Liver Cancer

Your healthcare provider may suspect you have liver cancer if they find liver cancer signs and symptoms during your physical examination. They may order the following tests to learn more:

• Blood tests: Healthcare providers may do blood tests for cancer, such as a liver function test, to check on liver enzymes, proteins and other substances that show whether your liver is healthy or damaged. They may test for alfa-fetoprotein (AFP). High AFP levels may indicate liver cancer.
• Ultrasound (sonography): This test provides pictures of your soft tissue structures. Healthcare providers use ultrasound to look for liver tumors.
• Computed tomography (CT) scan: This special type of X-ray takes detailed images of your liver, providing information about liver tumor size and location.
• Magnetic resonance imaging (MRI): This test produces very clear images of your body using a large magnet, radio waves and a computer.
• Angiogram: This test helps healthcare providers examine your liver’s blood vessels. During this test, your healthcare provider injects dye into an artery so they can track blood vessel activity and look for blockages.
• Biopsy: Healthcare providers remove liver tissue to look for signs of cancer. Biopsies are the most reliable way to confirm a liver cancer diagnosis.

Your healthcare provider may do the following tests if they think you may have IHC:

• Endoscopic retrograde cholangiopancreatography (ERCP): ERCP uses an endoscope and a catheter (thin, flexible tubes) to examine your bile ducts.
• Percutaneous transhepatic cholangiography (PTC): A PTC creates X-rays of your bile ducts like an ERCP. Instead of an endoscope and catheter, your healthcare provider delivers contrast dye by inserting a needle directly into your bile ducts and liver. A PTC is usually only for people who can’t have an ERCP.

What are liver cancer stages?

Healthcare providers stage HCC using standards set by the Barcelona Clinic Liver Cancer system (BCLC). This system evaluates HCC liver on characteristics, including whether your liver is working well, tumor size and your symptoms. Healthcare providers may use different terms for each BCLC stage; sometimes, presented as being stages I to IV or 0-C or by terms such as early and advanced stage HCC.

Hepatocellular carcinoma stages include the following:

• Stage I/very early stage/stage 0: You have a single tumor in your liver that measures less than 2 centimeters (cm). Blood tests show your bilirubin level is normal.
• Stage II/early stage/stage A: You have a single tumor that measures 5 cm or less or you have more than one tumor that measures less than 3 cm. The tumor may have spread to your blood vessels.
• Stage III/intermediate stage/stage B: In this stage, you may have more than one tumor and/or a tumor that measures more than 5 cm. The tumor may have spread to your lymph nodes, large blood vessels or another organ.
• Stage IV/advanced stage/stage C: The cancer has spread (metastasized) to other places in your body, such as your lungs or bones, as well as lymph nodes.