16.3 PTC Cancer Life Phases: Diagnosis of Liver Cancer

Every type of cancer is a little bit different in the way that the doctor will diagnose it. A lot of times, doctors will first look at you for visual symptoms. Then, if they notice anything they will do blood or urine tests. They might also do imaging tests like an MRI or CT scan. Sometimes they do a biopsy which is where they take a tiny sample of your tissue to take back to the lab to test for cancer cells. This happens a little bit differently for each type of cancer, but for any procedure that involves significant pain for a biopsy, they will numb you or put you under anesthesia (put you to sleep for the procedure) so that you don’t feel any pain. (anesthesia is not normally used for skin biopsies where simple numbing injections usually suffice)

Once you know what symptoms to LOOK out for, consider cancer tests that allow us to detect cancers that do not have external, easy to see symptoms. 

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How is it diagnosed clinically? 

Liver cancer is diagnosed by checking for visible signs like jaundice (yellow color in the eyes and skin). Then, if those signs make it seem like liver cancer is possible, then more tests will be done. These may include imaging tests like a CT scan, ultrasound, or MRI, lab tests like blood and urine tests, or a biopsy which is taking a part of your liver tissue and testing it for cancer cells. A special kind of blood test that is used for liver disease and cancer is called an Alpha-fetoprotein blood test. If this test comes back high, it is a possible indicator of cancer. Other blood tests that can help with a diagnosis are liver function tests, blood clotting tests, kidney function tests, complete blood count, and blood chemistry tests to name a few.

There are also three different kinds of biopsies that could happen. Usually, doctors give you a small shot that helps numb the place where they will biopsy. This can pinch a little bit but you shouldn’t feel any pain after that while they do the biopsy. The first kind of biopsy is a needle biopsy where a hollow needle goes through the skin in the belly and into your liver. The second kind is a laparoscopic biopsy which helps a doctor see the liver and take some smaller samples. For the third kind, you will be put to sleep using some kind of anesthesia so you won’t feel anything. The third is a surgical biopsy which would mean that the doctor makes a cut and then takes out a tumor in the liver through surgery.

If you are diagnosed with cancer, an angiogram which is an x-ray test of your blood vessels, and/or a bone scan can help to figure out how much cancer has spread or not.

What will happen when I go to the doctor about this?

According to the American Cancer Association, your doctor will ask you questions about your medical history when you go. These are things like diseases your parents have had before and what your lifestyle habits are like.

Your doctor will then examine you and will pay special attention to your abdomen. They will also check for jaundice by looking at the whites of your eyes and at the color of your skin to see if your eyes or skin seem yellow. If they think based on these two things that you might have cancer, they will probably do more tests like blood tests where they draw some blood with a needle, and/or urine tests where you pee in a cup.

Then if they think they should, they will do some kind of imaging tests like a CT scan, ultrasound, or an MRI where they use x-ray technologies and get some images of the inside of your body and your kidney. For this, they will use a machine. For an MRI and CT scan, you will likely go inside of the machine laying down. They are looking for any things that don’t look normal inside of your liver.

Sometimes doctors will do a biopsy, and these can be done in three different ways. Usually, doctors give you a small shot that helps numb the place where they will biopsy. This can pinch a little bit but you shouldn’t feel any pain after that while they do the biopsy. One way is that your doctor uses a hollow needle to go inside of your skin and into your liver and get a little piece of liver tissue. The next way they might do it is through a laparoscopy, or they might do a surgery where they remove part or all of a tumor. They then run tests on that little piece in the lab where they look at it under a microscope and look for cancer cells. After a biopsy, you might bruise, bleed, or could get an infection so be careful to keep that area clean afterward.

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