Liver Cancer Care

The liver cancer experts at UC San Diego Health are fighting primary malignancies and metastases in new and aggressive ways. Our multidisciplinary team is committed to providing the highest level of care and includes specialists from hepatology, surgical oncology, medical oncology, radiation oncology and interventional radiology.

Cancers and benign tumors are accurately identified, staged and monitored by our advanced endoscopy unit and diagnostics team in gastroenterology.

What is Liver Cancer?

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Our body is finely tuned so that normal cells grow and divide to form new cells as they are needed. When normal cells grow old or get damaged, they die, and new cells take their place.

Sometimes, this process goes wrong. Exposure to poisonous chemicals, toxins, radiation, viruses, smoking, too much alcohol, defective genes, or changes in genes can disturb this balance. In those situations, older cells do not die and also newer cells start dividing uncontrollably to form excess cells that our body does not need.

These extra cells form abnormal clumps of cells or a mass and are called tumors. These excess growths in the liver can be benign (not cancer) or malignant (cancer).

Benign tumors are not as harmful as malignant tumors.

Benign tumors:

  • Are rarely a threat to life
  • Can be removed and usually don’t grow back
  • Don’t invade the tissues around them
  • Don’t spread to other parts of the body

Malignant growths:

  • May be a threat to life
  • Sometimes can be removed but can grow back
  • Can invade and damage nearby tissues and organs (such as the stomach or intestine)
  • Can spread to other parts of the body

Most primary liver cancers begin in liver cells (hepatocytes). This type of cancer is called hepatocellular carcinoma (HCC) or hepatoma. This is the most common among all the liver cancers that start in the liver.

How Do You Get Liver Cancer?

Liver cancer does not occur all of a sudden. It starts in a liver that has been exposed to some of the risk factors for the disease. Anything that increases your chance of getting a disease is called a risk factor. Just because you have a risk factor does not mean you will get cancer; not having a risk factor doesn’t mean you won’t get cancer.

Risk factors for liver cancer:

  • Cirrhosis of the liver: People with cirrhosis of the liver are at an increased risk of developing primary liver cancer.
  • Chronic viral hepatitis: People infected with hepatitis B and hepatitis C are at very high risk of developing chronic hepatitis, cirrhosis of the liver, and primary liver cancer.
  • Hepatitis B can cause primary liver cancer without cirrhosis.

Other factors associated with increased risk:

  • Age: Primary liver cancer is more common in people over the age of 60.
  • Alcohol consumption: People who drink a lot of alcohol are at a greater risk of developing cirrhosis of the liver, which is associated with an increased risk of primary liver cancer.
  • Autoimmune hepatitis: A chronic disease in which the body’s immune system attacks the normal cells of the liver and causes liver damage. Autoimmune hepatitis can lead to cirrhosis and liver failure.
  • Environmental risks: Vinyl chloride and thorium dioxide may increase the risk of developing primary liver cancer. People who eat food contaminated with an aflatoxin (a mold that grows on peanuts and grains) are also at greater risk of developing primary liver cancer.
  • Nonalcoholic fatty liver disease (NAFLD)
  • Gender: Primary liver cancer is more common in men than in women.
  • Obesity: Obese people are at a greater risk of developing primary liver cancer than those who maintain a normal weight.
  • Race/ethnicity: In the United States, primary liver cancer is more common in Asian Americans and Pacific Islanders than in Latinos, African Americans and Caucasians.
  • Smoking: Smoking increases the risk of getting liver cancer. Former smokers have a lowered risk than current smokers, but both groups have a higher risk than those who never smoked.

Liver Cancer Areas of Expertise

Our Team

Liver Cancer Group (LCG) is a weekly multi-disciplinary liver cancer tumor board, led by Yuko Kono, MD, a hepatologist who specialize in caring for patients with hepatocellular carcinoma (HCC). The group includes experts in hepatology, surgery, diagnostic radiology, interventional radiology, radiation oncology, medical oncology, and pathology.

Diagnosis and Imaging

UC San Diego Health is home to a unique liver imaging group that includes radiologists, physicists, computer scientists, and biostatisticians. The group has developed sophisticated non-invasive techniques to diagnose pre-cancerous liver conditions and small tumors that were previously not detectable. These techniques — which include double-contrast magnetic resonance imaging (MRI) — can also be used to gather important information about a tumor, including its exact size, density, and how well it may respond to treatment.

Surgical Treatment

Hepatobiliary surgery is led by a team of surgeons with experience in complex surgeries of the liver, pancreas and bile ducts, including:

Chemotherapy and Radiotherapy

Specialists perform radiotherapy and administer advanced chemotherapies, including:

  • Stereotactic body radiation therapy (SBRT) -- SBRT is a special form of external beam radiation that delivers doses of radiation using beams precisely matched to the three dimensional shape of the tumor. Learn about the types of radiation therapy.
  • Transarterial chemoembolization (TACE) and drug-eluting beads (DEB) -- Transarterial chemoembolization is a targeted form of chemotherapy delivered locally (sometimes through small beads) to destroy a tumor. TACE helps block blood supply to a tumor.
  • Transarterial radioembolization (TARE) -- Transarterial radiotherapy is the use of radioactive isotopes (Yttrium 90) delivered selectively to the tumor through the hepatic artery.
  • Chemotherapy and targeted therapy for hepatocellular carcinoma (HCC) -- Chemotherapy uses chemical agents to treat the disease.