Here [at City of Hope], there is one mission: It is treatment of cancer patients to make them no longer cancer patients but recovering individuals that are going back to their families." Yuman Fong, M.D., chair, Department of Surgery
Liver cancer care at City of Hope means you will get the most advanced, leading-edge treatments available, including minimally invasive robotic surgery, novel cancer-fighting drugs and highly precise radiation delivery. Our multidisciplinary team of specialized experts — many of whom are leaders and innovators in the field of liver cancer treatment and research — are solely focused on giving you the greatest chance at a lasting cure.
We will answer your questions, calm your concerns and design a personalized treatment plan to give you the best possible outcome.
If you have been diagnosed with liver cancer, are at a high risk for developing liver cancer or are looking for a second opinion consultation about your treatment, you may request an appointment online or contact us at 800-826-4673. Please visit Making Your First Appointment for more information.
City of Hope has been named a best hospital for cancer by U.S. News & World Report for over a decade and a National Cancer Institute comprehensive cancer center, the highest designation that recognizes our commitment to cancer treatment, research and education. As a founding member of the National Comprehensive Cancer Network, our doctors also help develop and improve evidence-based liver cancer treatment guidelines for patients throughout the country.
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Liver cancer is a disease in which cancerous cells form in the liver, an organ that plays a major role in digestion, metabolism and detoxification in the human body. These cancerous cells do not function normally and may divide uncontrollably, crowding out healthy liver cancer cells and possibly invading other organs in the body.
The majority of primary liver cancer is hepatocellular carcinoma, which arises from the organ’s main cells, called hepatocytes. This cancer typically accompanies other liver diseases, such as hepatitis B or C infections, metabolic disorders and alcohol-related diseases such as cirrhosis.
Other, less common types of primary liver cancer include:
The liver is also a common site for secondary cancers, in which primary cancers from another organ or site (such as breast, colon or prostate) have spread to the liver and started developing a tumor there. Many secondary liver tumors are highly treatable and can even be cured with appropriate treatment.
Additionally, benign tumors may also form in the liver. These typically do not cause symptoms and are usually discovered in imaging tests for other conditions. They may not require treatment unless they cause bleeding or abdominal pain.
Factors that can elevate risk liver cancer risk include:
Common symptoms of liver cancer include:
Although these symptoms can be caused by other conditions, you should check with your doctor to get a definitive diagnosis.
Sources: National Cancer Institute and American Cancer Society
Precise liver cancer tests are crucial for treatment planning, and City of Hope is equipped with state-of-the-art technologies and specialized staff to ensure an accurate, comprehensive diagnosis of liver cancer.
Highlights of our screening and diagnosis services include:
Your doctor may use the following tests to look for liver cancer:
Based on the results of these tests, the liver cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs. Generally, liver cancer caught in earlier stages will have better outcomes than those caught in advanced or metastasized stages.
There are currently no screening guidelines for liver cancer, since no screenings have been shown to lower risk of dying from liver cancer for people of average risk. However, your physician may recommend more vigorous monitoring if you are at a high risk of developing this disease, which includes:
When you are able to provide patients a disease-free advantage ... it is extremely gratifying." Gagandeep Singh, M.D., Head of Liver and Pancreatic Surgery
City of Hope has one of the most renowned liver cancer programs in the United States, with a multidisciplinary team of medical experts across different fields — including surgery, radiation oncology, medical oncology and supportive care medicine.
Members of our liver cancer team meet twice weekly to review patient cases, bringing a variety of clinical perspectives and experience to the development of an individualized treatment plan. The team also participates in a weekly meeting to share clinical trial results, review information from surgical pathology reports and plan future research studies.
Our physicians are also active members in many collaborations and cooperative groups, and have led or participated in most national clinical trials for detecting, treating and preventing liver cancer. This dedication to research also ensures our patients have access to the most promising and leading-edge liver cancer therapies.
Learn more about our liver cancer treatment options below:
Surgery is the primary treatment for liver cancer. It can be curative for early stage liver cancer patients and can also improve survival outcomes and reduce discomfort for advanced liver cancer patients. The procedure can involve removing the tumor from the body or destroying the tumor while it’s still in the body (ablation) or halt its growth by cutting off its blood supply (embolization).
The liver is one of two organs in the human body that has the capacity to regenerate. Up to 80 percent of the liver can be surgically removed and, within several weeks, it will entirely rebuild itself. If one lobe -- and its associated blood vessels -- is surgically removed, the remaining lobe will compensate for the loss. Our surgeons routinely use a new technique called preoperative portal vein embolization, which redirects the blood supply to the healthy portion of the liver to stimulate cell growth before surgery. Our doctors also use liver-sparing surgical techniques that leave more of the healthy liver intact, reducing the need for regeneration and the possibility of complications.
The expertise of City of Hope’s surgeons also means that they can treat liver tumors that are considered inoperable elsewhere. This is done through advanced procedures that can navigate around sensitive areas (such as major blood vessels) and working with radiation and medical oncologists, who can shrink the tumor to down to an operable size and shape with radiation and drug therapies.
Our liver surgeons have performed thousands of liver tumor operations and we have one of the most experienced liver surgery teams in the nation. Our experience and leadership in this field has been demonstrated with published findings showing the following benefits compared to hospitals that do not perform a high number of liver surgeries.
Our experience also means we can surgically treat a greater range of liver cancer patients, including patients who may be deemed inoperable elsewhere due to advanced disease, older age or other health conditions.
Additional highlights of our liver cancer surgery program:
Ablation and embolization are minimally invasive procedures using small tubes and needles to deliver cancer therapy directly to the tumor. These needles and probes are inserted through the skin or a blood vessel and carefully guided to the cancer site using detailed imaging technology.
This therapy can either kill the liver tumor outright (ablation) or block its blood supply (embolization). The specific therapies offered at City of Hope include:
Ablation and embolization are viable options for patients who are current ineligible for surgery. In some cases, these therapies can shrink the tumor enough to make them operable.
Drug therapy may be given to patients to fight liver cancer cells throughout the body by killing the cancer cells or stopping their growth and spread. These drugs include:
The drug or drug combination used depends on the type and stage of liver cancer, previous treatments used, the patient’s health and overall treatment goals. This personalized medicine approach may be further enhanced by molecular or genetic testing of your cancer, which can help identify treatments that are more effective and with fewer side effects.
In addition to standard drug therapy regimens, City of Hope is also experienced in hepatic arterial infusion — which delivers cancer-fighting drugs to the major blood vessel from the heart to the liver. This direct delivery method can enhance the therapy’s effectiveness in shrinking or killing liver tumors.
City of Hope patients may also be eligible for new, promising drugs through our clinical trials program.
Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It may be delivered externally using focused beams of energy, or internally, placing an energy emitting substance in or near the tumor site.
Radiation can treat tumors that cannot be removed by surgery (sometimes shrinking them enough to be operable) and can be used to relieve pain and other liver cancer symptoms.
City of Hope is a leader in image-driven radiation planning, using computed tomography and magnetic resonance imaging scans to determine tumor size and location. This ensures radiation is accurately delivered to the tumor site, while minimizing exposure to nearby normal tissues.
Because cancer of the liver is difficult to control, regular follow-up care after the initial course of treatment — including periodic imaging, liver function, and blood tests — is very important. You should also never hesitate to let members of your care team know about pain or any symptoms, changes, or problems that occur after treatment. Follow-up care can be arranged to be ongoing at City of Hope or arranged in partnership with you primary care physicians.
There is a high incidence of recurrent liver cancer, even after successful treatment. Patients who have been treated for liver cancer should see their surgeon, oncologist, or other doctors for regular surveillance with imaging tests such as ultrasound, CT or MRI to determine whether the cancer has returned.
Some patients with liver cancer have chronic hepatitis B or C. These viruses cause chronic inflammation and scarring in the liver, which can lead to cirrhosis and liver cancer. Chronic hepatitis B and C can be controlled with antiviral medications. Treatment with antiviral medications is often recommended in combination with treatment for liver cancer.
Patients with liver cancer often have cirrhosis or associated diabetes. Dietary counseling can often help prevent other metabolic problems or symptoms of liver insufficiency. Patients should minimize or eliminate alcohol use and avoid intensive treatment with herbal remedies. City of Hope’s Supportive Care Medicine Program provides ongoing access to nutritional information and other quality-of-life support.
At City of Hope, patients with liver cancer are treated by a multidisciplinary team including surgeons, medical oncologists, gastroenterologists, diagnostic radiologists, interventional radiologists, pathologists and radiation oncologists who work together to determine the most appropriate treatment for each patient.
Because our doctors are also leaders in their field, patients under our care have access to the newest treatment approaches. Our clinicians are also noted clinical researchers, who lead some of the most innovative clinical trials in this area.
Select from the list below to learn more about our primary liver cancer specialists, their education, training, board certifications, current publications and specific areas of clinical expertise.
Diagnostic Radiology and Interventional Radiology
At City of Hope, we have a dedicated team of nurses who specialize in caring for patients with liver cancer during outpatient visits and inpatient hospital stays. Each nurse works in collaboration with one primary physician to oversee every patient’s care. This allows our nurses to assess a patient’s needs, triage symptoms, and, if necessary, make referrals to other departments within City of Hope, such as supportive care medicine, nutrition, and social work. Nurses also help patients understand the details of the treatment plan and what to expect throughout the course of treatment. They are actively involved with teaching both patients and their families, and provide educational materials as needed.
As the liaison between patients and physicians, nurses play an important role in the team approach to care offered at City of Hope.
At City of Hope, liver cancer clinicians and researchers collaborate extensively to develop and evaluate new therapies for better survival and quality-of-life outcomes. Our patients have access to a wide variety of clinical trials including new chemotherapy and targeted therapies, hormone therapies, novel surgical techniques, innovative radiation approaches and new prevention strategies.
These trials give current patients access to promising, leading-edge therapies and improve overall care for future patients worldwide. Visit our clinical trials page to learn more about current studies and their eligibility criteria.
Here are some of our current liver cancer research projects:
While our primary goal is to cure or control the disease, another top priority is relieving suffering and discomfort for liver cancer patients undergoing cancer treatments.
In addition to curative treatments, City of Hope liver cancer patients and their caregivers have access to the broad range of services offered by our Department of Supportive Care Medicine. The department’s staff of professionals, including registered dieticians, rehabilitation specialists, supportive medicine physicians and clinical social workers, can help patients and loved ones with a variety of care and wellness issues including:
For more information about the supportive care programs we offer, please contact the Sheri & Les Biller Patient and Family Resource Center at 626-218-2273 (CARE) or the Women’s Center at 800-934-5555.