The liver is the second largest organ (the first being the skin) in the human body weighing about 1500 grams. When the cells in the liver undergo abnormal changes (mutation), this may lead to uncontrolled cell division that spreads to other body parts. These cancerous cells grow and divide quickly, which deprives healthy body cells of nourishment and oxygen. Ultimately, the healthy cells may die due to cancer. Primary liver cancer (hepatocellular carcinoma) is cancer that starts in the liver. Metastatic or secondary liver cancer is cancer that spreads from other organs to the liver.
The main intervention to diagnose liver cancer is a computed tomography (CT) scan, magnetic resonance imaging (MRI) or (in some cases) an ultrasound (USG). The doctor will conduct the required tests based on the symptoms.
Besides, the doctor may order blood tests to look for a specific protein elevation in the blood. This protein or tumor marker is called alpha-fetoprotein (AFP) and is a screening tool for liver cancer. However, it is not specific to liver cancer, so it is not the first test of choice.
The AFP is a protein that can be found in high levels in adults with liver disease, liver cancers and testicular cancer. Again, many patients with early liver cancer have normal levels of AFP, so high AFP levels do not help determine if a liver mass is cancer.
The AFP test is performed for the following reasons
- In the people already diagnosed with liver cancer, the AFP level can help determine treatment options.
- A declining AFP level may help understand the effectiveness of treatment.
- This test can also be used after treatment to check if the cancer is gone or is still inside the body.
Other blood tests performed for liver cancer patients include
- Blood clotting tests: A damaged liver may not produce enough of the clotting factors, which are required to stop bleeding. The doctor may order blood tests to measure levels of clotting factors.
- Complete blood count: This is done to check for the various types of cells present in the blood. It is a routine test done before every surgery and as a follow-up to chemotherapy.
- Kidney function tests: Tests to assess the blood urea level and the blood creatinine level before surgery and chemotherapy.
- Tests for viral hepatitis: The doctor might order blood tests to check for hepatitis B and C. Hepatitis B and C infection have been linked to liver cancer.
- Liver function test (LFT): The test is done to measure the various parameters of liver function. It helps determine the health status of the liver and if the body can tolerate chemotherapy or major surgery. If not, the doctor may advise palliative treatment that helps improve quality of life.
- Biopsy: A biopsy is the removal of a sample of tissue for examination under a microscope. This reveals information about the nature of cancer cells to the doctor
- Radiological tests: Computed tomography (CT), magnetic resonance imaging (MRI), bone scans and positron emission tomography (PET) scans may be done to assess the spread of the tumor in the pelvis and other sites.
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