How Is a Liver Cancer Diagnosis Made?
If you suspect that you may have liver cancer, the best place to start is by making an appointment with your general practitioner. If your doctor also thinks that you might have liver cancer, he or she will likely refer you to a hepatologist (i.e. a medical doctor specializing in liver diseases) and/or an oncologist (i.e. a doctor specializing in cancer treatments).
The Early Signs of Liver Cancer
While the majority of people do not experience any signs and symptoms during the early stages of primary liver cancer, when they do appear they may include:
- Unexplained weight loss
- Lack of appetite
- Pain in the upper regions of the abdomen
- Swelling of the abdomen
- Generalized fatigue and/or weakness
- Jaundice (i.e. yellow discoloration) of the skin and/or sclera (i.e. whites of the eyes)
- Chalky white stools
Since appointments with both family doctors and specialists can be brief, as well as there typically being a lot of ground to cover, it is always a wise idea to go to appointments well prepared. The following is valuable information to assist in optimizing your liver cancer appointments.
How to Prepare for Your Appointment
- Ensure you are aware of any pre-appointment restrictions and/or preparations: Make sure to inquire if there is anything you need to do to prepare before your appointment (e.g. fast or restrict your diet).
- Make detailed notes of your symptoms: This includes any that may seem completely unrelated to liver cancer.
- Write down any key information: This may include any recent life changes and/or major stresses.
- Make a complete list of all prescription medications and/or vitamins/supplements that you are presently taking.
- Consider taking a family member or friend to your appointment: Sometimes, if you are worried or stressed, it can be extremely difficult to process all of the information you are bombarded with during an appointment. A companion may remember details that you may have forgotten and/or did not hear.
- Prepare a list of questions: Since time with doctors can be limited, this will help optimize the time you spend with them. Prioritize questions from the most important to the least important, just in case time runs out.
In the case of liver cancer, some basic questions to ask your doctor may include the following:
- At what stage is my liver cancer?
- What do my pathology reports indicate? Can I have copies for my records?
- Will I require any additional tests?
- Exactly what are my treatment options?
- How much time can my family and I take to make decisions concerning the choice of treatment(s)?
- Can you tell me the possible side effects of various treatments?
- Is there any particular treatment that you would recommend over others? Why?
- In what way(s) will my life be affected by my live cancer treatment(s)?
- Do I need to see a liver cancer specialist? If so, what will the costs be? Will my medical insurance cover all of these costs?
- Are there any printed materials that I can take home to learn about my condition? Do you recommend any educational websites related to liver cancer?
Never be afraid to ask other questions you think of during the course of your appointment. You have the right to know everything there is to know.
Questions Your Doctor Will Ask You
Be prepared to answer all the questions your doctor asks. This can make more time later in the appointment to cover other important issues.
- When did you initially start having your symptoms?
- Are your current symptoms occasional or continuous?
- How would you rate your symptoms in terms of severity?
- Does anything appear to make your symptoms better?
- Does anything appear to make your symptoms worse?
What Tests Are Used for a Liver Cancer Diagnosis?
The doctor will order an ultrasound first, since this test can show chances of the liver structure. Alpha-fetoprotein test (AFP) is a tumor marker that can rise in liver cancers. This test is usually requested every 6 to 12 months and can detect a liver cancer in earlier stages.
After treatment, an AFP test may be ordered again to evaluate how effective was the treatment. Other useful tests include CT scans, MRIs, liver biopsy (biopsy is a great test to confirm the diagnosis).
Figuring Out What to Do After Liver Cancer Diagnosis
Receiving the diagnosis of cancer can change your life completely. At first, you may deny it. As you get used to the idea, other questions will pop into your mind: how long will the treatment last? Can it be completely cured? What is the best treatment and how well does it work? The more you understand your condition, the less anxiety and worries you will have.
Learning More about Liver Cancer
Liver cancer can be divided into primary and secondary liver cancer:
- Primary liver cancer means that the cancer started in the liver. From the liver, it can spread to the bones.
- When you receive the diagnosis of secondary liver cancer – also called metastatic liver cancer, it means that the cancerous cells first developed somewhere else, and then spread to the liver.
Many cancers are known to spread to the liver, including bowel, pancreas, stomach, lung and breast cancers.
The Different Types of Liver Cancer
- Most cases of primary liver cancer are called hepatomas or hepatocellular carcinoma. It usually occurs as a result of cirrhosis or hepatitis.
- Fibrolamellar hepatoma is rare, it and develops in a previously healthy liver.
- Cholangiocarcinoma is a cancer of the bile duct.
- Hepatoblastoma is another rare form of liver cancer found in children and finally, angiosarcoma (another rare form of primary liver cancer) develops when the blood vessels cells supplying the liver become cancerous.
What Are the Treatment Options?
Surgery is usually indicated if the cancer is small, if it didn’t spread to other organs and if you are healthy overall. Chemotherapy uses oral or I.V. drugs that target the cancerous cells. Sorafenib is a new drug developed for liver cancer and shows promising results.
Other liver cancer treatments such as cryotherapy, radiofrequency ablation, and radiotherapy are also available and used in selected cases. The prognosis is not so great, but treatment can delay the natural progression of this cancer. New chemo drugs are currently being researched and hopefully, they will be more helpful for liver cancer patients.