HCC surveillance (liver monitoring)

About HCC (hepatocellular carcinoma)

HCC (hepatocellular carcinoma) is the most common type of liver cancer. It usually develops in people who have an underlying chronic disorder affecting their liver.

Causes

Common causes include the following:

• alcohol related liver disease
• fatty liver disease
• hepatitis infections.

If you have significant scarring (fibrosis) or cirrhosis of your liver then you are at increased risk of developing HCC.

People with less common causes of liver disease are also at risk of developing HCC.

About surveillance (liver monitoring)

Surveillance can help to diagnose HCC early, before symptoms develop. This makes treatment easier and more successful for people who need it.

Your doctor will discuss surveillance for HCC with you.

We will not give you HCC surveillance unless you choose to have it.

If you choose surveillance, you can expect the following every 6 months:

• a blood test
• an external liver ultrasound.

The ultrasound

This will happen in the Kingston Hospital Radiology Department. It usually takes 15 to 30 minutes.

• The radiographer will put some cold jelly on the right side of your upper abdomen.
• They will use a probe to look carefully at your liver to assess whether there are any visible lesions (tissue damage).
• The test is not usually uncomfortable.

Risks of HCC surveillance

If surveillance diagnoses HCC, it may not be at an early stage and we may not be able to cure it.

We may need to offer you additional tests and these can cause you to worry.

Outcomes of surveillance 

Most people tested (95 out of every 100) will have no signs of cancer and will not need additional tests.

Some people (5 out of every 100) will need further tests, usually an MRI scan.  

• Of these 5 people, 1 will be diagnosed with cancer.
• We will continue to monitor the other 4 people. 

If we find cancer

If we diagnose cancer, most patients (4 out of every 5) will have cancer that we can potentially cure.

1 out of 5 people will have cancer that we cannot cure.

Treatment

Treatment depends on the size and number of tumours, and on liver function and overall fitness.

Types of treatment include:

• surgery
• ablation (the use of heat into the tumour)
• chemotherapy 
• radiotherapy
• liver transplantation (less common).

Getting your results

Your doctor will contact you with the results within a few weeks of your surveillance investigations (blood test and ultrasound). They will do this by phone or by letter.

If the surveillance has found abnormalities, your doctor will arrange for you to have a more detailed liver scan (called an MRI) before they discuss the results with you.