Liver Cancer Center

Liver Cancer Diagnosis

People at higher risk for developing liver cancer may benefit from liver cancer screening before they exhibit symptoms of liver cancer. In fact, many doctors recommend testing for certain groups. These include people diagnosed with cirrhosis, chronic HBV or HCV infections or people with liver cancer in the family. If you think you are at high risk for liver cancer, talk to your doctor about whether preliminary testing is a good option for you.

Liver cancer might also be discovered in a routine office visit if your doctor feels hard lumps in the abdomen, or incidentally sees problems while viewing imaging tests of the abdomen. If you suspect that you are at risk of liver cancer, you can first see your family doctor who may refer you to a specialist. Specialists who both diagnose and treat liver cancer may include the following:

  • Gastroenterologist
  • Hepatobiliary surgeon
  • Medical oncologist
  • Oncology nurse
  • Radiation oncologist
  • Registered dietician
  • Surgical oncologist
  • Transplant surgeon

Medical exams
If you exhibit symptoms of liver cancer or if your doctor or suspects liver cancer, s/he can perform tests to confirm or exclude disease diagnosis. Expect a physical exam and to answer questions about your health in a medical history. Unfortunately, there are currently no screening tests used for liver cancer, and small tumors are hard to find by physical exams. Some of the tests that may be done are listed below.

AFP (alpha-fetoprotein) test - This blood test is used to detect a protein called AFP, which can indicate liver cancer (or another kind of cancer). Tests for AFP have been used to identify early tumors for people at high risk of developing liver cancer, however, some non-cancerous liver diseases can also raise AFP levels. Doctors can also compare AFP levels before and after treatment to judge how well treatment is working.

Angiography - An angiography is an x-ray method used to examine blood vessels. During the procedure, dye is injected into an artery which outlines the blood vessels and indicates which deliver blood to the liver cancer. This can help surgeons decide whether cancer can be removed and, if so, how plan for operation.

Biopsy - In most cases the only way confirm a liver cancer diagnosis is to take a piece of the tumor with a needle for microscopic examination - a procedure called a biopsy. Biopsy samples can also be taken during laparoscopy or are performed locally.

Blood tests - Blood tests can help doctors learn how well the healthy part of a liver is functioning, and how well other organs are performing. This information can help doctors decide whether surgery is an option, or not.

Bone scan - Images taken during a bone scan can indicate whether cancer has spread to the bones, or not. During a bone scan, doctors inject a small amount of a radioactive substance into the blood vessel to travels through the bloodstream and collects in the bones. A scanner machine then detects and measures radiation and takes pictures of the bones.

CT Scans (computed tomography) - CT scans offer precise information about the size, shape, and place of any tumors in the liver or other places in the belly (abdomen). A CT scan uses x-rays to take many pictures of the body. The pictures are then analysed by cross-section. During the procedure, doctors may inject a dye to help outline internal organs for analysis.

Laparoscopy - Laparoscopies help doctors plan surgery, treatments or to extract tissue samples for inspection. During a laparoscopy, doctors use a thin tube to observe the liver and other organs which is placed through a small cut in the front of the abdomen.

MRI (magnetic resonance imaging) - MRI scans use radio waves and strong magnets to create detailed pictures of parts of the body. MRI scans can frequently discern the difference between a benign tumor and a cancerous one.

Ultrasound - Ultrasound tests use sound waves to create images of the liver to find tumor and in some cases identify what type of tumor it is. Ultrasounds are also used to help find cancers earlier for people with certain liver cancer risk factors or may be performed before a biopsy. During an ultrasound, a doctor moves a over the abdomen to record images.

X-rays - These diagnostic tests create pictures of the inside of the body and can help identify cancerous tumors, measure the spread of cancer and help identify whether treatments are working, or not.

Although there is no definitive test to determine if you have liver cancer, patience and consistency can help you arrive at a diagnosis. You may seek several expert opinions as you seek diagnosis. Once a diagnosis is made, you'll need to have liver cancer staged. To learn more about the staging process, read the next section on Liver Cancer Stages now.

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