Hepatobiliary cancers

The group with the widest range of treatment options — and the one where the decision genuinely requires a multidisciplinary discussion.

What it is

This group covers hepatocellular carcinoma, arising in the liver itself, and cholangiocarcinoma of the bile ducts, together with gallbladder cancer.

Hepatocellular carcinoma usually develops on a background of chronic liver disease — viral hepatitis, cirrhosis or fatty liver. This means a large share of those at risk is already known and can be monitored.

Diagnosis and surveillance

In people with cirrhosis or chronic hepatitis, regular ultrasound surveillance allows detection at a stage where more treatment options exist. CT or MRI imaging is often diagnostic on its own in hepatocellular carcinoma.

Treatment options

The range is unusually broad and depends on the tumour and on liver function alike: surgical resection, transplantation, local techniques such as ablation and chemoembolisation, targeted therapies and immunotherapy combinations.

Here, perhaps more than in any other group, the decision genuinely requires a multidisciplinary discussion with a hepatologist and an interventional radiologist at the same table.

How this is approached at the practice

Every case is discussed in a multidisciplinary team meeting (MDT) — surgeon, radiation oncologist, pathologist, radiologist and, where needed, psycho-oncologist and dietitian. The treatment decision is not made by one doctor alone.

Before any treatment is proposed, the tumour undergoes full molecular and immunohistochemical characterisation, so the choice targets your specific biology rather than a generic protocol. Every alternative is presented with its trade-offs, and a second opinion is treated as an ally.

Biomarkers tested

Molecular and immunohistochemical characterisation is done before treatment is chosen, so the decision rests on this particular tumour’s biology.

Frequently asked questions

Can liver cancer be prevented?

To a significant extent, yes. Hepatitis B vaccination, treating hepatitis C, limiting alcohol and managing fatty liver disease all substantially reduce risk.