If your child's doctor suspects liver cancer, your child's history will be checked for risk factors. In addition, close attention is paid to the condition of your child's belly during physical exams.
Masses or lumps in the liver and belly often can be felt while your child is lying flat on the exam table. The liver usually is swollen and hard in patients with liver cancer.
The doctor also may be able to hear an unusual sound or rubbing noise when using a stethoscope to listen to the blood vessels that lie near the liver. The pressure of the tumor on the blood vessels causes the noises.
Your child's doctor may use other methods to diagnose HCC. They include:
Blood tests. Between 50 percent to 70 percent of liver patients have high levels of something called serum alpha-fetoprotein. Blood tests can tell if high levels are present in your child's blood. This test cannot be used by itself to diagnose HCC, as other diseases can also cause high levels. More blood work, including hepatitis B, iron, total iron binding capacity, ferritin and alpha-1 antitrypsin may help uncover any predisposing factors.
Imaging studies. Imaging studies help find tissue in the liver that is not normal. Liver tissue as small as an inch across now can be detected by ultrasound or computed tomography scan (CT scan). However, these imaging studies cannot tell the difference between a hepatocellular carcinoma and other abnormal masses or lumps of tissue.
Biopsy. A biopsy (removal and examination of a sample of tissue) of the tumor may be done to provide a definite diagnosis of HCC. This involves either removal of a sample of the liver or tissue fluid or complete tumor resection (removal), which is then checked under a microscope to see if there are cancer cells present.
Once HCC is found, more tests are done to find out if cancer cells have spread to other parts of the body. This is called staging. Your child's doctor needs to know the stage of the disease to provide the right treatment.
The following stages are used to define HCC:
- Stage I means the cancer can be removed with surgery.
- Stage II means most of the cancer may be removed in an operation, but very small amounts of cancer are left in the liver following surgery.
- Stage III means that some of the cancer may be removed in an operation, but some of the tumor cannot be removed and remains either in the belly or in the lymph nodes (part of the body that filters out and gets rid of cancer cells and other waste products from the body).
- Stage IV means the cancer has spread to other parts of the body.