How is liver cancer diagnosed?

A doctor may suspect liver cancer if lumps or other symptoms are found during a physical examination. Other tests may be ordered, including:

  • Blood tests, including a serum marker test and liver enzymes. The serum marker test measures the amounts of certain substances linked to cancer. For liver cancer, cirrhosis, and hepatitis, the substance alpha-fetoprotein (AFP) may show up in higher levels. Liver enzymes are often elevated, indicating an underlying liver problem.
  • Ultrasound (sonography), a procedure that transmits high-frequency sound waves through the body. The echoes are transformed into video or photographs of the internal soft tissue structures of the body.
  • Computed tomography (CT scan), a special type of X-ray that takes detailed images of organs
  • Magnetic resonance imaging (MRI), a test that produces very clear images of the human body using a large magnet, radio waves, and a computer
  • Angiogram, a test that uses dye injected into an artery to show liver tissue and any tumors
  • Laparoscopy, which uses a thin tube with a light (laparoscope) to observe the liver and other organs inside the abdominal cavity. A biopsy (removal of tissue for study under a microscope) may be done using a laparoscope. A biopsy is the most reliable way to determine cancer.

What are the stages of liver cancer?

One of the biggest concerns about cancer is whether the cancer has spread (metastasized) beyond its original location. In a process called staging, the doctor assigns a number (I through IV) to the cancer diagnosis. The higher the number, the more the cancer has spread. Cancers are also categorized by how they can be treated, i.e., whether the cancer can be removed by surgery.

Liver cancer stages include the following:

  • Stage I: One tumor is found in the liver only.
  • Stage II: One tumor is found, but it has not spread to the blood vessels, OR more than one tumor is present, but they are all smaller than 3 cm.
  • Stage III: In Stage III liver cancer, there is more than one tumor larger than 5 cm, OR the cancer has moved beyond the liver to blood vessels, another organ, or to the lymph nodes.
  • Stage IV: The cancer has spread to other locations in the body, such as the lungs or bones, as well as blood vessels or lymph nodes.

Liver cancer may also be categorized as recurrent, if it comes back. Recurrent liver cancer could come back in the liver or anywhere else in the body.

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