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How is liver cancer diagnosed?
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Last reviewed May 2012
Contents
Blood tests
Scans (imaging tests)
Other tests
Which health professionals will I see?
Information reviewed by
Primary liver cancer and secondary cancer in the liver are diagnosed using a number of different tests.
These include blood tests and scans. Tissue examination (biopsy) is only done rarely.
Blood tests
You will probably have a blood test to check how the liver is working (liver function) and how well your blood
clots. You may also have liver function tests before, during and after treatment.
If primary liver cancer is suspected, you will have blood tests to check for hepatitis B or C and various
genetic problems.
You may need a blood test to check the level of certain chemicals known as tumour markers that are
produced by cancer cells. Tumour markers can help diagnose some types of cancer. The tumour markers
used to diagnose primary liver cancer include alpha-fetoprotein (AFP), cancer antigen 19-9 (CA19-9) and
carcinoembryonic antigen (CEA). Carcinoembryonic antigen (CEA) can also be helpful in diagnosing
secondary cancer that has spread from the large bowel.
However the tumour markers do not rise in all people with these cancers. Also some conditions, such as
pregnancy, hepatitis and jaundice, can increase tumour marker levels without cancer being present. If the
markers are high due to cancer they should fall when treatment ends.
After blood tests, other tests will need to be done to confirm the diagnosis.
Scans (imaging tests)
You will have at least one of these scans but you may have more than one if the doctor needs further
information about the cancer.
CT scan
A CT (computerised tomography) scan is a type of x-ray that takes three-dimensional pictures of several
organs at the same time. It helps doctors make a diagnosis and see if the cancer has spread. It can also
help doctors plan surgery if this is appropriate.
M RI scan
An MRI (magnetic resonance imaging) scan uses both magnetism and radio waves to take detailed crosssectional pictures of the body. These show the extent of the tumour and whether it is affecting the main
blood vessels around the liver.
PET-CT scan
A positron emission tomography (PET) scan combined with a CT scan (see above) is a type of imaging test
available at some major metropolitan hospitals. It produces a three-dimensional colour image that shows
where some cancers are in the body.
Ultrasound
An ultrasound uses soundwaves to create a picture of a part of your body. It can show the size and location
of abnormal tissue in your liver. The test takes about 15 minutes and is painless.
If a solid lump is found the scan will help show whether it is cancer. Non-cancerous (benign) tumours in the
liver can also be found during an ultrasound. These occur in about four out of 10 people.
Other tests
Biopsy
A biopsy means removing a small amount of tissue to examine under a microscope. Tissue samples are
taken from the liver in either a fine needle aspiration or a laparoscopy. The biopsy can sometimes show if
the cancer in your liver is a primary or secondary cancer.
A biopsy can be done to make a diagnosis if no surgery is planned.
Before a biopsy you may have a test to check how well your blood clots (how quickly you stop bleeding)
because the liver has many blood vessels.
Laparoscopy
This operation is also called keyhole surgery. It allows the doctor to look at the liver and surrounding organs
using a thin tube containing a light and a camera (a laparoscope). It is often done if your doctor thinks the
cancer is in other areas besides the liver.
Which health professionals will I see?
Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer you will
probably be referred to a gastroenterologist who will organise further tests for you and advise you about
treatment options. You may see other specialists such as a surgeon or a medical oncologist to discuss the
different types of treatment.
You will be cared for by a range of health professionals who specialise in different aspects of your treatment.
The multidisciplinary team may include some of the professionals from the list below.
Health professional
Job description
Hepatobiliary surgeon
A doctor who specialises in surgery of the liver and its
surrounding organs
Gastroenterologist
A specialist in diseases of the digestive system
Hepatologist
A gastroenterologist who has further specialised in diseases
of the liver and gall bladder
Medical oncologist
Prescribes and coordinates the course of chemotherapy
Cancer nurse coordinators
and nurses
Administer drugs - including chemotherapy - provide care,
information and support throughout your treatment
Social worker,
physiotherapist, occupational
therapist
Link you to support services and help you to resume your
activities
Dietitian
Recommends an eating plan for you to follow while you are in
treatment and recovery
Palliative care team
Aims to improve people’s quality of life by symptom
management without trying to cure the disease
Information reviewed by: Dr Benjamin Thomson, Hepato-pancreato-biliary Surgeon, Royal Melbourne
Hospital and Peter MacCallum Cancer Centre, VIC; Joyce Bonello, Cancer Care Coordinator – GIT, Prince of
Wales Hospital, NSW; Carol Cameron, Cancer Nurse Coordinator Upper GI, WA Cancer & Palliative Care
Network; Karen Hall, Clinical Nurse Cancer Services Division, Flinders Medical Centre, and Cancer Council
Helpline Nurse, SA; Robyn Hartley, Consumer; Mamta Porwal, Project Coordinator, B Positive Project,
Cancer Council NSW; Chris Rivett, Clinical Nurse Oncology, Western Hospital, and Cancer Council Helpline
Nurse, SA; and Dr Kellee Slater, Hepatobiliary, General and Liver Transplant Surgeon, Princess Alexandra
Hospital, QLD.
Content printed from https://www.cancersa.org.au/information/a-z-index/how-is-liver-cancer-diagnosed
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