Dr. Chetan Kalal — Hepatologist and Liver Transplant Physician, Mumbai. MBBS, MD, DM (Hepatology).
If you or a family member has been told there is a mass in the liver, or a scan has raised the possibility of hepatocellular carcinoma, the most valuable thing you can do is get the case reviewed properly before any treatment begins. In liver cancer, the order in which decisions are made often determines whether a cure remains possible.
Why a hepatologist for liver cancer
Liver cancer is unusual among cancers because it almost always grows inside a liver that is already diseased. That means two problems have to be managed at once — the tumour, and the cirrhosis or hepatitis underneath it.
How much functioning liver a patient has left determines what treatment is survivable. A tumour that is technically removable may still make surgery unsafe. A patient told they are inoperable may still be a transplant candidate. These are hepatology judgements, and they are the reason liver cancer decisions should not be made on tumour size alone.
What a consultation covers
- Review of your actual images, not just the reports — bring every scan on disc or drive
- Assessment of liver function and reserve — bilirubin, INR, albumin, platelets, and the degree of portal hypertension
- Staging using the BCLC framework, which combines tumour extent, liver function and fitness
- A clear treatment recommendation — resection, ablation, TACE or TARE, radiotherapy, systemic therapy, or transplant
- An explicit answer on transplant — whether you are within criteria, and if not, whether downstaging could bring you within them
- Living donor guidance where transplant is relevant, including who in the family may be assessed
Second opinions
A second opinion is worth seeking in three situations in particular: when you have been told nothing more can be done; when transplant has been ruled out without a stated reason; and when a treatment has been proposed before a multidisciplinary review has taken place.
None of these mean the first opinion was wrong. They mean the decision is consequential enough to be worth confirming.
Conditions managed alongside liver cancer
- Cirrhosis of all causes
- Hepatitis B and hepatitis C, including cancer surveillance in carriers
- MASLD and fatty liver disease with advanced fibrosis
- Portal hypertension and varices
- Acute-on-chronic liver failure
Liver cancer screening — who needs it
Most patients diagnosed with liver cancer in India have never had a surveillance scan. If you have cirrhosis of any cause, or chronic hepatitis B even without cirrhosis, you should be having an abdominal ultrasound every six months, usually with an AFP blood test. Annual scans are not sufficient — tumours can outgrow curable size within a year.
If you have been told you have cirrhosis or hepatitis B and no one has put you on a six-monthly scan, that is worth correcting now rather than later.
Understanding the diagnosis in detail
For a full clinical explanation of how hepatocellular carcinoma is staged, what each treatment involves, and exactly when a liver transplant becomes the right answer, read the detailed guide: Hepatocellular Carcinoma: Stages, Treatment, and When Transplant Is the Answer.
Common questions
Should I see an oncologist or a hepatologist for liver cancer in Mumbai?
Ideally both, working together. Liver cancer treatment is limited as much by liver function as by tumour extent, so decisions about surgery, ablation, arterial therapy, systemic treatment and transplant need to be taken jointly rather than in sequence by separate specialists.
I have been told the tumour is too large for transplant. Is that final?
Not necessarily. Tumour burden can sometimes be reduced back within transplant criteria using TACE or TARE, after which transplant becomes possible again. This is called downstaging and it requires assessment at a centre that offers both interventional treatment and transplantation.
Can I bring scans done at another hospital?
Yes, and you should. Bring the images themselves, not only the reports. A triple-phase CT or MRI of the liver is the decisive investigation; a plain CT is not sufficient to plan treatment.
Do you see patients travelling from outside Mumbai?
Yes, including patients travelling from within India and from abroad. Where relevant, see the guidance on liver transplant in India for NRI and international patients.
Request a consultation
To arrange a consultation or a second opinion on a liver cancer diagnosis, get in touch here. Please bring all imaging, recent blood tests, and any biopsy or endoscopy reports.
This page is general information and does not replace individual medical advice. Treatment decisions in liver cancer must be made after review of your own imaging and liver function.