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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 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 treatments with chemotherapy, radiation therapy, or other therapies 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.

Follow-up care

Even if you have completed treatment, your doctors will still want to watch you closely. It is very important to go to all your follow-up appointments. During these visits, your doctors will ask questions about any problems you are having and might do exams and blood tests, such as alpha-fetoprotein (AFP), liver function tests (LFTs). Imaging tests, such as ultrasound, CT, or MRI scans might also be done. 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 after you have finished treatment. 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 for all liver cancer survivors, to tell their 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.

Doctors 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 is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments.

Follow-up after liver transplant: A liver transplant can be very effective at treating the cancer and replacing 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 strong medicines to help prevent rejection. These medicines can have their own side effects, including weakening your immune system, which can make you more likely to get infections.

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 for you. This plan might include:

• A suggested schedule for follow-up exams and tests
• A schedule for other tests you might need, 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 after your cancer treatment, you might find yourself seeing a new doctor who does not know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.

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 coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.

Getting treatment for hepatitis B or hepatitis C may help reduce damage to your liver that can increase liver cancer risk. Tobacco and alcohol use has clearly been linked to liver cancer, so not smoking and avoiding alcohol may help reduce your risk. We don’t know for certain if this will help, but we do know that it can help improve your appetite and overall health. It can also reduce the chance 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, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of liver or other cancers.

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 do not 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 health 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 at some point (called a recurrence), your treatment options will depend on the where the cancer is, what treatments you’ve had before, and your health. Treatment options might include ablation, embolization, radiation therapy, chemotherapy, targeted therapy, 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 liver cancer can still get other cancers. Learn more in Second Cancers After Liver Cancer.

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 friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.