Expert Videos

Module 1: Understanding Liver Cancer

What is liver cancer?

What is liver cancer?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, provides an overview of liver cancer and the function of the liver. Dr. Abou-Alfa explains that liver cancer is cancer that starts in the liver cells. It is called primary liver cancer or hepatocellular carcinoma (HCC). Other cancers may spread, or metastasize, to the liver. Only cancer that starts in liver cells is called liver cancer. The liver is the largest organ in your body and performs many essential functions. For example, it helps remove toxins from your body and store necessary nutrients.

Who is at risk of developing liver cancer?

Who is at risk of developing liver cancer?

Transplant hepatologist Dr. Amit Singal, MD, discusses the risk factors for developing liver cancer. Dr. Singal explains that the main risk factor for liver cancer is chronic liver disease, which can lead to cirrhosis. Chronic liver disease can be related to hepatitis B or C, chronic alcohol use, or metabolic dysfunction-associated steatotic liver disease.

What are the symptoms of liver cancer?

What are the symptoms of liver cancer?

Dr. Ghassan Abou-Alfa, MD, of Memorial Sloan Kettering Cancer Center in New York, provides an overview of the symptoms of liver cancer. Symptoms of liver cancer can be mild or nonexistent at first. Dr. Abou-Alfa discusses symptoms such as abdominal pain (especially in the upper right quadrant where the liver is located), yellow-tinged skin and eyes, and dark urine. More advanced liver cancer symptoms may include a distended belly (ascites), fatigue, weight loss, and changes in mental state.

What can I do to decrease my risk of liver cancer?

What can I do to decrease my risk of liver cancer?

Dr. Amit Singal, MD, of UT Southwestern Medical Center in Dallas, discusses ways to decrease the risk of liver cancer. It is possible to control some risk factors for liver cancer. Studies show that the best way to prevent liver cancer is vaccination for hepatitis B and treatment for hepatitis B or C. Avoiding too much alcohol, maintaining a healthy weight, and treating diabetes are also recommended.

What's the outlook for someone with liver cancer?

What's the outlook for someone with liver cancer?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, discusses the overall outlook for someone with liver cancer. He explains that, in general, earlier detection means a better outlook, including a higher chance of curative treatment. The outlook will depend on many other factors too, including liver function. Talk with your healthcare team to understand your treatment options and what you can expect.

Module 2: Screening and Diagnosing Liver Cancer

Who is at risk of developing liver cancer?

Who is at risk of developing liver cancer?

Transplant hepatologist Dr. Amit Singal, MD, discusses the risk factors for developing liver cancer. Dr. Singal explains that the main risk factor for liver cancer is chronic liver disease, which can lead to cirrhosis. Chronic liver disease can be related to hepatitis B or C, chronic alcohol use, or metabolic dysfunction-associated steatotic liver disease.

What are the symptoms of liver cancer?

What are the symptoms of liver cancer?

Dr. Ghassan Abou-Alfa, MD, of Memorial Sloan Kettering Cancer Center in New York, provides an overview of the symptoms of liver cancer. Symptoms of liver cancer can be mild or nonexistent at first. Dr. Abou-Alfa discusses symptoms such as abdominal pain (especially in the upper right quadrant where the liver is located), yellow-tinged skin and eyes, and dark urine. More advanced liver cancer symptoms may include a distended belly (ascites), fatigue, weight loss, and changes in mental state.

Who should be screened for liver cancer?

Who should be screened for liver cancer?

Transplant hepatologist Dr. Amit Singal, MD, provides an overview of who should be screened for liver cancer. The goal of liver cancer screening is to find liver cancer early in people who are at risk, when treatment is more likely to achieve a cure. The risk factors that Dr. Singal discusses include hepatitis B or C, heavy alcohol use, metabolic dysfunction (diabetes and obesity-related liver disease), primary biliary cholangitis, and hemochromatosis. Lastly, Dr. Singal also provides an overview of liver cancer screening guidelines.

What does liver cancer screening involve?

What does liver cancer screening involve?

Dr. Amit Singal, MD, of UT Southwestern Medical Center in Dallas, provides an overview of liver cancer screening. Liver cancer screening can include an ultrasound of the liver every 6 months, plus a blood test called AFP (alpha-fetoprotein) to look for a protein that can indicate liver cancer.

How is liver cancer diagnosed?

How is liver cancer diagnosed?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, discusses the steps and tests involved in diagnosing liver cancer. He explains that your doctor will talk with you about your medical history and do a physical examination. Additionally, you may have imaging tests such as a CT scan or MRI, and additional blood tests. Your doctor may also want you to have liver function tests (LFTs). Liver cancer is one of the only cancers that can be diagnosed in high-risk patients using imaging (without biopsy) in some cases. If you are not having surgery, you may need a biopsy. Your doctor will take a small sample of tissue from the liver to look for cancer cells.

How is liver cancer staged?

How is liver cancer staged?

Transplant hepatologist Dr. Amit Singal, MD, discusses the staging of liver cancer. Staging refers to how large the cancer is and whether it has spread outside the liver. Staging helps your doctors plan the best treatment for you. Dr. Singal provides an overview of the Barcelona Clinic Liver Cancer (BCLC) staging system. BCLC stages include the size and number of tumors, and whether you have symptoms, as well as liver health and activity level.

Module 3: Treating and Managing Liver Cancer

What treatment options are available for liver cancer?

What treatment options are available for liver cancer?

Dr. Amit Singal, MD, of UT Southwestern Medical Center in Dallas, provides an overview of the treatment options for liver cancer, and when they are used. He describes surgical resection (hepatectomy), liver transplantation, local ablation, embolization (including chemoembolization or radioembolization), targeted therapy, and immunotherapy for liver cancer.

How is liver resection surgery used to treat liver cancer?

How is liver resection surgery used to treat liver cancer?

Transplant hepatologist Dr. Amit Singal, MD, discusses how liver resection surgery is used to treat early-stage liver cancer. This surgery is called hepatectomy. If only tumors are removed, you will still have liver tissue remaining. Dr. Singal also talks about recent advances in liver resection techniques and the advantages of minimally invasive surgery performed laparoscopically or robotically.

How is liver transplant used to treat liver cancer?

How is liver transplant used to treat liver cancer?

Transplant hepatologist Dr. Amit Singal of UT Southwestern Medical Center in Dallas provides an overview of liver transplantation to treat liver cancer. A liver transplant is intended to cure the cancer, and this treatment has the lowest chance of the cancer coming back. A liver transplant is an operation that removes the entire liver and replaces it with a whole or partial liver from a healthy donor. This might be someone who has died and donated their liver, or someone still living who gives part of their liver. Dr. Singal also discusses eligibility for liver transplant.

How is ablation used to treat liver cancer?

How is ablation used to treat liver cancer?

Dr. Amit Singal, MD, of UT Southwestern Medical Center in Dallas, provides an overview of ablation that may be appropriate for certain patients with liver cancer. Ablation is treatment that destroys liver tumors. Doctors apply heat, cold, or electrical pulses directly to the tumor to destroy it.

How is embolization used to treat liver cancer?

How is embolization used to treat liver cancer?

Transplant hepatologist Dr. Amit Singal of UT Southwestern Medical Center in Dallas provides an overview of how embolization is used to treat liver cancer. If cancer within the liver cannot be removed with surgery, you may have embolization, including chemoembolization or radioembolization. This blocks blood flow to the tumor, sometimes with chemotherapy or internal radiation to kill tumor cells.

How is targeted therapy used to treat liver cancer?

How is targeted therapy used to treat liver cancer?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, provides an overview of targeted therapy to treat liver cancer. He explains that targeted therapy drugs target the specific genes of cancer cells. Targeted therapy blocks the growth and spread of cancer cells and limits damage to healthy cells.

How is immunotherapy used to treat liver cancer?

How is immunotherapy used to treat liver cancer?

Dr. Ghassan Abou-Alfa, MD, of Memorial Sloan Kettering Cancer Center in New York, provides an overview of immunotherapy for treating liver cancer. He explains that immunotherapy drugs help to strengthen or restore the immune system's ability to fight cancer. Dr. Abou-Alfa discusses single-agent immunotherapy and advances in using combination (or doublet) immunotherapy to treat liver cancer.

What if liver cancer comes back after treatment?

What if liver cancer comes back after treatment?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, discusses options if liver cancer comes back after treatment. The good news, he says, is that many treatment options are available to try next and he describes some of the possibilities. Treatment options depend on your general health, liver health, previous treatments, and stage of cancer.

What opportunities do liver cancer clinical trials offer patients?

What opportunities do liver cancer clinical trials offer patients?

Dr. Ghassan Abou-Alfa, MD, of Memorial Sloan Kettering Cancer Center in New York, provides an overview of clinical trials for liver cancer and the opportunities they offer patients. Dr. Abou-Alfa explains that all the approved liver cancer therapies we have today were made possible because of clinical trials. Ask your doctor about clinical trials as soon as you are diagnosed. You can search for clinical trials by visiting Blue Faery's clinical trials finder tool at bluefaery.org or visiting ClinicalTrials.gov.

How can I manage the side effects of liver cancer treatment?

How can I manage the side effects of liver cancer treatment?

Medical oncologist Dr. Ghassan Abou-Alfa, MD, discusses some of the potential side effects of liver cancer treatments, and how to manage them and get support. He provides a general overview of targeted therapy and immunotherapy side effects, and how to work with your doctor to manage them. Dr. Abou-Alfa emphasizes the importance of good communication with your doctor about any symptoms you may experience. Lastly, Dr. Abou-Alfa recommends reaching out to the liver cancer advocacy and support group Blue Faery (bluefaery.org) to find a support group.

This educational activity has been developed by Blue Faery: The Adrienne Wilson Liver Cancer Association in collaboration with Mechanisms in Medicine Inc.

This activity is supported by independent educational grants from AstraZeneca, Eisai, Exelixis, Merck, and Genentech.

Thank you to the funders of You And Liver Cancer. All content is developed independently by Blue Faery and Mechanisms in Medicine Inc., in collaboration with an Expert Faculty group; funders are allowed no influence on the content of You And Liver Cancer: An Animated Patient^® Guide to Liver Cancer.

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