Liver can have both primary as well as secondary liver cancers. Primary liver cancer is the cancer that originates in liver and secondary liver cancers are the ones that originate in other parts of the body and metastasize in liver. Since all the blood passes through liver, it is easily accessible to cancer cells. The most common primary liver cancer is hepatocellular carcinoma (HCC).
The prevalence of liver cancer in US has increased drastically in the past few decades. Liver cancer is twice more prevalent in males than females. In the US, about 2% liver cancers are primary liver cancers, but in underdeveloped countries, it accounts for up to 50% cases.
The causes of hepatocellular carcinoma include alcohol abuse, birth defects, hepatitis B and C, non-alcoholic fatty liver disease, exposure to certain drugs and toxins, hemochromatosis and cirrhosis. As liver is surrounded by ribcage, detecting liver cancer in its early stages becomes difficult, thus the prognosis of most of the liver cancers detected in its advanced stages is poor. Liver cancer in its early stages is also asymptomatic leading to delayed detection. Therefore, it becomes mandatory to detect liver cancers in its early stages to improve survival rate of the patients.
Can You Detect Liver Cancer From An Ultrasound Scan?
Diagnosis starts with physical examination along with signs and symptoms. Along with physical examination, the doctor will order blood test to look for alpha-fetoprotein (AFP). AFP is produced in greater amounts in fetal liver, but in adults it is usually low; in liver cancer the AFP levels rise drastically. Blood levels of AFP rises in about 50 to 70% of people with liver cancer.
Other Tests That A Physician Might Order To Confirm The Diagnosis Are:
Ultrasound: An abdominal ultrasound is the traditional method for liver cancer screening, but it misses cancer in its early stages. However, ultrasound along with AFP blood marker increases detection of HCC in its early stage from 45% to 63%. Thus, an ultrasound can detect a liver cancer when aided by other diagnostic tests.
Computed Tomography (CT): It forms a three dimensional image of the part of the body under inspection with views and cross sections from different angles, which is used to detect any abnormality/cancer. On occasions, a contrast dye may also be used for detailed viewing of the structures.
Magnetic Resonance Imaging (MRI): It is the use of magnetic field for the production of three dimensional and detailed images. A dye may also be used for an MRI; just like a CT scan it can also measure the size of the tumor.
Angiography: In this a catheter is inserted in the blood vessel leading to liver. An injected dye into the bloodstream increases the visibility of blood vessels on an X-ray. This helps detect a tumor and treatment plan too whether it can be removed or not. Angiography can also be combined with a CT or MRI for a detailed view of liver.
Biopsy: A tissue biopsy is usually done to confirm the diagnosis of liver cancer. There are different types of biopsies and the type of biopsy to be performed depends on the location of cancer. The different biopsies done are fine needle aspiration, laparoscopic biopsy and surgical/excision biopsy. In fine-needle aspiration, a long needle is used to aspirate liver cells from the tumor into a syringe and this aspirate is sent for pathological analysis. In laparoscopic biopsy, a laparoscope (having a tiny camera at its end) is used to view liver images for any abnormalities. A small sample can also be removed at the time for cancer cell analysis. A surgical/excisional biopsy is performed during a surgery; this may be done before removing the complete mass or part of the liver, if needed. An excisional biopsy is usually preferred during when already a surgery is being performed. Generally, a biopsy is avoided when there is a strong indication of hepatocellular carcinoma after AFP blood test, MRI or CT scan.
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