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Liver Cancer Screening

The Asian Liver Center at Stanford University is one of the nation's leading medical research institutions dedicated to hepatitis B and liver cancer. We are proud to partner with the Asian Liver Center in their national Jade Ribbon Campaign to raise awareness about these important health concerns.
All of the following information about liver cancer screening and evaluation has been excerpted from the Asian Liver Center website. Read the web linkFull Report.

Symptoms

Liver cancer is a silent killer because the majority of the patients appear to be perfectly healthy and have no early signs or symptoms. Pain is uncommon until the tumor is quite large, and some large tumors don't even cause pain or other symptoms.

Later stages of liver cancer, when the cancer is very large or when it impairs the functions of the liver, can produce more obvious symptoms such as pain over the right upper abdomen, weight loss, lack of appetite, and finally the development of yellow discoloration of the eyes and skin (jaundice) and abdominal swelling.

Screening Frequency

Hepatitis B carriers who become infected early in childhood have a high risk of developing liver cancer whether they have cirrhosis or not. The risk is greater in men and those with a positive family history for liver cancer.

A reasonable approach to liver cancer screening includes:

  • Alpha-fetoprotein (AFP) blood test every 6 months
  • Liver Ultrasound at least once or twice a year

Either test alone, however, can miss the diagnosis. Once the patient develops cirrhosis, more frequent screening is generally recommended.

Evaluation of Liver Cancer

Ultrasound of the liver and conventional CT scan are regularly obtained in the diagnostic evaluation of HCC (hepatocellular cancer or primary liver cancer), but they are often too insensitive to detect multi-focal small lesions and for treatment planning.

Thorough assessment with a biphasic spiral CT scan of the abdomen is essential. The fast spiral scanner allows scanning of the liver at the arterial phase shortly after the patient is given an intravenous bolus of contrast.

Percutaneous fine needle biopsy may be indicated in cases when the diagnosis of primary versus metastatic liver tumor is uncertain, providing that it can be safely performed. Post biopsy bleeding can be life threatening in cirrhotic patients with low platelet count, prolonged clotting time, and enlarged blood vessels that are under high pressure (portal hypertension). In general, metastatic liver lesions are rare in patients with cirrhosis.

Screening for liver cancer is the only effective way of improving the outcome of treatment

Visit the Asian Liver Center at Stanford University to learn more about their programs.

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Page last modified October 21, 2009