Diagnosis & staging
These are tests that may be used to diagnose this type of cancer.
- Liver cancer is generally not diagnosed until it has reached an advanced stage.
- Blood test for Alpha-fetoprotein (AFP) has been thought to be a useful screening test, but elevated levels are found in a number of diseases including, cancer of testes, stomach, pancreas and lungs, as well as cirrhosis of the liver and normal pregnancy. Also 30% of people with liver cancer do not have an elevated AFP.
- Liver function test
- Liver scan
- Bone scan
- Chest X-ray
- CT scan
- PET scan
- MRI scan
- Abdominal exploratory surgery
- Fine needle biopsy is usually only done if the tumour is inoperable.
For more information on tests used to diagnose cancer, see our Recommended Websites, Diagnosic Tests
Types and stages
- Hepatocellular Carcinoma
- 90 % of liver cancers are hepatocellular carcinomas arising from the liver cells (30-70% of patients have cirrhosis).
- 7 % arise in the liver's bile ducts.
- Fibrolamellar Carcinoma
- Fibrolamellar is an unusual type of hepatocellular carcinoma which generally occurs in young women.
- This type of cancer has a somewhat better prognosis than other hepatocellular carcinomas.
- Angiosarcomas are very rare, but of growing importance because they are associated with polyvinylchloride (PVCs) and other similar industrial toxins.
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary)
N describes involvement of lymph nodes
M relates to whether the cancer has spread (presence or absence of distant metastases)
- It should be noted that TNM staging alone is not enough to accurately form a prognosis, as presence of viral hepatitis, extent of cirrhosis, grade, and remaining liver function are other important factors for prognosis and treatment.
A single tumour and it has not spread to nearby blood vessels
A single tumour and it has spread to nearby blood vessels, or more than one tumour 5 cm or smaller
More than one tumour larger than 5 cm
Tumour that has spread to a branch of the portal or hepatic vein(s)
The cancer has spread to nearby organs other than the gallbladder or has broken through the lining of the peritoneal (abdominal) cavity