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To find out if someone has liver cancer, doctors start by asking about symptoms and doing a physical exam. If they suspect cancer, they may use blood tests, scans, or a liver tissue sample to confirm the diagnosis and learn more about the disease.

Alpha-Fetoprotein Blood Test (AFP): Alpha-fetoprotein (AFP) is a protein made by the liver in babies before they are born. After birth, AFP levels drop to almost zero. In adults, a high AFP level may be a sign of liver cancer. If AFP levels keep going up, it can mean that a tumor is growing. People with liver damage from hepatitis or cirrhosis may get regular AFP tests to catch cancer early. Sometimes doctors test for other tumor markers along with AFP to get more accurate results.

Imaging Tests (Scans): Imaging tests give doctors detailed pictures of the liver. These can help find tumors and guide treatment decisions.

• : This test uses sound waves to create an image of the liver. It helps find abnormal spots and is often used to check for liver problems over time.
• Computed Tomography Scan (CT Scan): This test takes many X-ray pictures from different angles. A computer puts the images together to show a clear view of the liver. It’s quick, painless, and done at a hospital or imaging center.
• Magnetic Resonance Imaging (MRI): MRI uses magnets and radio waves to make detailed images of the inside of the body. It’s especially good for seeing soft tissues like the liver.
• Angiography: This test looks at blood flow in the liver. A special dye is injected into the blood vessels, and pictures are taken to see how blood moves and if there are any blockages.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): In this test, a thin tube called an endoscope is passed through the mouth to reach the digestive system. Dye is injected into the bile and pancreatic ducts, and X-rays are taken. ERCP helps find tumors, blockages, or other problems, and sometimes treatment can be done during the same procedure.

: A liver biopsy is a test that removes a tiny piece of liver tissue with a hollow needle. The sample is sent to a lab to check for cancer. If a tumor is clearly seen on a scan and AFP levels are high, a biopsy might not be needed. But if other tests aren’t clear, this procedure helps confirm the diagnosis. A liver biopsy can also show how much liver damage has occurred and helps doctors decide on the best treatment.

Tumor Genetic Testing: If a biopsy is done, doctors may also study the tumor’s genes. This helps them learn which treatments may work best. Some gene changes mean that certain medicines won’t help, so doctors use this information to plan more effective treatment.

Liver Cancer Staging

“Staging” means finding out how far the cancer has spread. Doctors use a system called the Barcelona Clinic Liver Cancer (BCLC) system. It looks at things like tumor size, symptoms, and how well the liver works. More tests may be needed to figure out the cancer stage.

Here are the main stages:

• Very Early Stage (Stage 0 or I): One small tumor (less than 2 centimeters) and normal blood test results.
• Early Stage (Stage A or II): One tumor up to 5 centimeters, or a few smaller ones. Cancer may be in small blood vessels.
• Intermediate Stage (Stage B or III): Several tumors, or one large tumor. Cancer may be in big blood vessels, lymph nodes, or nearby organs.
• Advanced Stage (Stage C or IV): Cancer has spread to other parts of the body, like the lungs or bones.

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