HCC is a cancer arising from liver cells known as hepatocytes.
In terms of cancer deaths in Singapore, HCC was ranked third amongst men and fourth amongst women during the period of 2011-2015.
Most patients with HCC do not have any symptoms especially in the early stage of the disease. In the later stages, patients may develop jaundice, confusion, bleeding tendencies or fluid in their abdomen known as ascites.
Diagnosis of HCC can usually be made using CT or MRI scans. In a small proportion of cases, a liver biopsy may be needed to establish a diagnosis.
The most common risk factor for HCC in Singapore is being a hepatitis B virus carrier. Other risk factors include any cause of liver cirrhosis including non-alcoholic fatty liver disease, chronic alcohol dependence, chronic hepatitis C virus infection, autoimmune hepatitis and primary biliary cirrhosis. There is also increasing evidence that obesity and diabetes may be risk factors for cirrhosis.
It is possible to detect HCC early in the absence of symptoms. Patients with risk factors for HCC should undergo screening every six months using ultrasound of the liver and by undergoing a liver tumour blood test (alpha-fetoprotein).
There are now several curative treatment modalities for HCC in selected patients. These include radiofrequency ablation (RFA), surgery and liver transplantation. There are also a host of other treatment modalities used in more advanced stages of HCC including transarterial chemoembolisation (TACE), Yttrium-90 radioembolisation (Y-90), stereotactic body radiation therapy and molecular targeted therapies such as sorafenib, regorafenib and levantinib as well as immunotherapy. In addition, there are numerous clinical trials available for patients with advanced stage HCC.