Diagnosing liver cancer is more complex than diagnosing many other cancers. That’s because, if you have liver cancer, your liver may already be damaged and both the cancer and liver function affect your outcomes.
Understanding how advanced the cancer is and how well the liver is working help your health care team recommend treatments and set realistic expectations.
The cancer experts at Banner Health have extensive experience diagnosing people with liver cancer and developing customized treatment plans. If you’re at high risk for liver cancer, have signs or symptoms or have already been diagnosed, our caring team of specialists can help.
Liver cancer is usually diagnosed using a combination of medical history, physical exam, imaging and blood tests. Many people who are diagnosed with liver cancer already know they have cirrhosis or another type of liver disease and are routinely monitored for signs of liver cancer. Monitoring is only recommended for people at high risk.
Unlike many cancers, liver cancer can often be diagnosed without surgery or biopsy when imaging findings are clear.
Blood tests help check liver health and may help health care providers figure out if liver cancer is likely. They do not confirm liver cancer.
AFP is a protein that could be higher than normal in people with liver cancer, especially hepatocellular carcinoma.
AFP alone cannot diagnose liver cancer but is useful along with imaging
AFP blood tests are recommended every six months for people at high risk.
Blood tests also measure how well the liver is working. These tests help determine:
Imaging is a key method used to diagnose liver cancer.
Ultrasound is a first-line screening test for people with cirrhosis or chronic hepatitis. It can look for new liver nodules that might be signs of cancer. It’s recommended every six months for people at high risk.
Contrast-enhanced CT scans can spot liver tumors and show how they interact with nearby blood vessels. Some specialized CT scans can show a pattern that helps diagnose hepatocellular carcinoma.
MRI is often the most accurate imaging test for liver cancer. Special contrast agents help experts tell the difference between cancer and benign liver nodules.
In many cases, characteristic imaging features are enough to confirm liver cancer.
Sometimes you can have more than one imaging test, such as CT and MRI. The information you get from two tests can help confirm the diagnosis without needing a biopsy.
A biopsy is a procedure where health care providers remove a small tissue sample to examine it in a lab. With liver cancer, you don’t always need a biopsy. When possible, avoiding biopsy lowers your risk of bleeding and may speed up treatment planning.
Your health care team may recommend a biopsy when:
Prognosis refers to how the disease is expected to change or respond over time. In liver cancer, prognosis varies widely and depends on many different factors.
Unlike cancers that develop in otherwise healthy organs, liver cancer prognosis depends on:
A biopsy can help identify genes, proteins and other characteristics of the tumor that can help your team select treatment options
Key factors include:
People diagnosed at an early stage with good liver function often have better outcomes and more treatment options than those who are diagnosed at later stages.
Staging classifies liver cancer based on how far it has progressed. Unlike most cancers, liver cancer staging considers both the tumor(s) and liver function.
To stage liver cancer, providers evaluate:
Stage I (1) liver cancer is found only in the liver. There’s usually just one tumor or a small number of tumors. In most cases, the liver is still functioning well.
At this stage:
Intermediate-stage liver cancer means there are multiple tumors within the liver but they haven’t invaded blood vessels very much or spread to parts of the body that are far away.
Treatment often focuses on:
Stage IV (4) liver cancer has spread to major blood vessels or outside the liver.
At this stage:
End-stage liver cancer causes severe liver failure and most treatment options will not help. Care often focuses on keeping you comfortable and relieving symptoms.
Staging and prognosis help your care team better understand:
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