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 Full
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.
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
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Page last modified October 21, 2009