Liver Cancer - Diagnosis

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How is liver cancer diagnosed?

The best way to detect liver cancer is through surveillance ultrasound of the liver done every six months in a patient with a diagnosis of cirrhosis and to treat the liver cancer as soon as it is detected.

Once a suspicion of liver cancer arises, a physician will order one the following:

  1. Blood tests: alfa-fetoprotein (AFP), which may be elevated in 70% of patients with liver cancer. AFP levels could be normal in liver cancer. A rising level of AFP is suspicious for liver cancer. Other labs tests include des-gamma-carboxy prothrombin, which can be elevated in most patients with liver cancer.
  2. Imaging studies: Multiphasic helical CT scan and MRI with contrast of the liver are the preferred imaging for detecting the location and extent of blood supply to the cancer. If any imaging study is inconclusive, then an alternative imaging study or follow-up imaging study should be performed to help clarify the diagnosis. Lesions smaller than 1 cm are usually difficult to characterize.
  3. Liver biopsy is performed to sample tissue from the lesion in the liver, which is analyzed by a pathologist to confirm the suspected diagnosis of liver cancer. Liver biopsy is not needed in every case, especially if the imaging study and lab markers are characteristic for liver cancer. Risks of liver biopsy are infection, bleeding, or seeding of the needle track with cancer. Seeding is when cancer cells get on the needle used for a biopsy and spread to other areas touched by the needle. Liver biopsy of suspected liver cancer carries the added risk of seeding the liver biopsy needle track in 1%-3% of cases. If a liver biopsy is inconclusive, then a repeat imaging study is recommended at three- to six-month intervals.
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Comment from: No joy, 55-64 Male (Patient) Published: January 21

In June 2012, I had an exploratory examination because of a car accident and was diagnosed with liver cancer and was referred to a cancer clinic. After blood tests, CT scans, etc., I was put on the waiting list for a liver which I received in August 2013 and was put on anti-rejection medications. After blood test every other week and CT scans every three months, in October 2014 a 4 cm spot appeared on the last CT scan. A procedure to kill cancerous cells failed, now I am scheduled for radiation, what after that? Chemotherapy perhaps. I am 56 years old.

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Comment from: Danial, 75 or over Male (Caregiver) Published: February 03

My maternal grandmother age 82 was feeling much sick, after the death of my grandfather, which was due to stomach cancer. She had pain in her right portion of chest and was not able to eat much due to the pain which she felt when she ate some amount of food. Two or three weeks ago she had a severe constipation problem, even liquid enemas failed to remove her constipation. Two days ago on Friday I got back to our local hospital to get her checked again and the doctor prescribed an ultrasound of her abdomen and chest. In the test the doctor found 2 lumps of malignant mass on her liver and some part of her gallbladder was also affected. The doctor ordered a test of LDH (lactate dehydrogenase), which was found to be much higher than the normal level; it was about 995. Now the doctor said he can't do anything about her condition. I am going to take her to a better oncology hospital situated in the nearby town.

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