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Cancer and Treatments > Liver Cancer
Some symptoms of liver tumors or liver cancers are:
Jaundice
Also known as icterus, jaundice is a yellowish discoloration of the skin, the whites of the eyes and mucous membranes caused by
hyperbilirubinemia (increased levels of bilirubin).
Cirrhosis
A liver condition characterized by replacement of liver tissue by fibrotic scar tissue as
well as regenerative nodules, leading to progressive loss of liver function,
- Jaundice
Bile duct blockage can lead to jaundice in 70-85% of patients with tumors in the bile ducts.
80% of patients with the most common type of liver cancer, called hepatocellular carcinoma (HCC), may have cirrhosis
which is often accompanied by jaundice.
Symptoms of jaundice include:
- yellowing of the skin
- yellowing of the whites of the eyes
- light-colored (clay colored) bowel movements
- dark-colored urine
- itching
- Nausea, Vomiting, Weight Loss
Stomach emptying can be delayed when the small bowel or stomach is compressed. This causes a feeling of
fullness and contributes to symptoms of nausea and vomiting. This symptom occurs in only a minority of patients.
- Fatigue
Patients can have a feeling of being tired and fatigued. Many patients can experience fatigue related to liver
disease as well. There are many causes of fatigue in patients with cancer.
- Abdominal Pain
A minority of patients with liver tumors can have abdominal pain or a feeling of fullness. This may be described as
cramping or gas-like pain. Pain may also spread, or radiate, to the back and shoulders.
Patients with symptoms suspicious for a liver tumor will undergo tests to determine the cause of these symptoms.
Because the overwhelming majority of patients will not have any symptoms, patients with underlying liver disease,
history of colorectal cancer, or other gastrointestinal malignancy should be actively engaged in screening
programs.
Below are some tests and procedures used for diagnosis:
- Laboratory tests
Blood can be drawn and tested for markers of liver injury or obstruction. Additionally, the blood can be checked
for various "tumor markers" to allow for diagnosis as well as to how well the patient is responding to therapy.
- Ultrasound of the abdomen
An ultrasound can identify a tumor or mass in the liver or bile duct system that may be causing blockage,
jaundice, or change in liver function tests. Additionally, this test can be used as a primary screening tool in
those with underlying liver disease or cirrhosis.
- Computed Tomography (CT)
The CT scan can show small tumors as well as important blood vessels that the tumor might be growing into or
around. Additionally, a CT scan can be used as a primary screening tool for those with a recent history of
colorectal cancer or other gastrointestinal cancer or tumor. A CT scan can also look at surrounding organs for
spread (metastasis) of the cancer into the lymph nodes and other areas. The doctor may suggest a 3
phase liver CT to be done at the UM for the first clinic visit to better assess the tumor for sizes, l
ocation and involvement of surrounding vessels and organs. A special dye is used for the CT, to give
additional information to the radiologist; therefore a temporary IV (intravenous catheter) will be
placed prior to the scan.
- Magnetic Resonance Imaging (MRI)
In some cases, the MRI allows additional diagnostic information regarding liver tumors. It may also provide
imaging of the bile ducts, as well as looking at the surrounding blood vesses, organs, and lymph nodes.
A special dye is used for the MRI, to give additional information to the radiologist; therefore a temporary
IV (intravenous catheter) will be placed prior to the scan.
- ERCP (endoscopic retrograde cholangiopancreatography)
An ERCP is done with a lighted tube called an endoscope and is used to look at the bile ducts. It can also be
used to place a stent or tube to open a blocked bile duct for drainage. The patient is not awake during the test
(sedation is given through an IV in most cases). The ERCP helps determine what is causing the
blockage. Some causes of these blockages include bile duct cancer (cholangiocarcinoma) and gall bladder cancer.
Bile duct fluid and tissue samples may be obtained and sent to the pathologist to evaluate
for cancer cells.
- PTC (Percutaneous transhepatic cholangiography)
A PTC is done by looking at the liver bile ducts with a small catheter. The patient is not awake during the test
(sedation is given through an IV in most cases). This procedure helps to identify blockages that are higher up in
the bile ducts. Some causes of these blockages include bile duct cancer (cholangiocarcinoma) and gall bladder camcer.
Bile duct fluid and tissue samples may be obtained and sent to the pathologist to evaluate for cancer cells.
- Interventional Radiology
In some cases the radiology department can perform needle biopsies using the CT or ultrasound technique to
locate the mass (tumor) and obtain a tissue sample through the abdomen for a diagnosis. At the UM Interventional
Radiology department, there are specialists who may be consulted to do one of these procedures.
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updated 11/2007
