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The Results Are In!

For liver cancer, specifically hepatocellular carcinoma (HCC),
education and research are helping contribute to new understanding
and renewed hope. And that's information you deserve to know.

Our Goal...

is to highlight the perspectives of caregivers supporting patients with HCC
and provide foundational information about the disease as well as
additional resources.

Wherever you are in your personal, unique experience as a caregiver of a
loved one with HCC, or as an HCC patient, this information is intended to
help inform and guide you.


Brought to you by:
Bristol-Myers Squibb

In collaboration with:
Blue Faery - The Adrienne Wilson Liver Cancer Association
Blue Faery was compensated for its time spent as an advisor
on the Liver Cancer Outlook Survey and related content.

About Liver Cancer & HCC

Facts & Figures

  • The incidence of liver cancer in the U.S. has more than tripled since 1980
    • Primary liver cancer is cancer that starts in the liver
    • Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer
  • In 2017, it is estimated that there will be approximately 41,000 new diagnoses of liver
    and intrahepatic bile duct cancer, and 29,000 deaths from the disease in the U.S.
Hepatocelluar cancer in the U.S Hepatocelluar cancer in the U.S

Risk Factors

Common liver cancer risk factors include, but are not limited to:

  • Gender
  • Race/Ethnicity
  • Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections
  • Cirrhosis
  • Heavy alcohol use
  • Obesity
  • Type 2 diabetes
  • Certain genetic syndromes
  • Non-alcoholic steatohepatitis (NASH)


Signs and symptoms of liver cancer include, but are not limited to:

  • Unintended weight loss
  • Loss of appetite
  • Nausea or vomiting
  • Enlarged liver and/or spleen
  • Abdominal pain and/or swelling
  • Itching
  • Yellowing of the skin and eyes

Tests for liver cancer include, but are not limited to:

  • Medical history and physical exam
  • Certain imaging tests
  • Laparoscopy
  • Biopsy
  • Certain lab tests


There are several staging systems for liver cancer, and not all doctors use the same system. The Barcelona Clinic Liver Cancer (BCLC) system, for example, uses very early, early, intermediate, advanced, and terminal stage classifications. The TNM system (below) is a common staging system that evaluates tumor size and number, lymph nodes, and metastases (if the cancer has spread).

Stage I

  • There is a single tumor (any size) that has not grown into any blood vessels. The cancer has not spread to nearby lymph nodes or distant sites.

Stage II

  • Either there is a single tumor (any size) that has grown into blood vessels, or there are several tumors, all of which are less than 5 cm (2 inches) across. The cancer has not spread to nearby lymph nodes or distant sites.

Stage III

  • Stage IIIA There is more than one tumor, and at least one is larger than 5 cm (2 inches) across. The cancer has not spread to nearby lymph nodes or distant sites.
  • Stage IIIB At least one tumor is growing into a branch of a major vein of the liver (portal vein or hepatic vein). The cancer has not spread to nearby lymph nodes or distant sites.
  • Stage IIIC A tumor is growing into a nearby organ (other than the gallbladder), or a tumor has grown into the outer covering of the liver. The cancer has not spread to nearby lymph nodes or distant sites.

Stage IV

  • Stage IVA Tumors in the liver can be any size or number and they may have grown into blood vessels or nearby organs. The cancer has spread to nearby lymph nodes. The cancer has not spread to distant sites.
  • Stage IVB The cancer has spread to other parts of the body (tumors can be any size or number, and nearby lymph nodes may or may not be involved).

Current Treatment Options


This involves an operation to remove tumor tissue, or a liver transplant.

Typical goals of surgery are to:

  • Remove tumors that haven’t spread yet
  • Replace the liver with a liver without cancer

Tumor Ablation

This involves destroying tumors without removing them, by heating them,
freezing them, running high-energy radio waves through them, or injecting them
with concentrated alcohol.

Typical goals of ablation are to:

  • Kill cancer cells without removing the tumor
  • Treat patients waiting for a liver transplant

Tumor Embolization

This involves the injection of certain substances to try to block or reduce
the blood flow to cancer cells in order to kill these cells. These procedures may reduce
the blood supply to some of the normal liver cells.

Typically, the goal of embolization is to kill cancer cells by blocking or reducing blood flow.


This involves the use of certain drugs to kill rapidly dividing cells.

When your oncologist decides on chemotherapy as a treatment option, it is given
with the intent to kill cancer cells, because cancer cells grow and divide rapidly.
These drugs do not have the ability to tell healthy cells from cancer cells.

Typical goals of chemotherapy are to:

  • Shrink tumors
  • Kill cancer that has come back or spread


This works by damaging cell DNA (the blueprint of the cell) in an attempt to
destroy cancer cells. Sometimes normal tissue around the area of the tumor is
damaged during radiation therapy.

Typically, the goal of radiation therapy is to shrink tumors.

Targeted   Drug   Therapy

Targeted drug therapy works differently from standard chemotherapy. Targeted
drug therapy can specifically target certain changes in cells that may cause
different types of cancers.

Typically, the goal of targeted therapy is to kill cancer cells.


Immuno-oncology uses your body’s own immune system to help fight cancer. It includes
treatments known as immunotherapies that work with the immune
system in different ways.

Typically, the goal of immunotherapy is to activate cells in your immune system
that can attack cancer cells. While doing so they may also affect other cells in
your body.

Liver Cancer Outlook Survey

About the Liver Cancer Outlook Survey

The Liver Cancer Outlook survey was conducted to gauge the knowledge, feelings, and needs of liver cancer caregivers. Findings shed light on liver cancer caregivers’ desire for resources and information and their feelings towards their loved one’s disease and future.


The Liver Cancer Outlook survey was conducted online by Bryter on behalf of Bristol-Myers Squibb between July 24 and August 31, 2017 in the U.S., of 90 caregivers of people living with early stage (n=30) and advanced stage (n=60) liver cancer. Only caregivers of patients with active disease were included in the survey. Upon completion of the survey, the data has been tabulated and significance tested at the 95% confidence interval. Bryter abides by the rules and guidelines of the Market Research Society. A full methodology is available upon request.

*Where noted, the below results are reflective of 60 caregivers of advanced stage liver cancer patients.

Limited knowledge and misperceptions of liver cancer
were common prior to diagnosis


of caregivers* believe they were
aware of but not knowledgeable
about liver cancer prior to their
loved one's diagnosis


of caregivers* believed heavy alcohol use was the most common risk factor before their loved one was diagnosed with liver cancer

Caregivers* place high importance and interest in liver cancer treatment options and areas of research


of caregivers* indicated that liver cancer research is important to them.

Caregivers* are interested in learning more about these treatment options/areas of research:

Cancer research areas

There is a need for more information on
liver cancer treatment options


of caregivers* wish they knew
more about the latest
developments in liver cancer
treatment or areas of research


of caregivers* believe more
information needs to be available
about different types of liver cancer treatments or areas of research

The possibility of additional treatment options brings hope to many caregivers*


of caregivers* feel hopeful about having additional treatment options become available for liver cancer

Caregivers want more public awareness and attention about the seriousness of liver cancer


of caregivers think liver cancer doesn't get as much attention as other cancers


of caregivers wish there was more public awareness of the seriousness of a liver cancer diagnosis

Support and advocacy are critical


of caregivers report there is
a stigma (ie, shame) associated with liver cancer


of caregivers agree that negative perceptions about liver cancer make it difficult to find support


of caregivers report that stigma (ie, shame) prevented their loved one from actively seeking support for their liver cancer


of caregivers believe liver cancer advocacy organizations provide a much-needed service to patients and caregivers

but only


of caregivers are familiar with at
least one liver cancer-focused
advocacy organization

*These results are reflective of 60 caregivers of advanced stage liver cancer patients.

Other Resources

Blue Faery - The Adrienne Wilson Liver Cancer Association Blue Faery - The Adrienne Wilson Liver Cancer Association

Blue Faery is dedicated to preventing, treating and curing primary liver cancer, specifically HCC, through research, education and advocacy.


CancerCare is the leading national organization dedicated to providing free, professional support services including counseling, support groups, educational workshops, publications and financial assistance to anyone affected by cancer. All CancerCare services are provided by oncology social workers and world-leading cancer experts.

Cancer Support Community

The Cancer Support Community (CSC) provides social and emotional support to all those impacted by cancer. Through providing service in its 170 locations, advancing research through the Research and Training Institute, and elevating the patient voice via the Cancer Policy Institute, CSC is committed to ensuring that all patients have access to
high-quality, comprehensive, evidence-based cancer care.


This is not a complete list of resources and is provided as a convenience. Bristol-Myers Squibb does not endorse and is not responsible for information provided by third party organizations.