If your HCC comes back (recurrence)

Unfortunately, HCC can come back after treatment. Your doctor will monitor you for signs that the cancer has returned with regular check-ups .

HCC may come back within the liver or elsewhere in the body.

Recurrence in the liver

If HCC comes back after surgery to remove it, this is most likely to be within the liver. If this happens, your doctor may suggest

• more surgery to remove the cancer
• a liver transplant
• treatment to destroy the new liver tumours (ablation)
• TACE – localised chemo into the liver together with blocking the cancer’s blood supply
• TARE – localised radiotherapy into the liver, together with blocking the cancer’s blood supply

There is information on all these in the page on treatment for early stage HCC (0-A).

Whether you can have treatment to remove cancer that has come back in the liver depends on a number of factors, including:

• where the cancer is and how much there is
• how well you are overall
• how well your liver is working

Your specialist will talk through all the options with you, so you can decide together on the best course of action.

Cancer that comes back outside the liver

HCC can sometimes come back in other parts of the body. Doctors call this secondary cancer or metastatic cancer. The most likely areas that HCC travels to are the bones, lungs and adrenal glands.

If your cancer has spread somewhere else, local treatment to the liver won’t help. If you are well enough, your doctor is most likely to suggest a ‘systemic’ therapy. That means treatment with drugs that circulate through the body in the bloodstream and will reach cancer cells wherever they are.

Your doctor is most likely to suggest treatment with

• A combination of drugs called bevacizumab and atezolizumab
• A drug called sorafenib
• A drug called lenvatinib

There is information on all these in the page on treatment for advanced HCC (stage C).

If you are not well enough for this type of treatment, your doctor will focus on controlling any symptoms you have and helping you to feel better. There is more about controlling symptoms of advanced cancer  in the general liver cancer treatment section.