Can Liver Cancer Be Detected by a Blood Test?

Liver cancer is not detected by blood tests alone.

Liver cancer is not detected by blood tests alone. Certain substances present in the blood called the blood markers may be elevated in patients with liver cancer. Raised levels of a tumor marker called alpha fetoprotein (AFP) can indicate diseases of the liver, including liver cancer.

The doctor may order routine blood tests, including a blood count, chemistry profile, coagulation (clotting) profile and liver function tests to evaluate the liver functions in cases of suspected liver cancer.

Alpha fetoprotein/serum tumor marker test

• A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues or tumor cells in the body.
• Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers.
• An increased level of alpha fetoprotein (AFP) in the blood may be a sign of liver cancer. Other cancers and certain noncancerous conditions, including cirrhosis and hepatitis, may also increase AFP levels.
• Sometimes the AFP level is normal even when there is liver cancer.

Liver function tests

• A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver.
• A higher-than-normal level of a substance can be a sign of liver cancer.
• Elevated levels of liver enzymes and aminotransferases (AST and ALT) may signify the level of liver damage in a person. The interpretation of elevated AST and ALT results depends on the personal history, exposure to toxins, viruses and drugs.

Physical exam and history

• An examination of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual.
• A history of the patient’s health habits, past illnesses, family illnesses and treatments will also be taken.

Ultrasound exam

• A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes.
• The probe uses the echoes to create a picture of body tissues called a sonogram.
• The picture texture can help us look for a mass or a cavity in the liver.

Computed tomography scan (CT scan)

• This procedure makes a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles.
• The pictures are made by a computer linked to an X-ray machine.
• A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
• Images may be taken at three different times after the dye is injected. This helps to get the best picture of abnormal areas in the liver. This is called triple-phase CT.
• A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an X-ray machine that scans the body in a spiral path.

Magnetic resonance imaging (MRI)

• This procedure uses a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body, such as the liver.
• This procedure is also called nuclear magnetic resonance imaging (NMRI).
• To create detailed pictures of blood vessels in and near the liver, dye is injected into a vein. This procedure is called magnetic resonance angiography (MRA).
• Images may be taken at three different times after the dye is injected to get the best picture of abnormal areas in the liver. This is called triple-phase MRI.

Biopsy

It is the removal of suspicious cells by a needle. These cells are examined under a microscope by a pathologist to check for signs of cancer. Procedures used to collect the sample of cells or tissues include

• Fine-needle aspiration biopsy: The removal of cells, tissue or fluid using a thin needle.
• Core needle biopsy: The removal of cells or tissue using a slightly wider needle.
• Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen, and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Another instrument is inserted through the same or another incision to remove the tissue samples.

If the cancer has not spread yet and if there is a chance it can be removed, then a biopsy might not be done on an outpatient basis. This is due to the small risk of cancer spreading along the path made by the biopsy needle when it was inserted and removed. In this situation, the operation to remove the tumor is scheduled, the mass is sent for biopsy while the patient is on the operation table. Depending on the diagnosis, the surgeon will decide on the parts of the liver to be removed during surgery.

Having regular checkups help ensure that the condition is diagnosed early. The earlier liver cancer is diagnosed, the more effective treatment is likely to be.