Medical history and physical exam
Imaging tests
Ultrasound
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Angiography
Laparoscopy
Biopsy
Lab tests
Your doctor may order lab tests for a number of reasons:
- To help diagnose liver cancer
- To help determine what might have caused your liver cancer
- To learn how well your liver is working, which can affect what types of treatments you can have
- To get an idea of your general health and how well your other organs are working, which also could affect what types of treatments you can have
- To see how well treatment is working
- To look for signs that the cancer has come back after treatment
Alpha-fetoprotein blood (AFP) test
AFP is a protein that is normally present at
high levels in the blood of fetuses but goes down to low levels shortly
after birth. Levels in the blood of adults can go up from liver
disease, liver cancer, or other cancers.
If AFP levels are very high in someone with a
liver tumor, it can be a sign that liver cancer is present. But because
liver cancer isn’t the only reason for high AFP levels and many
patients with early liver cancer have normal levels of AFP, it isn’t
very helpful in determining if a liver mass might be cancer.
This test is sometimes useful in people
already diagnosed with liver cancer. The AFP level can help determine
what treatment might be an option. During treatment, the test can be
used to help give an idea of how well it is working, as the AFP level
should go down if treatment is effective. The test can be used after
treatment as well, to look for possible signs that the cancer has come
back (recurred).
Other blood tests
Liver function tests (LFTs): Because
liver cancer often develops in livers already damaged by hepatitis
and/or cirrhosis, doctors need to know the condition of your liver
before starting your treatment. A series of blood tests can measure
levels of certain substances in your blood that show how well your liver
is working.
If the part of your liver not affected by
cancer isn’t working well, you might not be able to have surgery to try
to cure the cancer, as the surgery might require removal of a large part
of your liver. This is a common problem in people with liver cancer.
Blood clotting tests: The liver also
makes proteins that help blood clot when you are bleeding. A damaged
liver might not make enough of these clotting factors, which could
increase your risk of bleeding. Your doctor may order blood tests such
as a prothrombin time (PT) to help assess this risk.
Tests for viral hepatitis: Your doctor might order blood tests to check for hepatitis B and C.
Kidney function tests: Tests of blood urea nitrogen (BUN) and creatinine levels are often done to assess how well your kidneys are working.
Complete blood count (CBC): This test
measures levels of red blood cells (which carry oxygen throughout the
body), white blood cells (which fight infections), and platelets (which
help the blood clot). It gives an idea of how well the bone marrow,
where new blood cells are made, is functioning.
Blood chemistry tests and other tests:
Blood chemistry tests check the levels of a number of minerals and
other substances in the blood, some of which might be affected by liver
cancer. For example, liver cancer can raise blood levels of calcium,
while blood glucose levels may fall. Liver cancer can also sometimes
raise cholesterol levels, so this may be checked as well.