Liver cancer is divided into two main types:

  • Primary liver cancer, which means cancer that starts in the liver, also known as hepatocellular carcinoma, or HCC cancer.
  • Secondary liver cancer, meaning cancer that spreads to the liver from another part of the body.

There are estimated to be more than 2,500 new cases of primary cancer of the liver and 70,000 new cases of secondary cancer of the liver every year in the UK.

Our liver specialist team at the Royal Free Hospital provides a range of liver cancer treatment, such as:

  • resection: removing the part of the liver that is affected by the cancer
  • liver transplant: removing the whole liver and replacing it with a healthy one
  • radiofrequency ablation (RFA): using heat to kill the cancerous cells

We work together with other specialist teams at the Royal Free London to provide you with the best possible care. 

Patients are referred to our hepatocellular carcinoma (HCC) department if they have symptoms that could be caused by primary liver cancer. 


It is important that any cancer is diagnosed as early as possible so that it can be treated effectively. The following tests are used for diagnosing HCC:

  • contrast enhanced (magnetic resonance imaging) MRI or CT (computerised tomography) 
  • liver
  • biopsy
  • blood test (alpha-fetoprotein serum)

If a HCC is diagnosed during these initial tests, further tests are then carried out to ‘stage’ the cancer. This means establishing the size, type and whether there is any spread to other parts of your body. A CT chest scan is used to stage the cancer.

Most HCC occurs in patients with chronic liver disease. Liver function tests will be carried out to investigate the cause of the liver disease, if it is not already known. 

Treatment planning

The management of HCC depends on the stage of disease at diagnosis, the patient’s liver function and their fitness to undergo treatment. 

Once diagnostic and staging tests are completed, every patient is discussed at a multidisciplinary team meeting. This is a meeting of the surgeons, oncologists, hepatologists, radiologists, histopathologists and clinical nurse specialists. 

All relevant information is discussed and options for treatment are recommended on an individual basis. 

Patients do not attend this meeting, but you will have an appointment with the appropriate team member after the meeting to discuss the outcome and plan. 

Treatment options

All treatment plans offered will be tailored to your cancer and your fitness to undergo treatment. They will be fully discussed with you so that you understand why the treatment is being offered. 

The Royal Free Hospital is one of the few hospitals in the UK that can offer all treatment options to patients with HCC, including: 

  • transplantation (one of only seven centres in the UK to offer this)
  • surgical resection
  • thermal ablation
  • transarterial embolisation
  • selective internal radiation therapy
  • stereotactic body radiation therapy
  • systemic therapy 
  • clinical trials

Clinical trials

As a major centre for HCC, we undertake research and perform clinical trials to improve outcomes for patients with HCC. 

You may be invited to take part in research and will be provided with detailed information so you can choose whether you want to participate or not. 

Not all patients are suitable for trials or are willing to take part in research. But all patients will be given the opportunity to contribute to research and you should feel free to ask if there are any research options for you.