The diagnosis of liver cancer is not difficult. There are numerous radiological tests such as ultrasound, CT scan or magnetic resonance imaging that may be used to evaluate the liver cancer.

A confirmatory diagnosis by a needle biopsy is always required to determine the type of liver cancer.

Stages of Liver Cancer

Almost every cancer is staged. Staging identifies how far the cancer has spread, allowing physicians to recommend treatment options that are appropriate for each patient’s unique situation. Liver cancer has several staging systems, but in essence the lower the stage, the better the prognosis.

• Stage I: In this stage, the liver cancer is usually confined to the liver. The chances of cure are much higher if the cancer can be completely removed at this stage.
• Stage II: In this stage, the cancer may be small but is often located in an area where it cannot be completely removed. The cancer may be located near delicate arteries or nerves and the risks of surgery may be exorbitantly high.
• Stage III: In this stage, the cancer has spread to other parts of the body, typically the lungs and bones. In such an advanced scenario, cure is rarely possible. The majority of individuals with advanced liver cancer do not live long.
• Stage IV: In this stage, the liver cancer has been previously resected, but has recurred again. The prognosis for recurrent liver cancer is poor. The majority of these individuals are not candidates for surgery.

Associated Complications

Unfortunately, liver cancer is often associated with a fair number of complications. The majority of patients with liver cancer experience the following complications:

• Liver failure occurs when the tumor burden is so great that the liver is no longer able to function.
• Kidney failure is commonly associated with liver failure. This is usually a terminal event, preventing most individuals from excreting harmful substances from their body.
• Liver cancer can spread to the lungs and bones during the later stages of the disease’s development. At this stage, the prognosis is quite poor.

Liver Cancer Screening

There is no test to screen for liver tumors. However, there are some individuals with Hepatitis B, liver cirrhosis, primary sclerosis cholangitis or hepatitis C who have a higher chance of developing liver cancer. It is recommended that these individuals undergo regular liver function tests or an ultrasound. When liver cancer is suspected, there are several radiological tests that can help make the diagnosis:

Testing for Liver Cancer

• Ultrasound (US) is first test of choice besides a physical examination. This painless non invasive test can rapidly obtain pictures of the liver. US can reveal size of the mass and also will also reveal the presence of any abdominal fluid.
• CT scan is always done when liver cancer is suspected; this invasive test uses dye and exposure to x-rays. CT scan is excellent at revealing the size, spread and location of the tumor. For those people who are allergic to contrast dyes, MRI should be the choice of study.
• Magnetic resonance imaging (MRI) is as good as CT scan for evaluating the liver. The latest MRI has superb resolution and can easily reveal size and location of any liver mass.

The above radiological tests only reveal the presence of a liver mass but definitive diagnosis requires a tissue diagnosis. The best way to make a tissue diagnosis is by performing a liver biopsy. This procedure can be done under local anesthesia. A fine needle is inserted through the skin, the tissue obtained from the liver, and it is examined underneath a microscope. Needle biopsy does carry a tiny risk of bleeding, bruising and infection.

There are no specific blood tests to determine the presence of a liver cancer. The routine blood work will reveal functional status of the liver. All patients who have been diagnosed with liver cancer undergo periodic blood tests to determine the status of liver function.