Diagnosis of Liver Cancer

Liver cancer diagnosis is based on a previous medical condition. If the persisting medical condition is difficult to cure or has worsened, patients will be required to go through a few tests to diagnose liver cancer. Here are a few steps to diagnose liver cancer-

Blood Tests—Tests for liver function check the level of liver enzymes, proteins, and bilirubin in the blood. The presence of alpha-fetoprotein (AFP) in the blood confirms liver cancer. AFP is a protein seen in the liver of the foetus in the womb, and the production of this protein stops after birth.

Abdominal CT and MRI Scan- Imaging tests such as CT and MRI scans of the abdomen help to get accurate images of the liver and other organs. This enables the doctor to locate the tumour easily and learn more about the tumour, such as the size and the area of infection.

Liver Biopsy- During a liver biopsy, a small piece of tissue is removed for examination under a microscope. This procedure is usually performed using imaging guidance and does not require general anaesthesia.

Needle Biopsy of the Liver – This is the most common method, performed by inserting a fine needle through the abdominal wall into the liver. It is typically guided by ultrasound or CT scan to ensure precise sampling of the suspected tumour.

This helps confirm the diagnosis of liver cancer. Once the size, location, and stage of the cancer are established, appropriate treatment can be planned.

In certain cases, a PET-CT scan may be used to assess the extent of the disease and identify whether the cancer has spread to other organs.

Treatment - Just like other cancer treatments, the treatment for liver cancer differs from one person to another depending on the size, location of tumour cells, the functionality of the liver, presence of cirrhosis and the stage of cancer. Some of the treatment options based on these conditions are -

Surgery (Hepatectomy)- During the operation to eradicate liver cancer, an affected portion of the liver is removed with a small portion of healthy tissue to prevent the infection from spreading. This procedure is called a partial hepatectomy. After the surgery, the healthy leftover part of the liver helps recover and replace the missing part. If the tumour is small and in an uncomplicated location and the liver functions excellently well, the recovery is fast and easy.

Liver Transplant- Another way to treat liver cancer through surgery is a liver transplant. The affected liver is replaced by a healthy liver donated by a donor, which is called transplantation. This treatment does not work on all liver cancer patients and works well only on patients suffering from early stages of liver cancer.

Liver Ablation (Radiofrequency Ablation-RFA)- In this procedure, the cancer cells are destroyed by heat from an electric current. The images from an ultrasound help the doctor insert one or many fine needles into the abdomen. An electric current is passed to heat the needles, damaging the liver's tumour cells. Microwaves or lasers are also used to heat the needles. This procedure does not help in recovering liver cancer in patients who have already undergone surgery or transplant.

Cryoablation: Freezing of cancer cells- The procedure of killing cancer cells by freezing them is called Cryoablation. In this procedure, the doctor freezes cancer cells and destroys them by placing an instrument called a cryoprobe filled with liquid nitrogen directly into the tumour. This is done with the help of ultrasound images.

Chemotherapy in Liver Cancer- An assertive drug therapy through IV or tablets to kill cancer cells is called chemotherapy. Chemotherapy is an effective treatment to treat liver cancer. However, patients face side effects such as nausea, vomiting, decreased appetite, chills and an increased chance of infections.

Radiation Therapy in Liver cancer - The cancer cells are killed using high-energy radiation beams. Radiation therapy can be conducted in two ways-

External Radiation - In this process, the radiation beams are targeted at the external parts of the abdomen and chest.

Internal Radiation- This process uses a catheter to infuse tiny radioactive spheres into the hepatic artery, a blood vessel that supplies blood to the liver. This process helps reduce the blood flow to the tumour as the hepatic artery is destroyed by the radiation beams. The portal veins continue to feed the liver once the hepatic artery is shut.

Targeted Therapy for Liver cancer- cancer cells are killed by stopping blood flow to the tumour. During targeted therapy, Sorafenib (Nexavar), a drug for liver cancer, is supplied to target the infectious cells. This therapy is not effective for patients who have undergone hepatectomy and transplant earlier and has serious side effects.

Embolization and Chemo-embolization—This surgery is performed to block the hepatic artery in the liver. Small sponges and other particles are inserted into the artery to decrease blood flow. The process is conducted only after chemotherapy drugs are injected into the artery. It helps retain the chemotherapy medicines for a longer period in the liver.

Immunotherapy- Cancer cells produce a protein that blinds the immune system cells and destroys their ability to fight against them. The process is interrupted through immunotherapy, allowing them to fight against cancerous cells. This treatment works well on patients suffering from advanced liver cancer.

Palliative care- This is a supportive treatment along with other cancer treatments that help cancer patients to overcome pain, side effects and stress during their treatment period. It is supportive care, which is often preferred by patients suffering from advanced cancer and who do not wish to undergo further medical treatments.