The liver is located in the right abdomen, above the stomach. It is the largest internal organ in the human body, and it performs several important functions. One of its main jobs is to produce bile, a thick fluid that helps the body digest fats. The liver also removes toxins from the bloodstream, processes and stores nutrients absorbed from the intestines, and produces clotting factors that help stop bleeding from a cut or injury.

There are two broad categories of liver cancer.

  1. Primary liver cancer: Tumors that originate in the liver itself
  2. Secondary, or metastatic liver cancer: Cancer that has spread to the liver from other parts of the body

The Froedtert & MCW liver cancer team is a group of specialists who have extensive experience in treating patients with challenging liver malignancies. Because they focus on liver cancer, they understand the many nuances of the disease, including diagnosis, and are up-to-date on the most current and advanced liver cancer treatment options.

Every patient in the program receives a multidisciplinary treatment plan. Our team includes surgical oncologists, medical oncologists, radiation oncologists, interventional radiologists, hepatologists, transplant surgeons, and specialized diagnostic radiologists and pathologists. These experts meet weekly to discuss patients and ensure every individual is receiving the most effective care.

Committed to clinical excellence, our team members provide the full range of standard and innovative therapies for liver cancer. Their dedication to research and education ensures patients benefit from the latest knowledge of liver cancer treatment.

Liver Cancer Symptoms

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

  • Jaundice — The first, and sometimes only, sign of a liver tumor is a yellow discoloration of the skin and whites of the eyes caused by high levels of bile pigment (bilirubin) in the blood.
  • 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).

Primary Liver Cancer

More than 24,000 new cases of primary liver cancer are diagnosed in the U.S. every year. Most primary liver tumors are the result of chronic liver disease.

  • Most common
    • 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
  • Less common
    • Hemochromatosis (iron overload of the liver)
    • Wilson disease (copper overload of the liver)
    • Autoimmune liver diseases
      • Primary biliary cirrhosis (PBC)
      • Primary sclerosing cholangitis (PSC)
      • Autoimmune hepatitis (AIH)
    • Alpha-1-antitrypsin deficiency

Over the last 20 years, primary liver cancer has become much more common in the United States, mainly because of the spread of chronic viral hepatitis. Men are more than twice as likely as women to develop this cancer.

Because the liver is made up of different types of cells, several types of cancer can form within the liver. The most common forms of primary liver cancer are Hepatocellular Carcinoma (HCC) and Cholangiocarcinoma.

Hepatocellular Carcinoma  or Hepatoma

A primary cancer that begins in the hepatocytes, the cells that make up the main functional part of the liver. Approximately three out of four primary liver cancers are hepatocellular carcinoma (HCC), sometimes referred to as hepatoma. Some hepatocellular carcinomas begin as a single tumor that grows and later spreads to other parts of the liver. In other cases, hepatomas begin as many small tumors scattered throughout the organ. This cancer may spread elsewhere in the body.


Cholangiocarcinoma is a cancer that starts in the bile ducts — the tubes that connect the liver and the gallbladder to the small intestine. About 10 to 20 percent of primary liver cancers are cholangiocarcinomas. These tumors are classified as:

  • Intrahepatic cholangiocarcinoma — tumors that arise from the bile duct system that is inside the liver.
  • Extrahepatic cholangiocarcinoma — tumors that arise in the part of the biliary system outside the liver. About 90 percent of bile duct tumors fall in this category.

There are also several kinds of non-cancerous tumors and that can arise in the liver, including hemangiomas, adenomas and cysts. Some of these carry a risk of becoming a cancer.

Metastatic Liver Cancer

Most liver tumors are cancers that have spread (or metastasized) to the liver from other parts of the body. The most common source of liver metastases is colorectal cancer. Other frequent sources are cancers of the breast, lungs, stomach and pancreas, and neuroendocrine tumors.

Patients with metastatic liver cancer frequently do not experience any symptoms related to their liver tumor. When symptoms do arise, they can include jaundice and other common indications of liver disease.

Liver Cancer Diagnosis

Physicians use a variety of tests to diagnose liver cancer and determine the extent of a patient’s disease.

  • 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.
  • 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 where a needle is inserted through the skin. Ultrasound or CT imaging guides the biopsy of the liver.

Learn more about Froedtert & MCW advanced liver cancer diagnostic techniques.

Clinical Trials for Liver Cancer

The liver cancer team at Froedtert & the Medical College of Wisconsin is actively involved in national research programs offering patients access to new clinical treatment protocols.

Managing Liver Disease

Many patients with liver cancer may also have underlying liver disease, such as cirrhosis. Our liver cancer specialists include physicians in the Gastroenterology/Hepatology Program who specialize in managing liver disease and preventing liver cancer. In addition, our nationally known Palliative Care Program provides support and services for patients with complex symptoms.

Liver Cancer Questions and Answers

A liver cancer diagnosis can be extremely overwhelming. To help you get through this difficult time, we've created liver cancer video answers to common questions you may have.

Liver Cancer Second Opinion Program

When you are diagnosed with any serious disease, it makes sense to get a second opinion. Our liver cancer team will confirm your diagnosis, talk to you about your alternatives and make sure you are receiving the most effective care for your specific condition.

Our physicians will talk about concerns, reexamine the diagnosis and take a fresh look at all options. They are able to offer a full range of the most sophisticated treatments available:

Learn more about our Cancer Second Opinion program.

Virtual Visits Are Available

Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.

Recognized as High Performing by U.S. News & World Report

Froedtert Hospital is recognized by U.S. News & World Report as high performing in three adult specialties and 16 procedures and conditions, including cancer and gastroenterology and GI surgery.