How is Liver Cancer Diagnosed?

The diagnosis of liver cancer (hepatocellular carcinoma, HCC) is crucial for effective treatment and management.

Early and accurate diagnosis increases the chances of successful outcomes, guiding the most appropriate treatment strategies.

Blood Tests

Blood tests are often the first diagnostic step for liver cancer. These tests help identify abnormalities in liver function and detect tumour markers, like alpha-fetoprotein (AFP), which is often elevated in liver cancer patients.

Imaging Tests

Imaging techniques play a vital role in identifying liver cancer and understanding its extent:

  • Ultrasound: A non-invasive imaging method used to detect liver abnormalities or tumours.
  • CT Scan (Computed Tomography): Provides detailed cross-sectional images to assess the size and location of the liver tumour.
  • MRI (Magnetic Resonance Imaging): Offers high-resolution images to evaluate cancer spread and surrounding tissue involvement.

Liver Biopsy

A liver biopsy involves extracting a small tissue sample from the liver to examine under a microscope for cancer cells. Although it’s a critical step in confirming the diagnosis, it carries risks like bleeding or infection.

Staging Liver Cancer

Once liver cancer is diagnosed, staging tests determine the extent of cancer spread. Staging systems, such as Roman numerals (I-IV), help classify the cancer stage. Imaging tests, like CT scans and MRIs, are essential in staging liver cancer and planning appropriate treatment.

Treatment Options for Liver Cancer

The treatment of liver cancer depends on factors such as the stage of the disease, liver function, and the patient’s overall health. Early detection and intervention are key to achieving better outcomes.

Below are the primary treatment options:

Hepatectomy (Liver Resection)

Hepatectomy involves the surgical removal of a portion of the liver affected by cancer. It's often effective in patients with localised tumours and good liver function. However, it is not suitable for everyone and depends on tumour size and location.

Liver Transplantation

For patients with small tumours that cannot be removed by surgery, liver transplantation may be recommended. This procedure involves replacing the diseased liver with a healthy donor liver. It offers a potential cure for early-stage liver cancer and underlying liver conditions, such as cirrhosis.

Radiofrequency Ablation (RFA)

RFA is a minimally invasive technique commonly used for small liver tumours. It uses radiofrequency energy to destroy cancer cells. It’s especially useful when surgery isn’t an option and is typically performed by an interventional radiologist.

Transarterial Chemoembolization (TACE)

TACE is a specialised chemotherapy method for hepatoma, where chemotherapy drugs are directly injected into the tumour's blood supply. This localised treatment minimises systemic side effects, making it suitable for intermediate-stage liver cancer patients.

Systemic Chemotherapy

For advanced liver cancer, systemic chemotherapy is used to treat cancer cells throughout the body. Chemotherapy can be administered intravenously or orally and is generally effective when liver cancer has spread.

Radiotherapy

Radiotherapy uses high-energy beams, like X-rays or protons, to target and destroy cancer cells. Stereotactic Body Radiotherapy (SBRT), a specialised type of radiotherapy, focuses on delivering precise radiation to tumours while sparing healthy tissues.

Targeted Molecular Therapy

Targeted molecular therapy focuses on specific genetic mutations or abnormalities in cancer cells. These therapies block the growth and spread of cancer cells while sparing healthy cells. Genetic testing of cancer cells may be required to determine eligibility for targeted therapy.

Immunotherapy

Immunotherapy enhances the body’s immune system to fight cancer. It is often used for advanced liver cancer and works by disrupting the cancer cells' ability to evade immune detection.

Palliative Care

Palliative care focuses on symptom management to improve the quality of life for patients with advanced liver cancer. This care is provided alongside curative treatments, aiming to alleviate pain, nausea, and fatigue.

Preparing for Your Appointment

To ensure you make the most of your appointment and actively participate in your treatment plan, follow these helpful tips:

Steps to Prepare

  • List Your Symptoms: Record all symptoms, including fatigue, unexplained weight loss, pain, or any changes in your health. Even minor symptoms can provide valuable insight.
  • Gather Your Medical History: Prepare details about any pre-existing conditions, medications you're currently taking, and lifestyle factors (like alcohol use, diet, or exercise habits) that could impact your liver health.
  • Prepare Questions for Your Doctor: Write down any questions or concerns to ensure you get all the information you need. Common questions include:
    • At what stage is my liver cancer?
    • What treatment options are available for me?
    • What are the potential side effects of my recommended treatment?
    • Would you recommend a second opinion?

What to Expect from Your Doctor

During your visit, your doctor will ask important questions to help diagnose your condition and recommend the best course of action. Expect questions such as:

  • When did your symptoms first appear?
  • Are your symptoms persistent or do they come and go?
  • What activities seem to improve or worsen your symptoms?

These details help the doctor understand your condition better and tailor a personalised treatment plan to meet your needs.

Advanced Liver Cancer Care at SJMC

At Subang Jaya Medical Centre (SJMC), we offer a wide range of diagnostic and treatment options for liver cancer. Our experienced team of hepatologists, oncologists, and radiologists collaborate to create personalised care plans.

Using cutting-edge technologies like Stereotactic Body Radiotherapy (SBRT) and Radiofrequency Ablation (RFA), we strive to provide the best care possible, with advanced treatment strategies ensuring the best possible outcomes.

FAQs About Liver Cancer Diagnosis and Treatment

Hepatectomy is a surgical procedure to remove the affected portion of the liver. It is recommended for patients with localised tumours and good liver function.

Yes, non-surgical options like radiofrequency ablation (RFA), TACE, targeted therapy, and immunotherapy are effective for certain cases of liver cancer.

Liver cancer is confirmed through blood tests, imaging scans like CT or MRI, and a liver biopsy to examine tissue for cancer cells.

For early-stage liver cancer, hepatectomy or liver transplantation offers the best chances of a cure.

Early detection improves the chances of successful treatments like hepatectomy and liver transplantation, offering a higher potential for a cure. Regular screenings are vital, especially for high-risk individuals with chronic hepatitis or cirrhosis.

Yes, liver cancer can be treated without systemic chemotherapy. Options include surgery (hepatectomy or liver transplantation), localised treatments like RFA or TACE, and targeted therapies. These methods are often used based on the stage and type of liver cancer.

Reference:

  1. Mayo Clinic: Liver Cancer - Diagnosis and Treatment
  2. Cancer & Radiosurgery Subang Jaya Medical Centre: Liver Cancer
  3. Johns Hopkins Medicine: Liver Cancer Overview
  4. National Health Service (NHS): Liver Cancer - Diagnosis and Treatment
  5. Cleveland Clinic: Liver Cancer