How is Liver Cancer Diagnosed?
Liver cancer is a common type of cancer which begins in the liver cells, or hepatocytes. Liver cancer is a cancer which affects one of the largest and most important organs of the body. Liver cancer is type of cancer which, when diagnosed at early stages, can be successfully treated. In order to secure effective treatment per the stage of liver cancer, there is need for diagnosis and staging. Several types of cancer can develop in the liver, but the most common type of liver cancer is hepatocellular carcinoma. Other less common types of liver cancer are hepatoblastoma and intrahepatic cholangiocarcinoma.
Diagnosing liver cancer can be a very challenging procedure, since the cancer has no obvious symptoms in its early stages and tumors cannot be felt outside the body. It is important to be aware of the fact that liver cancer cannot be diagnosed through its symptoms alone.
Upon visiting your doctor the following symptoms can be the first line diagnostic test for liver cancer:
- Vomiting or nausea
- Unaccounted weight loss
- A feeling of deep fatigue, tiredness and weakness
- Pain of the upper abdomen
- A feeling of heaviness on the upper abdomen
- Stomach bloating
- Reduced appetite and a feeling of fullness
- Dark urine
- Chalky and pale bowel movements
With examination of the above symptoms, your doctor will be able to determine whether your cancer is affecting one of the organs in your upper abdomen. Symptoms such as appetite loss, abdominal pain, and feeling of tiredness may help your doctor in determining whether the cancer has invaded the liver. However, symptoms are not enough to diagnose liver cancer, nor can they determine how developed it is. Since your symptoms cannot give convey comprehensive information about your liver cancer and its stages, I will discuss the tests available for accurately diagnosing liver cancer.
Imaging tests are tests which use sound waves, x-rays and magnetic fields to create pictures or images of the deep organs of your body. The imaging tests are performed for the following reasons:
- To help determine how far your liver cancer has spread
- To help discover any potentially cancerous tumors
- To help diagnose your liver cancer
- To identify any possibility of your liver cancer recurrence
- To help your doctor determine the best medication for your liver cancer
- To help your health professional guide a biopsy needle into the area of the liver suspected to be cancerous
The following imaging tests are performed to individuals who have or may have liver cancer:
An ultra sound - also known as ultrasonography - is a procedure or test which uses sound waves to create clear pictures of the structures or organs in your body by use of a limited amount of radiation. The sound waves in this test often bounce over the liver tumors and other organs, creating different pictures which are seen on a computer. These images show masses of tumor growth which can later be tested for cancer
- Magnetic resonance imaging (MRI)
Just like CT scans, MRI scans create detailed pictures of your body's soft tissue. However, MRI scans use radio waves plus strong magnetic fields to create images instead of x-rays. A certain special type of a dye called contrast medium is administered before the scan to help produce clearer images of your liver. Contrast medium is administered though intravenous injection or oral liquid.
In MRI scans, strong energy from radio waves is absorbed by your liver and then released in a certain pattern, which is interpreted by the computer to create detailed images of your liver. These scans are very helpful and important in identifying liver tumors. In many cases, they can help differentiate between malignant and benign tumors. MRI scans are also helpful in looking at your blood capillaries around the liver and also show how far your liver cancer has spread.
- Computed Tomography (CT)
This is a type of scan produces a 3D picture of the liver by use of X-rays taken at different angles. A computer is then used to combine the images and produce a detailed and cross-sectional view that displays your liver tumors and abnormalities. A special dye known as contrast medium is administered before the CT scan to help produce clearer images. This dye can be injected directly into your veins or swallowed in the form of a liquid. A CT scan helps diagnose liver cancer based on special features specific to the type of cancer. This can help many patients avoid liver biopsy. The scan gives clear information about the position, type and size of tumors in the liver or any other abdominal part. CT scans can also be used to guide biopsy needles to the suspected area of tumor in the liver. Alongside liver CT scans, a scan of the chest is performed to look for any probable spread of liver cancer to the lungs.
This is a test which gives your doctor a chance to see the inside of your body organs by use of a thin, lightened and flexible tube known as a laparoscope. A small incision is made on the abdomen and the camera-bearing lightened tube is inserted to examine the liver among other adjacent organs for tumors. A laparoscopy is always done in an operating room and under anesthesia to numb the pain.
This is a special type of X-ray which targets the blood vessels on your liver. A contrast medium is injected into your blood vessels to give their outline through x-ray images. This type of scan helps show the arteries supplying the liver cancer with blood to help your doctor determine the type of treatment best suited to treat your cancer.
Biopsy is a procedure which involves removal of a small tissue sample of your liver for microscopy examination. A biopsy is the major and most accurate way to determine liver cancer. Biopsies are sometimes performed during laparoscopies, where a fine needle removes a piece of small tissue from your liver. A biopsy is always conducted by a radiologist who uses an ultrasound to direct the tube to the specific area of liver tumor. This is a procedure performed to confirm liver cancer if other imaging tests such as CT and MRI scans fail.
- Alpha-fetoprotein blood test (AFP test)
The AFP protein is a protein which is found at high levels in unborn babies. The level of AFP proteins goes down after birth. However, AFP protein is produced in cases of liver cancer, liver diseases, and other cancers. If levels of AFP increase in an individual with a liver tumor, it could be a sign of liver cancer. This test is very important for people who have already been diagnosed with liver cancer to help determine the best treatment option.
- Liver function tests (LFTs)
Since doctor need to be aware of the condition of your liver before treatment, LFT test is very important. A series of blood tests are therefore performed to see how well your liver is working before any treatment is given
- Blood clot tests
Since your liver is the source of proteins which help in blood clotting, testing for the amount of these proteins can help determine whether your liver is damaged or not. Blood tests such as prothrombin time tests are performed to determine if the damage is a result of liver cancer.
Other uncommon laboratory tests which can help diagnose liver cancer are:
- Complete blood count
- Kidney function tests
- Blood chemistry tests
As discussed above, liver cancer is a condition of the liver which - when not diagnosed early enough - can cause a lot of complications. It is therefore important to diagnose liver cancer and stage it to get the best, most effective treatment options. Major and minor lab and image tests are available to help you get a detailed idea of how liver cancer can be diagnosed.