How secondary liver cancer is diagnosed

The examination will include feeling your upper abdomen to see whether your liver is enlarged or tender to touch. They will take a blood test to check your general health and see how well the liver is working.

If you’ve had cancer before, and the doctor thinks you might now have a secondary cancer of the liver, they may do a number of tests to confirm the diagnosis. If you’ve not had cancer before, and the doctor thinks you may have a secondary cancer in the liver, they will examine you to see if there are any signs of a cancer anywhere else in your body. They may arrange tests to try to find out where in the body the cancer started.

For some people with secondary liver cancer, the primary cancer can’t be found|. Understandably, many people find this difficult to accept. Even if your doctors can’t tell where the cancer started they will try to discover the type of cell your cancer developed from. This will help them choose the most helpful treatment| for you.

Your doctor may arrange for you to have one or more of the following tests at the hospital. These 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.

CT (computerised tomography) scan Back to top

A CT scan takes a series of x-rays which builds up a three-dimensional picture of the inside of the body. The scan is painless but takes 10-30 minutes. CT scans use a small amount of radiation, which is very unlikely to harm you and won’t harm anyone you come into contact with. You’ll be asked not to eat or drink for at least four hours before the scan.

You may be given a drink or injection of a dye which allows particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you’re allergic to iodine or have asthma you could have a more serious reaction to the injection, so it’s important to let your doctor know beforehand. You’ll probably be able to go home as soon as the scan is over.

Liver ultrasound Back to top

Sound waves are used to make up a picture of the inside of the liver. This is done in the hospital scanning department. If you’re having an ultrasound scan you’ll 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.

Liver biopsy Back to top

Sometimes the doctors will take a small piece of tissue from the liver to look at under the microscope - this is called a liver biopsy. The area is numbed using a local anaesthetic injection, then a fine needle is passed into the tumour through the skin. CT or ultrasound may be used at the same time to make sure the biopsy is taken from the right place.

You’ll need to stay in hospital for a couple of hours after a liver biopsy, and possibly overnight. This is because there is a risk of bleeding afterwards.

MRI (magnetic resonance imaging) scan Back to top

This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body. The scanner is a powerful magnet so you may be asked to complete and sign a checklist to make sure it’s safe for you. The checklist asks about any metal implants you may have, for example a pacemaker, surgical clips, bone pins, etc.

You should also tell your doctor if you have ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body it’s likely that you won’t be able to have an MRI scan. In this situation another type of scan can be used.

Before the scan, you’ll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm, which doesn’t usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly.

During the test you will lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It’s also noisy, but you’ll be given earplugs or headphones. You can hear, and speak to, the person operating the scanner.

Laparoscopy Back to top

This is a small operation which allows the doctor to look at the liver. While you’re under anaesthetic, the doctor makes a small cut in the lower abdomen and carefully inserts a laparoscope, which is a thin fibre-optic telescope tube with a camera attached. The doctor can look at the liver through the laparoscope and take a small sample of tissue (a biopsy) to examine under a microscope.

After a laparoscopy you may have one or two stitches 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 for someone who has had major surgery to their abdomen in the past.

It will probably take several days for your test results to be ready and a follow-up appointment will be made for you. Obviously this waiting period can be an anxious time. It will probably help if you can talk things over with a relative or friend. You can also contact one our cancer support specialists|.