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Liver Cancer

  • Posted: 04/29/2009

Diagnosis

If you have symptoms that suggest liver cancer, your doctor will try to find out what's causing the problems.

You may have one or more of the following tests:

  • Physical exam: Your doctor feels your abdomen to check the liver, spleen, and other nearby organs for any lumps or changes in their shape or size. Your doctor also checks for ascites, an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
  • Blood tests: Many blood tests may be used to check for liver problems. One blood test detects alpha-fetoprotein (AFP). High AFP levels could be a sign of liver cancer. Other blood tests can show how well the liver is working.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your liver and other organs and blood vessels in your abdomen. You may receive an injection of contrast material so that your liver shows up clearly in the pictures. On the CT scan, your doctor may see tumors in the liver or elsewhere in the abdomen.
  • MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body. Sometimes contrast material makes abnormal areas show up more clearly on the picture.
  • Ultrasound test: The ultrasound device uses sound waves that can't be heard by humans. The sound waves produce a pattern of echoes as they bounce off internal organs. The echoes create a picture (sonogram) of your liver and other organs in the abdomen. Tumors may produce echoes that are different from the echoes made by healthy tissues.
 

Biopsy

A biopsy usually is not needed to diagnose liver cancer, but in some cases, the doctor may remove a sample of tissue. A pathologist uses a microscope to look for cancer cells in the tissue.

The doctor may obtain tissue in one of several ways:

  • A needle through the skin: The doctor inserts a thin needle into the liver to remove a small amount of tissue. CT or ultrasound may be used to guide the needle.
  • Laparoscopic surgery: The surgeon makes a few small incisions in your abdomen. A thin, lighted tube (laparoscope) is inserted through the incision. The laparoscope has a tool to remove tissue from the liver.
  • Open surgery: The surgeon can remove tissue from the liver through a large incision.
You may want to ask the doctor these questions before having a biopsy:
  • How will the biopsy results affect my treatment plan?
  • What kind of biopsy will I have?
  • How long will it take? Will I be awake? Will it hurt?
  • Is there a risk that a needle biopsy procedure will cause the cancer to spread? What are the chances of infection or bleeding after the biopsy? Are there any other risks?
  • How soon will I know the results? How do I get a copy of the pathology report?
  • If I do have cancer, who will talk with me about treatment? When?