How is liver cancer diagnosed?
Liver cancer is also known as hepatocellular carcinoma, HCC. It is a cancer that originates in liver. Liver cancers are malignant tumors that grow on the surface or inside the liver.
Diagnosis of Liver Cancer
Blood Tests
- Liver cancer depends so much on the vigilance of the physician screening with a tumor marker (alpha-fetoprotein) in the blood and radiological imaging studies.
- If the blood tests become abnormal or worsen due to liver cancer, this usually signifies extensive cancerous involvement of the liver.
- in liver cancer, the cancerous liver cells may take on the characteristics of other types of cells.
- For example, liver cancer cells sometimes can produce hormones that are ordinarily produced in other body systems.
- These hormones then can cause certain abnormal blood tests
- These include a high red blood count (erythrocytosis), low blood sugar (hypoglycemia) and high blood calcium (hypercalcemia).
- High serum cholesterol (hypercholesterolemia), is seen in up to 10% of patients from Africa with liver cancer.
- The high cholesterol occurs because the liver cancer cells are not able to turn off (inhibit) their production of cholesterol.
- There is no reliable or accurate screening blood test for liver cancer.
- The most widely used biochemical blood test is alpha-fetoprotein (AFP)
- AFP is a protein normally made by the immature liver cells in the fetus.
In adults, high blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations:
- Liver cancer.
- Germ cell tumors (cancer of the testes and ovaries).
- Metastatic cancer in the liver (originating in other organs).
There are a number of other liver cancer tumor markers like:
- Des-gamma-carboxyprothrombin (DCP),
- A variant of the gamma-glutamyltransferase enzymes,
- Variants of other enzymes (for example, alpha-L-fucosidase).
Imaging Studies
These studies provide information
- as to the size of the tumor.
- the number of tumors.
- whether the tumor has involved major blood vessels locally or spread outside of the liver.
Ultrasound Examination
- It is usually the first study ordered if liver cancer is suspected in a patient.
- The accuracy of an ultrasound depends very much on the technician and radiologist.
- Computerized axial tomography (CT scan) is a very common study used in the U.S.
- The ideal CT study is a multi-phase, spiral CT scan using oral and intravenous contrast material.
Pictures are taken in three phases:
- Without intravenous contrast.
- With intravenous contrast (enhanced imaging) that highlights the arterial system (arterial phase).
- When the contrast is in the venous phase.
Magnetic Resonance Imaging (MRI)
- It can provide very clear images of the body.
- Its advantage over CT is that MRI can provide sectional views of the body in different planes.
Others
- If there is uncertainty about the diagnosis, the presence of liver cancer may be confirmed with a biopsy.
- Tissue from the liver is removed through a needle or during an operation and checked under a microscope for the presence of cancer cells.
- Laproscopy is another method.
Staging
The following stages are used for adult primary liver cancer:
- Localized resectable
Cancer is found in one place in the liver and can be completely removed by surgery.
- Localized unresectable
Cancer is found only in one part of the liver, but the cancer cannot be totally removed.
- Advanced
Cancer has spread through much of the liver or to other parts of the body.
- Recurrent
Cancer has come back or recurred after it was treated. It may come back in the liver or in another part of the body.
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What are different symptoms of liver cancer?
Liver cancer is also known as hepatocellular carcinoma, HCC.
- It is a cancer that originates in liver.
- Liver cancers are malignant tumors that grow on the surface or inside the liver.
- It is also known as primary liver cancer or hepatoma.
- The liver is made up of different cell types.
- They are cancer of, for example, bile ducts, blood vessels, and fat-storing cells.
- Liver cells (hepatocytes) make up 80% of the liver tissue.
- The majority of primary liver cancers (over 90%-95%) arise from liver cells.
- Liver cancer is often referred to cancer that has spread to the liver that has originated in other organs.
- This type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer.
- The term liver cancer actually can refer to either metastatic liver cancer or hepato cellular cancer.
Rarer forms of liver cancer include:
- Mesenchymal tissue
- Sarcoma
- Hepatoblastoma
- Cholangiocarcinoma (bile duct cancers)
- Angiosarcoma and hemangiosarcoma
- Lymphoma of liver
Signs and Symptoms of Liver Cancer
- Abdominal mass
- Abdominal pain
- Jaundice
- Nausea
- Liver dysfunction
What are liver cancer symptoms and signs?
- The initial symptoms are not known as these cancers are mostly recognized only at advanced stages.
- Abdominal pain is uncommon with liver cancer
- It usually signifies a very large tumor or widespread involvement of the liver.
- Unexplained weight loss.
- Unexplained fevers.
- The sudden appearance of ascites (abdominal fluid and swelling).
- Jaundice (yellow color of the skin)
- Muscle wasting without causative (precipitating) factors (for example, alcohol consumption).
- Block in the portal vein (a large vein that brings blood to the liver from the intestine and spleen).
- The blood will travel paths of less resistance, such as through esophageal veins which leads to increased pressure in these veins.
- Dilated (widened) veins called esophageal varices occur.
- The patient then is at risk for hemorrhage from the rupture of the varices into the gastrointestinal tract.
- Turbulent blood flow in the artery.
- The turbulence results in a distinct sound in the liver (hepatic bruit).
- Muscle wasting.
- Very swollen liver and massive formation of ascites.
- In some patients, as previously mentioned, the tumor can invade the portal vein and lead to the rupture of esophageal varices.
Symptoms of Cholangiocarcinoma
- Sweating
- Jaundice
- Abdominal pain
- Weight loss
- Hepatomegaly
Symptoms of Hepatocellular carcinoma
- Abdominal mass
- Abdominal pain
- Emesis
- Anemia
- Back pain
- Jaundice
- Itching
- Weight loss
- Fever
Categories: Cancer, growth, Liver, Metabolism, Problems, Risk, Risk factors, Symptoms, Techniques, Tissues, Tumor, Types Tags: Body, Brain, Break down, Carcinoma, Chemicals, Cholesterol, Detoxification, Detoxify, digestion, Diseases, Fats, Functions, growth, health, Healthy, Human, Liver, Metabolism, Organs, Origin, Regulate, Store, Sugar, Symptoms, Vital