Liver Cancer : Diagnosis

Liver cancer is an abnormal growth of cells, in the liver. Liver cancer can be classified into two major categories, primary and secondary liver cancer.

Primary liver cancer originates from the cells present in the liver and is more common among middle-aged men and aged individuals (above 60 years of age). Primary liver cancer can be differentiated into two major categories, depending on the origin of the tumor.

Clinical findings: An abdominal examination makes the doctor suspect liver cancer based on the any change in the size or shape of the abdominal organs such as the liver, spleen or other neighboring organs. It can also reveal the presence of any abnormal fluid collection in the abdomen.

Ascitic fluid analysis: Analysis of ascitic fluid and presence of cancer cells in the fluid points to a diagnosis of malignancy.

Blood test: A specialized test is the screening for alpha-fetoprotein, a tumor marker. It is a protein secreted by fetal liver. Soon after birth, the levels of this protein come down to normal level. Elevated levels of the protein are seen in liver cancer, ovarian and testicular tumors and spread of a tumor from other organs to the liver. A level of AFP greater than 500 ng/ml is strongly suggestive of severe liver cancer. AFP level can also be used to determine the outcome of liver cancer treatment

Ultrasound: It is non-invasive, safe and relatively inexpensive compared to the other methods. It can be used to assess the presence of the tumor, the number of tumors (single/multiple) or the extent of involvement of the neighboring structures and blood vessels.

Computed tomography: Serial images of the body are taken that helps in the identification of tumor in the liver, if any. In order to obtain more information, a contrast material is given either through the mouth or through the intravenous route. If required, detailed information about the blood supply to and from the liver can be obtained.

Magnetic resonance imaging: Advanced forms of this imaging technique can provide a reconstruction of the images that would help the physician plan the treatment better.

Angiography: A dye is usually injected into a blood vessel and X-rays are taken. It can demonstrate the blood supply to the cancer.

Liver biopsy: To determine the type of liver cancer, a thin needle is inserted through the skin surface to remove a small amount of the tissue. In some cases, the sample can be taken through ultrasound or CT guidance. It can also be removed when the patient is undergoing a surgery. The obtained sample is then sent to the pathologist who examines the tissue.

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