Liver Cancer:
Diagnosis and Staging

This page covers tests that are often used to help diagnose and stage liver cancer.
Depending on the symptoms you have, you may also be asked to undergo other tests and investigations.

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Diagnostic Tests to Determine Cancer Type

Once the doctor is sure of an abnormality, the following tests are done to determine further details about the type of cancer present.

These tests are used to supplement blood tests such as the complete blood count (CBC), liver function test (LFT) and certain tumour marker tests.

Abdominal Ultrasound

What to expect

An abdominal ultrasound is a painless procedure that utilizes sound waves to make images of the internal body organs. Ultrasounds are often used to detect if suspicious area is a fluid-filled sac (cyst) or a solid mass which might be cancerous. They also pinpoint the position of a tumour and this guides the physician to the exact spot to insert a needle during biopsy.

During an abdominal ultrasound

First, you may be asked to undress the upper part of your body (down to your waist) and lie on your back on a bed or examination table. Ask for a robe or blanket to cover yourself while you wait for the specialist to arrive.

The specialist may instruct you to lie on your side, or change sides during the scan. He or she may also ask you to raise your arms over your head.

Next, the specialist will cover a small instrument (called a transducer) with a special gel, and move it around your abdomen and the surrounding area. If the abdominal tissue is dense, the specialist might use some pressure to get a clearer image.

The ultrasound should take about 10-15 minutes. If you experience any pain, be sure to inform your doctor.

Biopsy

What to expect

Biopsy involves the removal of a sample of liver cells or tissues for laboratory testing and is the only definitive method to diagnose liver cancer. It is a way to evaluate a suspicious area in your liver to determine whether it is cancerous.

Typically, biopsies will be done along with the abdominal ultrasound. It is important that you choose a doctor and clinical team that you are comfortable with to perform your procedure.

For a few days after the biopsy, your abdominal area may feel sore and bruised. Don’t hesitate to talk to your clinical team about pain medication if you feel you might need it. The pain and bruising will generally subside in a couple of weeks. If it persists, please contact your doctor immediately.

There are two types of biopsy used for liver cancer:

  • Fine-needle aspiration (FNA) biopsy is a quick, simple test in which a thin needle is used to remove tissue or fluid for examination under a microscope.
  • Core biopsy which involves the removal of a tissue sample using a wide needle for examination under a microscope. This procedure is also called core needle biopsy. Before your doctor starts the procedure, he or she will typically inject a local anaesthetic into the area to numb it. You may feel a little pain or a sensation of pressure for a short time during the biopsy.

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