Primary and Metastatic Liver Cancer

Piedmont Oncology provides patient-centered and personalized care to every patient.

There are two broad categories of liver cancer — tumors originating in the liver itself (primary liver cancer) and cancer that has spread to the liver from other body parts (secondary or metastatic liver cancer).


Primary Liver Cancer

Over the last 20 years, primary liver cancer has become much more common in the United States. More than 24,000 new cases are diagnosed every year.


Common causes of Liver Cancer include:

  • Hepatitis B — Most commonly acquired through sexual contact, intravenous drug use or, in some countries, mother-to-baby transmission

  • Hepatitis C — Most commonly acquired through needle sticks, intravenous drug use, or blood transfusions before 1992

  • Alcoholic liver disease

  • Non-alcoholic fatty liver disease usually associated with obesity


Less common causes include:

  • Hemochromatosis (iron overload of the liver)

  • Wilson disease (copper overload of the liver)

  • Autoimmune liver diseases

  • Alpha-1-antitrypsin deficiency


Unfortunately, patients with primary liver cancer often do not experience symptoms until the disease is advanced. When symptoms do appear, they can include:

  • Jaundice

  • Loss of appetite and weight loss

  • Upper abdominal pain

  • Nausea and vomiting

  • Fatigue and weakness.

  • Abdominal distention caused by ascites (fluid accumulation in the abdomen).


Metastatic Liver Cancer

The most common type of liver cancer has spread into the liver from somewhere else in the body, usually the colon. Other sources are cancers of the breast, lungs, stomach and pancreas, and neuroendocrine tumors.

Many patients with metastatic liver cancer typically do not experience any symptoms. However, symptoms can include jaundice and other common manifestations of liver disease – like ascites/abdominal fullness, fatigue, weight loss and weakness.



Your care providers at Piedmont will use a variety of tests to diagnose and determine the extent of the disease, including:

  • CT and MRI imaging may be used to determine the number, size and location of liver tumors and to find out if the cancer has spread outside the liver.

  • Blood tests are used to evaluate the overall health of a patient’s liver and also to detect proteins that can indicate the presence of liver cancer.

  • A needle biopsy may be performed to obtain a small sample of liver tissue to test for the presence of liver cancer cells. Local anesthesia is used to numb the skin when a needle is inserted through the skin. Ultrasound or CT imaging guides the biopsy of the liver.



We take a team approach to caring for patients with liver cancer. Our multidisciplinary team of doctors, nurses and navigators work together to provide personalized treatment for each patient. Treatment planning conferences are used to provide patients with treatment recommendations.

Treatment options include:

  • Transplant

  • Surgery

  • Tumor ablation

  • Radiation therapy

  • Chemotherapy



Piedmont has some of the country's most experienced liver cancer surgeons, performing a high volume of surgeries each year. Our multidisciplinary approach is unique because all specialists are involved in your care. In addition, our dedicated coordinator facilitates all aspects of care within one clinic, which provides patients with an expedited evaluation and a full continuum of care.


Our team includes:

  • Transplant surgeons

  • HPB surgeons

  • Surgical oncologists

  • Diagnostic and interventional radiologists

  • Radiation and medical oncologists

  • Medical oncologists

Piedmont’s full range of cancer support services and programs are available to enhance your care experience, help lessen anxiety, answer questions, and empower and guide you through every step of your cancer journey. Services include clinical trials, cancer rehabilitation, patient navigation, genetics counseling, nutrition counseling, social services and financial assistance. Cancer wellness programs include education, nutrition workshops, exercise, art therapy, support groups and more.


Surgical Team


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