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For some people with liver cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but you might find it hard not to worry about cancer coming back. This is a very common concern if you have had cancer.

For many people with liver cancer, the cancer may never go away completely, or it might come back in another part of the body. These people may still get regular treatment to help keep the cancer under control for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.

Regardless of your situation, there are steps you can take to help you live well, both physically and emotionally.

Follow-up care

Whether or not you’ve completed treatment, your cancer care team will want to watch you closely. It is very important to go to all your appointments.

During these visits, your doctors will ask questions about any problems you are having. They will also examine you and might order blood tests, such as alpha-fetoprotein (AFP) and liver function tests (LFTs). Imaging tests, such as ultrasound, CT, or MRI scans might also be ordered. These tests will help look for signs of cancer or side effects of treatment.

Some treatment side effects might last a long time or might not even show up until years later. Your doctor visits are a good time to ask questions and talk about any changes or problems you notice or concerns you have.

It’s important to tell your health care team about any new symptoms or problems, because they could be caused by the cancer coming back, by a new disease, or a second cancer.

Doctor visits and tests

If you have been treated with surgery, a liver transplant, or ablation/embolization and have no signs of cancer remaining, most doctors recommend follow-up with imaging tests and blood tests every 3 to 6 months for the first 2 years, then every 6 to 12 months.

Follow-up after liver transplant: A liver transplant can both treat the cancer and replace a damaged liver. But this is a major procedure that requires very close follow-up after treatment. Along with monitoring your recovery from surgery and looking for possible signs of cancer, your medical team will watch you carefully to make sure your body is not rejecting the new liver.

You will need to take medicines to weaken your immune system to help prevent rejection. These medicines can have their own side effects, including making you more likely to get infections. They might also increase your risk of getting another type of cancer later.

Your transplant team should tell you what to watch for in terms of symptoms and side effects and when you need to contact them. It is very important to follow their instructions closely.

Anti-viral treatment: If you have hepatitis B or C that may have contributed to your liver cancer, your doctor may want to put you on medicines to treat or help control the infection.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan. This plan might include:

• A schedule for follow-up exams and other tests you might need in the future, such as tests to look for long-term health effects from your cancer or its treatment
• A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
• Suggestions for things you can do that might improve your health, including possibly lowering your chances of the cancer coming back

Keeping health insurance and copies of your medical records

Even if you've finished treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point, you might find yourself seeing a new doctor who does not know about your medical history. It’s important to have copies of (or have access to) your medical records so you can give your new doctor the details of your diagnosis and treatment. You can also ask the cancer treatment center to send your records to your new doctor.

Can I lower my risk of liver cancer progressing or coming back?

If you have (or have had) liver cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. While it’s not yet clear if there are things you can do that will help for sure, there are some things that might.

Both tobacco and alcohol use have clearly been linked to an increased risk of liver cancer, so not smoking and avoiding alcohol may help lower your risk. We don’t know for sure if this will help, but we do know that it can help improve your overall health in many ways, including lowering your risk of developing other types of cancer. If you want to quit smoking and need help, call the American Cancer Society at 1-800-227-2345.

Other healthy behaviors such as eating well, being active, and staying at a healthy weight might help as well, although more research is needed to be sure. These types of changes can have positive effects on your health that can go beyond your risk of liver cancer or other cancers.

If you have hepatitis B or hepatitis C, getting treated for the infection may help reduce any further damage to your liver. This might help lower your risk of developing another liver cancer later on.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of liver cancer progressing or coming back. This doesn’t mean that no supplements can help, but it’s important to know that so far none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States. They don’t have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do.

If you’re thinking about taking any type of nutritional supplement, talk to your cancer care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If your cancer does come back (recur) at some point, your treatment options will depend on where the cancer is, what treatments you’ve had before, and your health.

Treatment options might include surgery, ablation, embolization, radiation therapy, immunotherapy, targeted therapy, chemotherapy, or some combination of these. See Treatment of Liver Cancer, By Stage.

For more general information on cancer recurrence, see Understanding Recurrence.

Second cancers after treatment

People who’ve had cancer can be affected by other health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer.

Unfortunately, being treated for liver cancer doesn’t mean you can’t get another cancer. If you’ve had liver cancer, you can still get the same types of cancers other people get. In fact, you might be at a higher risk of certain types of cancer.

While there isn’t a lot of data on the types of second cancers that a person who has survived liver cancer can get, what is known suggests an increased risk of:

• Oral cavity cancer
• Ovarian cancer
• Kidney cancer
• Thyroid cancer

For people diagnosed with liver cancer before age 50, there appears to be an increased risk of these second cancers:

• Colon cancer
• Ovarian cancer
• Bladder cancer
• Acute Myeloid Leukemia (AML)

Exactly how high the risk is of developing these second cancers is not known at this time.

Can I lower my risk of getting a second cancer?

There are steps you can take to lower your risk and stay as healthy as possible. For example, smoking is linked to an increased risk of several cancers, so if you smoke, stopping might help lower that risk.

To help maintain good health, people who’ve had liver cancer should also:

• Get to and stay at a healthy weight.
• Keep physically active and limit the time you spend sitting or lying down.
• Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods.
• Avoid or limit alcohol. This is especially important in people who’ve had liver cancer, as alcohol can damage the liver.

These steps may also lower the risk of some other health problems.

People who’ve had liver cancer should also follow the American Cancer Society Guidelines for the Early Detection of Cancer, including for breast, cervical, colorectal, lung, and prostate cancer.

See Second Cancers in Adults for more information about causes of second cancers.

Getting emotional support

It is normal to feel depressed, anxious, or worried when liver cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether that’s from friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.