Liver cancer: what are the usual steps from diagnosis to starting treatment?
Liver cancer can be diagnosed by imaging alone (for example contrast CT or MRI), and the treatment strategy depends on the stage; most patients are at a late stage when diagnosed, and treatment is mainly palliative; for patients with early disease that can be operated on, surgery is the main curative treatment, and some selected patients may also have a chance of cure through liver transplantation; a multidisciplinary team approach to management decisions and coordination is important (Hong Kong Cancer Strategy 2019, Annex One, July 2019).
Financial support and welfare: what to do first?
A first step is to ask the treating doctor or a nurse for a referral to a medical social worker; patients and their families can also apply for medical social services directly to the medical social services unit stationed at a public hospital or specialist clinic, and health care staff at the hospital or clinic, other government departments or welfare agencies can refer a case as well (Social Welfare Department, August 2023).
Medical social workers provide counselling on the emotional, family and caregiving problems that illness brings, help patients plan their discharge, and provide financial or material assistance, for example medical fee waivers, applications for fund subsidies, and referrals for patients and their families to apply for social security allowances (Social Welfare Department, May 2023). For the help available, see Cancer financial support in Hong Kong.
Compiled by this site: when you see the doctor, you can also ask when and where the next follow-up or test will be, and which doctor or case manager to contact; the Hospital Authority has cancer case managers who coordinate the diagnosis and treatment process for cancer patients (government paper submitted to the Legislative Council, July 2025). If you are thinking of moving hospitals or seeing another doctor, you can get the referral letter, test reports and images together first; for the documents needed, see Moving from public to private, or private to public.
What are the usual steps for liver cancer from diagnosis to starting treatment?
Compiled by this site: based on the sources in the table below, the general steps for liver cancer from first finding a problem to starting treatment are as follows; the order of the steps and the time they take vary from person to person.
The order of tests and treatment for an individual patient is decided by the treating doctor according to the patient's condition.
| Step | What official sources say |
|---|---|
| Finding something abnormal | Early liver cancer usually has no symptoms, and people with symptoms such as unexplained weight loss, yellowing of the skin and the whites of the eyes, abdominal pain or abdominal swelling should seek medical attention as early as possible (Hong Kong Cancer Strategy 2019, Annex One, July 2019); routine liver cancer screening is not recommended for people without symptoms who are at average risk, and people with chronic hepatitis B or C and people with cirrhosis are at higher risk and should seek a doctor's advice on regular surveillance with ultrasound and alpha-fetoprotein every 6 months (Hong Kong Cancer Expert Working Group on Cancer Prevention and Screening, June 2025) |
| Tests and diagnosis | Liver cancer can be diagnosed by imaging alone (for example contrast CT or MRI) (Hong Kong Cancer Strategy 2019, Annex One, July 2019); the tests listed by the Cancer Online Resource Hub include blood alpha-fetoprotein, abdominal ultrasound, CT, MRI and biopsy |
| Deciding on treatment | The treatment strategy depends on the stage, and a multidisciplinary team approach to management decisions and coordination is important (Hong Kong Cancer Strategy 2019, Annex One, July 2019); the Hospital Authority has multidisciplinary team clinics or meetings for some cancer types (Hong Kong Cancer Strategy 2019, July 2019) |
| Starting treatment | For patients with early disease that can be operated on, surgery is the main curative treatment, and some selected patients may also have a chance of cure through liver transplantation; for most patients, treatment is mainly palliative and is provided by different specialties, for example transarterial chemoembolisation, radiofrequency ablation, and drug treatments such as targeted therapy and immunotherapy (Hong Kong Cancer Strategy 2019, Annex One, July 2019) |
| Coordination | The Hospital Authority currently has more than 40 cancer case managers, who coordinate and improve the management process for patients with cancers such as breast cancer, colorectal cancer, gynaecological cancers, blood cancers, musculoskeletal tumours and urological cancers (Government paper to the Legislative Council, July 2025) |
Why does liver cancer need a multidisciplinary team?
The various treatments for liver cancer are provided by different specialties, and a multidisciplinary team approach to management decisions and coordination is important; because most patients develop symptoms at a late stage, palliative care is equally important in liver cancer care (Hong Kong Cancer Strategy 2019, Annex One, July 2019). Capacity and expertise in oncology, diagnostic and interventional radiology, liver surgery and liver transplantation should be strengthened (Hong Kong Cancer Strategy 2019, Annex One, July 2019).
After diagnosis the doctor will recommend treatment according to the patient's condition; the treatments listed on the page include surgical resection, transarterial chemoembolisation, alcohol injection, radiofrequency ablation, liver transplantation, selective internal radiation therapy, stereotactic ablative radiotherapy, targeted therapy and immunotherapy (Cancer Online Resource Hub, April 2026).
How are Hospital Authority cancer services arranged?
Most Hospital Authority cancer services (for example diagnostic radiology, pathology, endoscopy, surgery, radiotherapy, chemotherapy and palliative care) are provided mainly in regional hospitals or cancer centres (Hong Kong Cancer Strategy 2019, July 2019). The Hospital Authority has multidisciplinary team clinics or meetings for some cancer types; Hospital Authority cancer services will take a patient-centred multidisciplinary team approach, with teams of doctors, nurses, medical social workers, clinical psychologists, radiation therapists, physiotherapists, occupational therapists, dietitians and other professionals caring for the social and psychological needs of patients and their families (Hong Kong Cancer Strategy 2019, July 2019).
Which specialties are involved? How do I look up fees and financial support?
For the specialties related to liver cancer, see How to choose a liver cancer doctor; for the difference between Clinical Oncology and Medical Oncology, see What is the difference between Clinical Oncology and Medical Oncology?.
For ultrasound, CT and MRI fees, see Ultrasound fees compared, CT fees compared and MRI fees compared; for public, private and financial support compared, see Cancer treatment costs in Hong Kong.
What can I ask the doctor?
Compiled by this site: examples of questions you can ask: What type of cancer has been diagnosed, and what stage is it? Which tests are needed next, and who will arrange them? Will the treatment plan be discussed by several specialties together? Which doctor or case manager will be my contact? What will it cost, and what financial support is available?
For how a family member can help at appointments, see What to prepare for a first doctor's visit; for the documents needed to transfer between hospitals, see Moving from public to private, or private to public; for a second opinion, see How to prepare for a second opinion.
For a fuller checklist of what to ask your doctor and care team after a diagnosis, see what to ask your cancer doctor.
Frequently asked questions
How is liver cancer diagnosed?
Liver cancer can be diagnosed by imaging alone (for example contrast CT or MRI), and the treatment strategy depends on the stage (Hong Kong Cancer Strategy 2019, Annex One, July 2019); the tests listed by the Cancer Online Resource Hub include blood alpha-fetoprotein, abdominal ultrasound, CT, MRI and biopsy.
Why does liver cancer need a multidisciplinary team?
For patients with early disease that can be operated on, surgery is the main curative treatment, and liver transplantation can be considered for some selected patients; for most patients, treatment is mainly palliative and is provided by different specialties, for example transarterial chemoembolisation, radiofrequency ablation and drug treatment, so a multidisciplinary team approach to management decisions and coordination is important (Hong Kong Cancer Strategy 2019, Annex One, July 2019).
Does the cancer case manager service cover liver cancer?
At that time, the Hospital Authority's cancer case manager service covered only breast cancer and colorectal cancer (Hong Kong Cancer Strategy 2019, July 2019); the Hospital Authority currently has more than 40 cancer case managers, who coordinate the management process for patients with cancers such as breast cancer, colorectal cancer, gynaecological cancers, blood cancers, musculoskeletal tumours and urological cancers, and the list does not name liver cancer separately (Government paper to the Legislative Council, July 2025).