Liver Cancer Diagnosis

Liver cancer is usually diagnosed after symptoms appear. Some are more specific to your liver not working correctly while others are more general symptoms associated with a cancer diagnosis:

Liver-specific symptoms:

  • Yellowing of the skin or eyes: This is called jaundice, and it happens when the liver isn't working properly.
  • Itching: sometimes, liver problems can cause itching all over the body.
  • Dark urine and pale stools: Your pee may get darker, and your stool could turn lighter in color.
  • Pain or discomfort in the upper right belly or right shoulder
  • Bloating:
Your belly might get bigger without overeating. This is often a fluid build-up that can be caused by cancer.

General cancer symptoms related to liver cancer:

  • Unexpected weight loss: If you're losing weight without making any changes in diet or exercise, this could be a sign of cancer.
  • Loss of appetite
  • Fatigue: feeling excessively tired for no apparent reason

Set an appointment with your doctor if you notice any of these symptoms for more than a few days. If your doctor suspects it could be liver cancer, several tests will be run including blood tests and imaging. These may include:

  • A physical exam: Your doctor feels your abdomen to check the liver, spleen, and other nearby organs for lumps or changes in shape or size. Your doctor also checks for ascites, an abnormal buildup of fluid in the abdomen. Your skin and eyes may also 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 in 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.

When Liver Cancer is Suspected

If a liver mass is detected additional tests are likely, including:

Angiography

An angiogram is a contrast imaging test of the blood vessels. A dye is injected into an artery through a catheter to highlight the blood vessels while images are taken. These can be X-ray images, but a CT or MRI is more common today. The images allow the doctor to visualize the arteries supplying blood to the liver tumor and help determine whether surgery is possible as part of the treatment plan.

Biopsy

A biopsy is one of the final steps in determining whether cancer is present. It can be performed in various ways, such as using a needle to extract a tissue sample or through laparoscopy, which involves making a small incision in the abdomen. The sample of tissue is reviewed under a microscope by a pathologist. They will indicate how differentiated the cells look compared to regular cells.

If pathology testing of the tissue removed during a biopsy returns a liver cancer diagnosis, your doctor will work with other members of the Compass Oncology team, including our GI Surgeon, to determine the next steps. They will review treatment options based on the stage of liver cancer and whether it can be surgically removed (resectable).