Randomized Control Trial (RCT) of Early Palliative Care for HCC

Inclusion Criteria: * Diagnosed HCC by biopsy or liver protocol CT scan or MRI characteristics * Permanent street address with Harris County, Texas and consent to study participation * English or Spanish speaking with ability to respond to the QoL questionnaires * Child-Pugh C, not eligible for liver transplantation (TXP), surgical resection, ablation, locoregional or systemic therapy * Child-Pugh C, eligible for systemic chemotherapy (Sorafenib), not eligible for TXP, surgical resection, ablation or locoregional therapy * Child-Pugh A or B, not eligible for surgical resection or ablation (\>3 lesions or 2 lesions with one being \>5cm) * Child-Pugh A, not eligible for TXP, surgical resection, ablation or locoregional therapy Exclusion Criteria: * Primary modality of treatment is potentially curative TXP, surgical resection or ablation as deemed by GI MDC * Child-Pugh A or B (up to 2 lesions \< 5cm in size) * Medical (e.g. severe encephalopathy), psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results * Any medical condition (acute myocardial infarction or stroke) that could jeopardize the safety of the patient and his/her compliance in the study * Vulnerable population (inmates in jail or prison) * Non-English or Non-Spanish Speaking patients.