carcinoma. This cancer starts as a growth of cells in the liver. Most people with this type of cancer have an ongoing liver condition, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Hepatocellular carcinoma happens when cells in the liver called hepatocytes develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

Factores de riesgo

Factors that may increase the risk of hepatocellular carcinoma include:

  • Older age. Hepatocellular carcinoma is more common in older adults.
  • Infection with hepatitis B virus or hepatitis C virus. Ongoing or previous infection with the hepatitis B virus or hepatitis C virus increases the risk of hepatocellular carcinoma.
  • Cirrhosis. Cirrhosis is a progressive and irreversible condition that causes scar tissue to form in the liver. It increases the chances of developing hepatocellular carcinoma.
  • Certain inherited liver diseases. Some liver diseases that can run in families may increase the risk of hepatocellular carcinoma. Examples include hemochromatosis and Wilson's disease.
  • Excess fat in the liver. Nonalcoholic fatty liver disease, also called metabolic dysfunction-associated steatotic liver disease, happens when fat builds up in the liver. People with this condition are at an increased risk of hepatocellular carcinoma.
  • Diabetes. People with this blood sugar condition have a greater risk of hepatocellular carcinoma than those who don't have diabetes.
  • Obesity. People with obesity have a higher risk of cirrhosis and excess fat in the liver. These conditions increase the risk of hepatocellular carcinoma.
  • Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with aflatoxins, which can end up in foods made of these products.
  • Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase the risk of hepatocellular carcinoma.
  • Smoking cigarettes. People who smoke cigarettes are at an increased risk of hepatocellular carcinoma.

Prevención

Reduce your risk of cirrhosis

Cirrhosis is scarring of the liver, and it increases the risk of hepatocellular carcinoma. You can reduce your risk of cirrhosis if you:

  • Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
  • Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.

Get vaccinated against hepatitis B

Infection with the hepatitis B virus increases the risk of hepatocellular carcinoma. You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine. The vaccine can be given to almost anyone, including infants, children, adults and older adults.

Take measures to prevent hepatitis C

Infection with the hepatitis C virus increases the risk of hepatocellular carcinoma. No vaccine for hepatitis C exists, but you can reduce your risk of infection.

  • Know the health status of any sexual partner. Don't engage in unprotected sex unless you're certain your partner isn't infected with hepatitis B, hepatitis C or any other sexually transmitted infection. If you don't know the health status of your partner, use a condom every time you have sexual intercourse.
  • Don't use intravenous drugs, but if you do, use a clean needle. Reduce your risk of hepatitis C by not injecting legal or illegal drugs that may be sold on the streets. But if that isn't an option for you, make sure any needle you use is sterile, and don't share it. Contaminated needles are a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
  • Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop won't answer your questions or don't take your questions seriously, take that as a sign that the facility isn't right for you.

Seek treatment for hepatitis B or C infection

Treatments are available for hepatitis B and hepatitis C infections. Research shows that treatment can reduce the risk of hepatocellular carcinoma.

Ask about liver cancer screening

For most people, screening for liver cancer hasn't been proved to reduce the risk of dying of liver cancer, and it isn't generally recommended. People with conditions that increase the risk of liver cancer might consider screening. People with an increased risk include those who have:

  • Hepatitis B infection.
  • Hepatitis C infection.
  • Liver cirrhosis.

Talk about the pros and cons of screening with your healthcare team. Together you can decide whether screening is right for you based on your risk. Hepatocellular carcinoma screening typically involves a blood test and an abdominal ultrasound every six months.

Diagnóstico

Las pruebas y los procedimientos que se utilizan para diagnosticar el carcinoma hepatocelular incluyen los siguientes:

  • Análisis de sangre para medir la función hepática.
  • Pruebas por imágenes, como tomografía computarizada y resonancia magnética.
  • Biopsia de hígado, en algunos casos, para extraer una muestra de tejido hepático para análisis de laboratorio.

Tratamiento

El mejor tratamiento para ti dependerá del tamaño y la ubicación de tu hepatocarcinoma, de lo bien que esté funcionando tu hígado y de tu salud en general.

Los tratamientos para el hepatocarcinoma incluyen los siguientes:

  • Cirugía. La cirugía para extirpar el cáncer y un margen de tejido sano que lo rodea puede ser una opción para las personas con cáncer hepático en etapa temprana que tienen una función hepática normal.
  • Cirugía de trasplante de hígado. La cirugía para extirpar todo el hígado y reemplazarlo con un hígado de un donante puede ser una opción en personas por lo demás sanas cuyo cáncer de hígado no se haya diseminado más allá del hígado.
  • Destruir las células cancerosas con calor o frío. Los procedimientos de ablación para matar las células cancerosas en el hígado usando calor o frío extremos se pueden recomendar para las personas que no pueden someterse a una cirugía. Estos procedimientos incluyen ablación por radiofrecuencia, crioablación y ablación con alcohol o microondas.
  • Administrar quimioterapia o radiación directamente a las células cancerosas. Usando un catéter que pasa a través de los vasos sanguíneos hasta el hígado, los médicos pueden administrar medicamentos de quimioterapia (quimioembolización) o pequeñas esferas de vidrio que contienen radiación (radioembolización) directamente a las células cancerosas.
  • Radioterapia. Se puede recomendar la radioterapia con energía de rayos X o protones si la cirugía no es una opción. Un tipo especializado de radioterapia, llamada radioterapia corporal estereotáctica, consiste en enfocar muchos haces de radiación simultáneamente en un punto del cuerpo.
  • Terapia con medicamentos con diana específica. Los medicamentos con diana específica atacan debilidades específicas en las células cancerosas y pueden ayudar a retardar la progresión de la enfermedad en personas con cáncer hepático avanzado.
  • Inmunoterapia. Los medicamentos de inmunoterapia utilizan el sistema inmunitario del cuerpo que combate los gérmenes para atacar las células cancerosas. La inmunoterapia puede ser una opción para tratar el cáncer de hígado avanzado.
  • Ensayos clínicos. Los ensayos clínicos te dan la oportunidad de probar nuevos tratamientos para el cáncer de hígado. Pregúntale a tu médico si eres elegible para participar en un ensayo clínico.

Estrategias de afrontamiento y apoyo

With time, you'll find ways to cope with feelings that happen after a cancer diagnosis. Until then, here are some ideas for coping with hepatocellular carcinoma.

Learn enough about cancer to make decisions about your care

Ask your healthcare team about your cancer, including your test results, treatment options and, if you like, your prognosis. As you learn more about hepatocellular carcinoma, you may become more confident in making treatment decisions.

Keep friends and family close

Keeping your close relationships strong can help you deal with hepatocellular carcinoma. Friends and family can provide the practical support you may need, such as helping take care of your home if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by having cancer.

Find someone to talk with

Find someone who is willing to listen to you talk about your hopes and worries. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.

Ask your healthcare team about support groups in your area. Other sources of information include the U.S. National Cancer Institute and the American Cancer Society.

Preparing for your appointment

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

If your healthcare professional thinks you might have hepatocellular carcinoma, you may be referred to a doctor who specializes in diseases of the liver, called a hepatologist. If a cancer diagnosis is made, you also may be referred to a doctor who specializes in treating cancer, called an oncologist.

Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down symptoms you have, including any that may not seem related to the reason for which you scheduled the appointment.
  • Write down important personal information, including major stresses or recent life changes.
  • Make a list of all medicines, vitamins or supplements you're taking and the doses.
  • Take a family member or friend along. Sometimes it can be very hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write down questions to ask your healthcare team.

Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For hepatocellular carcinoma, some basic questions to ask include:

  • Do I have hepatocellular carcinoma?
  • What is the stage of my hepatocellular carcinoma?
  • Has my hepatocellular carcinoma spread to other parts of my body?
  • Will I need more tests?
  • What are the treatment options?
  • How much does each treatment increase my chances of a cure or prolong my life?
  • What are the potential side effects of each treatment?
  • How will each treatment affect my daily life?
  • Is there one treatment option you believe is the best?
  • What would you recommend to a friend or family member in my situation?
  • Should I see a specialist?
  • Are there any brochures or other printed material that I can take with me? What websites do you recommend?
  • What will determine whether I should plan for a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
April 28, 2023

Living with cáncer de hígado?

Connect with others like you for support and answers to your questions in the Liver Cancer support group on Mayo Clinic Connect, a patient community.

Liver Cancer Discussions

cu2
Living with Stage 4 Liver Cancer

49 Replies Fri, May 02, 2025

suchita90
Diagnosed with cholangiocarcinoma, can this be treated?

40 Replies Sat, Apr 26, 2025

donnabl
I have liver cancer: What next?

37 Replies Sat, Apr 05, 2025

See more discussions
  1. AskMayoExpert. Hepatocellular carcinoma (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  2. Hepatobiliary cancers. Plymouth Meeting, Pa.: National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed Feb. 21, 2019.