Liver Foundation
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Overview
To diagnose secondary liver cancer, your doctor will arrange tests such as blood tests and imaging scans.
The test results show the size and number of cancers in the liver, and how fast it is growing. This helps your doctor work out the expected outcome of the cancer. This is called a prognosis.
Secondary liver cancer is considered advanced cancer (also called stage 4 cancer) because it has spread from another part of the body. Most cases of secondary of liver cancer cannot be cured, but treatments can keep many cancers and symptoms under control for months or even years.
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Tests
Secondary liver cancer may be diagnosed at the same time as the primary cancer or up to several years after the primary cancer has been treated. It may also be diagnosed before the primary cancer. Secondary liver cancer is found using several tests, including blood tests and imaging scans.
Blood tests
Blood tests
Blood tests alone cannot diagnose secondary liver cancer, but they can give doctors more information about the cancer.
Samples of your blood may be tested to check how well the liver is working (liver function tests) and to see if the liver is making proteins that help the blood clot.
Imaging scans
Imaging scans
Various imaging scans may be needed when secondary liver cancer is suspected:
- You may first have an ultrasound scan, which helps to show if there is a tumour in the liver and how large it is.
- You will also have a CT (computerised tomography) scan and/or an MRI (magnetic resonance imaging) scan. These types of scans can provide more detail about the size of the cancer and the number of tumours.
- A PET (positron emission tomography) scan can be combined with a CT scan to provide even more detail about the cancer. This is called a PET–CT scan. Medicare does not always cover the cost of PET–CT scans for cancer diagnosis; if this test is recommended, check with your doctor if you will have to pay.
At first, I found the MRI frightening, going into the cylinder and having to hold my breath. But now when I have this scan, I count to myself. This helps me feel more in control.
Biopsy
Biopsy
Occasionally, a tissue sample may be removed from the tumour to confirm a diagnosis of secondary liver cancer. This test is called a biopsy.
Tests to find the primary cancer
Tests to find the primary cancer
If test results show that you have secondary liver cancer, the next step is to work out where in the body the cancer started. This may be known if you have been treated for cancer in the past; otherwise, you will need further tests.
Sometimes, even after several tests, the primary cancer can’t be found. This is called cancer of unknown primary (CUP).
Depending on where your doctor thinks the primary cancer started, you may have:
- an examination of the bowel (colonoscopy), stomach (endoscopy) or breasts (mammogram)
- a urine test to show whether the kidneys and bladder are working properly
- a blood test to check for particular chemicals produced by cancer cells. These are known as tumour markers and they relate to the primary cancer – for example, bowel cancer sometimes produces a tumour marker called carcinoembryonic antigen (CEA).
Staging
Staging is the process of working out how far a cancer has spread through the body. Because the cancer has spread from another part of the body, secondary liver cancer is considered advanced cancer (also called stage 4 cancer).
The secondary cancer will be given a stage using the system for the primary cancer. For example, if it started in the bowel, it will often be staged using a system called TNM (tumour–nodes–metastasis).
Prognosis
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for anyone to predict the exact course of the disease.
To work out your prognosis, your doctor will consider factors such as the type of primary cancer, the size and number of cancers in the liver, and how fast the cancer is growing. Your age, fitness and overall health will also affect your prognosis. Doctors often use numbers (statistics) when considering someone’s prognosis. While statistics give doctors a general idea about how a disease might progress, they won’t necessarily reflect your specific situation.
Although most cases of secondary liver cancer can’t be cured, surgery and other treatments can keep many cancers and symptoms under control for months or even many years for months or even many years.
Find out more about palliative care and living with advanced cancer.
Calling 13 11 20 after I was diagnosed helped me to take in the new information. Eventually, I joined a support group, which was also a great help.
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