How is secondary liver cancer diagnosed?

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.

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 (computed 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.

Occasionally, a tissue sample may be removed from the tumour to confirm a diagnosis of secondary liver cancer. This test is called a biopsy.

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).