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How liver cancer is found

Suspicious symptoms usually prompt tests for liver cancer.

The liver is the largest internal organ in the human body. Located on your right side, below the ribs, it has many different jobs. It filters and stores blood, helps convert food into energy, and helps remove toxic wastes from the body.

Like other organs, the liver can be affected by cancer. In most cases in the United States, cancer that affects the liver starts in another part of the body and spreads (called secondary liver cancer). Cancer that begins in the liver (primary liver cancer) is less common.

Symptoms of liver cancer

The American Cancer Society (ACS) lists these possible symptoms of liver cancer:

  • Unexplained weight loss.
  • Loss of appetite.
  • Fever, fatigue and weakness.
  • Very full feeling after a small meal.
  • Ongoing stomach pain.
  • Pain around the right shoulder blade.
  • A swollen belly.
  • Yellowing of the skin and eyes.
  • Worsening condition if you have chronic hepatitis or cirrhosis.
  • A hard lump just below the rib cage on the right side.

These symptoms can also be caused by other cancers, by a noncancerous liver tumor or by less serious conditions.

How liver cancer is diagnosed

If you have symptoms of liver cancer, or if cancer is suspected, your doctor will likely perform a medical exam and take your medical history. He or she may also recommend additional tests. These tests may be done to help determine if cancer is present, the size and location of tumors, whether cancer has spread, or if treatment is working. Tests that your doctor orders may include:

Blood tests. Doctors sometimes check the blood for a protein called AFP, or alpha-fetoprotein. This substance is sometimes, but not always, found in the blood of adults who have liver cancer or another kind of cancer. A complete blood count may also be done to check the number of red cells, white cells and platelets and the amount of hemoglobin in the blood, among other things.

Ultrasound. This noninvasive test uses sound waves to create a picture of the tissues and structures inside of your body. It can help locate tumors in the liver.

CT scan (computed tomography). A CT scan uses x-rays to take multiple cross-sectional pictures, called slices, of areas inside your body. The slices are then put together to show a detailed image of the part of your body being studied. CT scans can give precise information about the size and shape of tumors and where they are situated.

MRI (magnetic resonance imaging). MRI scans use radio waves and strong magnets to create detailed pictures of parts of the body. These images can sometimes tell whether a tumor is cancerous or non-cancerous.

Angiography. In this test, dye is injected into an artery. This allows the blood vessels in the liver to be seen on an x-ray.

Biopsy. In this test, the doctor takes a sample of liver tissue. The tissue is checked under a microscope for cancer cells.

Laparoscopy. A laparoscope is a slender, tube-shaped instrument with a light on the end that a doctor can use to look inside the body. This test requires a small cut in the abdomen so the laparoscope can be inserted. The doctor may take a tissue sample during this test.

Some people whose risk for liver cancer is high are screened regularly with blood tests, ultrasound or both. But there's no effective routine screening test for primary liver cancer for the general population, according to the ACS.

Reviewed 6/22/2022

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