Liver Cancer - Diagnosis & Treatment

How is liver cancer diagnosed?

If you experience signs or symptoms that suggest liver cancer, your doctor may carry out the following diagnostic tests:

• Blood tests – These are necessary to determine liver function abnormalities. One of the vital things to check is the Alpha-fetoprotein (AFP), a tumour marker for liver cancer.
• Ultrasound – Using high-frequency sound waves, ultrasound is useful in detecting tumours growing in the liver. These tumours can then be tested for cancer if necessary.
• Computerised tomography (CT) scan – This diagnostic test makes use of a series of X-rays to create a three-dimensional picture of the body. Your doctor may require you to undergo CT scan of the abdomen to check for different types of liver tumours.
• Magnetic resonance imaging (MRI) – This imaging tool makes use of strong magnetic field and radio waves to create a more detailed picture of the liver to check for liver tumours. MRI can also be used to examine if there are blockages in the blood vessels in and around the liver.
• Biopsy – While liver cancer can be diagnosed based on the results of blood tests and imaging tests, there may be cases when a liver biopsy is needed to confirm the diagnosis. During a biopsy, a part of the abnormal tissue in the liver will be removed and sent to a pathologist for a thorough examination.

How is liver cancer treated?

Treatment depends on the size and number of liver cancer tumours, whether the cancer has spread outside the liver, the underlying liver function, and the general fitness of the patient.

Liver cancer treatments include:

Liver transplant

Liver transplant is a surgery that involves the removal of the entire liver and replaced with a healthy donated liver. This can only be done if a donated liver is available, cancer has not spread to other parts of the body, and the cancer can be eliminated through surgery. This treatment is suitable for patients whose liver cancer tumours meet certain criteria. It is especially suitable for patients whose liver is too weak to receive other treatments.

Liver resection

Liver resection is a surgery that removes the affected part of the liver. It is suitable for patients with a normal-functioning liver, and is a potentially curable treatment for early stage liver cancer.

Tumour ablation

Tumour ablation directly destroys the liver cancer cells with heat or alcohol. It can destroy liver tumours without the need to remove them. This treatment is usually recommended if surgery is not ideal due to the patient’s poor health or dwindling liver function. Tumour ablation can also be a good treatment option if the tumours are few and small.

Trans-arterial chemotherapy

Chemotherapy destroys the cancer cells. Drugs can be given as injections into the artery supplying the tumour via a process called chemoembolisation. At the same time, a gel may be injected to block blood supply to the tumour. Your doctor will recommend chemotherapy as a treatment only if your liver is still functioning properly.

Selective internal radiation therapy (SIRT)

SIRT involves injecting radioactive particles directly into the liver tumours via the artery. It can shrink tumours and is useful for tumours that have spread into the liver veins.

Targeted therapy

Targeted therapy stops the cancer from growing or spreading by reducing blood flow to the cancer cells. Drugs are used to target the genes and proteins that contribute to the growth and survival of cancer cells. These drugs can be delivered orally or intravenously.