Diagnosis of liver cancer can be difficult as most people have vague signs and symptoms. If your doctor suspects liver cancer he will take a detailed history, do physical exam and then recommend tests.
[Read: How to Prevent Liver Cancer]
Physical Exam and Medical History: During the history your doctor will ask about your symptoms, presence of risk factors such as excessive alcohol consumption, infection with hepatitis B or C virus, and family history of liver disease or cancer. During the examination he will check you for jaundice, ascites (abnormal collection of fluid in the abdomen), liver size by palpating your abdomen and other signs of liver disease.
Exams and Tests for Liver Cancer: Some of the tests done to diagnose liver cancer diagnosis may include;
- Blood tests: Several blood tests are done if liver cancer is suspected. Levels of alpha-fetoprotein (AFP) in blood are checked as elevated levels of AFP possibly indicate liver cancer. Blood tests are also done to check how well the liver is working.
- Computed tomography (CT) scan: This is a painless and non-invasive test, which takes a series of detailed pictures of the liver and other organs and blood vessels present in the abdomen. If needed, your doctor will inject a dye so that the liver is visualised more clearly in the images. CT scan, can show tumors in the liver or other organs and places in the abdomen.
- Ultrasound: Ultrasound is also a painless and non-invasive test but it is not as good as CT scan to detect liver cancer or other pathologies in early stages. It can show tumors, enlarged lymph nodes and presence of fluid (ascites in the abdomen).
- Magnetic resonance imaging (MRI): MRI scan is more sensitive than CT scan to detect tumors in the liver, other organs or places in the abdomen. It can detect tumors which are very small in size and may be missed by CT scan.
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- Angiogram: In this test a dye is injected into an artery so that the blood vessels in the liver become conspicuous on an x-ray. The angiogram may show tumor in the liver.
- Laparoscopy: In this surgical procedure the organs inside the abdomen are checked for signs of liver cancer. Laparoscope is an instrument (a thin, lighted tube) used to do this procedure. It is inserted into the abdomen through small incisions made in the wall of the abdomen. It may be used to do biopsy of the tumor, or remove organs or certain growths.
- Biopsy: Your doctor will take a sample of tissue from the growth and examine under a microscope to look for cancer cells in the tissue and the type of cancer cells. The risks of liver biopsy are bleeding, bruising and infection.
Determining the extent of the liver cancer: After liver cancer is diagnosed your doctor will try to determine the stage of the cancer (that is the size of the tumor, extent of spread, and the type of tumor). Staging helps to decide the treatment and prognosis. Staging can be done using imaging tests (such as CT, MRI, chest X-ray and bone scan) and biopsy.
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