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Decisions about your treatment

Find out about how your doctor decides which treatment you need and the types of treatment. 

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Treatment overview

The main treatments are:

  • surgery to remove the cancer (resection)
  • liver transplant
  • biological therapy
  • chemotherapy
  • chemotherapy directly into the liver (chemoembolisation)
  • radiofrequency ablation (RFA)
  • radiotherapy

Treatment depending on stage

If surgery is possible

Surgery is the best treatment if the cancer hasn't spread.

Surgery to remove the cancer

Surgery to remove the cancer might be an option if your cancer is only in your liver and the rest of your liver is healthy. Your surgeon can remove anything from a small wedge to up to 80% of your liver. You are more likely to have this type of surgery if you don't have cirrhosis. 

Fibrolamellar hepatocellular cancer develops more often in people who do not have cirrhosis. It is often possible to remove these cancers with surgery.

Liver transplant

People who have cirrhosis usually can't have a liver resection because the rest of the liver isn't healthy enough. So, your specialist may suggest a liver transplant if you have cirrhosis of the liver and you have: 

  • a single liver tumour that is 5cm across or less
  • up to 5 tumours that are all 3cm across or less
  • a single tumour 5 to 7cm in size that has not grown for at least 6 months

Finding a donor is difficult and can take months. You may need other treatments while you are waiting for the transplant to control the growth of the cancer. Severe cirrhosis of the liver can mean you aren't fit enough for a transplant. Assessing your fitness will be part of the process of deciding whether you can have the operation. It is a very big operation and if you are already ill you may not survive it.  


Children who have a type of liver cancer called hepatoblastoma are more likely to have a combination of surgery to remove the tumour and chemotherapy. 

If surgery is not possible

Surgery may not be possible because:

  • the tumour is too large
  • the tumour is in a part of the liver that makes it hard to remove, such as being near a blood vessel
  • you have several tumours spread through the liver
  • you aren't well enough for surgery

You might have more local treatments to the liver including:

  • chemoembolisation
  • radiofrequency ablation (RFA)
  • alcohol (ethanol) injections into the tumour
  • radioembolisation 
  • microwave ablation

You might also have: 

  • biological therapy such as sorafenib
  • chemotherapy
  • radiotherapy

Advanced cancer

Advanced liver cancer means that the cancer has spread beyond the liver to other parts of your body. Treatment aims to help you live longer and to maintain a good quality of life by controlling the growth of your cancer and treating symptoms. 

You might have: 

  • biological therapy such as sorafenib
  • chemotherapy
  • radiotherapy

Your doctor may offer treatment to help control symptoms such as pain, breathing problems, weight loss and jaundice. Sometimes people with liver cancer and cirrhosis may get a build up of fluid in the abdomen (ascites). Your doctor may drain some of the fluid away or prescribe water tablets (diuretics). 

Tell your doctor and nurses about any symptoms you have so they can treat them. 

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Last reviewed: 
09 Feb 2015
  • DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology (Cancer: Principles & Practice (10th Revised edition)
    VT DeVita (Ed) and TS Lawrence (Ed) 
    Lippincott Williams and Wilkins, 2014

  • Hepatocellular Carcinoma: ESMO-ESDO Clinical Practice Guidelines
    C Verslype, O Rosmorduc and P Rougier
    Ann Oncol 2012; 23 (Suppl 7): vii41-vii48.

  • Hepatoma - management 
    British Medical Journal (BMJ) Best Practice Online. September 2016

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