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Saturday, May 3, 2008

How secondary liver cancer is diagnosed

You may see your family doctor (GP) or your cancer specialist (oncologist), who will examine you and arrange for any tests or scans that may be necessary.

Initial examination

The examination will include feeling your upper abdomen to see whether your liver is enlarged or tender to the touch. If you have had cancer before, the doctor will arrange for tests to see whether you have a secondary liver cancer.

If you have not had cancer before, the doctor will examine you thoroughly and ask you to have tests to see if there are any signs of another cancer in your body, which has spread to your liver.

A blood test will be taken to check your general health and also to check how well the liver is working.

If it is thought that you have secondary cancer of the liver, your doctor may do a number of tests to confirm the diagnosis. If you have not had cancer before, the doctor may order further tests to find out where in the body the cancer started.

In some people with secondary liver cancer it may be impossible to find the original primary cancer. Understandably, many people find this difficult to accept. Sometimes the primary cancer cannot be found because it is too small to be detected by the tests currently available.

Your doctor may arrange for you to have one or more of the following tests at the hospital. The tests are designed to confirm whether you have liver cancer and if so:

  • to see whether the cancer is primary or secondary
  • check the extent of the disease in the liver
  • see whether the cancer has spread to other parts of the body as well as the liver.

Liver ultrasound

Sound waves are used to make up a picture of the inside of the liver. It is done in the hospital scanning department. If you are having an ultrasound scan you will be asked not to eat anything for at least four hours before your appointment.

Once you are lying comfortably on your back, a gel is spread onto your abdomen. A small device, like a microphone, which produces sound waves, is passed over the area. The sound waves are then converted into a picture by a computer.

This is a painless test and only takes a few minutes.

Abdominal CT (computerised tomogrophy) scan

In this scan, a series of x-rays are taken of the abdominal area and fed into a computer. This builds up a detailed picture of the size and position of the cancer.

Before the scan you will be asked to drink a special liquid which shows up on x-ray and ensures that a clear picture is obtained. Once you are lying in a comfortable position, the scan will be taken. About halfway through the scan, a special dye may be injected into one of your veins to show up the blood vessels in the liver. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.

The scan itself is painless but it will mean lying still for about 10–30 minutes.

You will probably be able to go home as soon as the scan is finished.

MRI (magnetic resonance imaging) scan

This test is similar to a CT scan, but uses magnetism instead of
x-rays to build up cross-sectional pictures of your body.

As with CT scans, some people are given an injection of dye into a vein in the arm to improve the picture.

During the test you will be asked to lie very still on a couch inside a long chamber for up to an hour. This can be unpleasant if you don't like enclosed spaces; if so, it may help to mention this to the radiographer. The MRI scanning process is also very noisy, but you will be given earplugs or headphones to wear. You can sometimes take in CDs of your own music to listen to.

The chamber is a very powerful magnet, so before entering the room you should remove any metal belongings. People who have heart monitors, pacemakers or certain types of surgical clips cannot have an MRI because of the magnetic fields.

You will probably be able to go home as soon as the scan is finished.


This is a small operation which allows the doctor to look at the liver. While you are under anaesthetic, the doctor makes a small cut in the lower abdomen and carefully inserts a thin mini-telescope (laparoscope). The doctor can look at the liver through the laparoscope and take a small sample of tissue (biopsy) for examination under a microscope.

After a laparoscopy you will have one or two stitches in place in your lower abdomen. You should be able to get up as soon as the effects of the anaesthetic have worn off. You may need to stay in hospital for a day or so.

A laparoscopy may not be possible in someone who has had major surgery to their abdomen in the past.

Further tests

If the tests described above show that you have secondary cancer of the liver (and it was not previously known that you had a primary cancer elsewhere in your body), your doctor may need to do some further tests.These will be to find out where the primary cancer is.

All medical tests take time and may be uncomfortable, so your doctor will only arrange tests that are most likely to affect your future treatment. If it is necessary to do such tests, your doctor will discuss them with you first.

Via: http://www.cancerbackup.org.uk

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