Sunday, March 3, 2024

Blood Tests For Liver Cancer

I Have Liver Cancer How Do I Take Care Of Myself

Doctor explains Alpha Fetoprotein (AFP) blood test | Liver and testicular cancer

Liver cancer and liver cancer treatments take a toll on your body. Some people have liver transplants or surgery to remove part of their liver. Other people may need treatment for as long as they live. Either way, you should plan on regular appointments with your healthcare provider so they can monitor your progress and watch for signs of recurring liver cancer . For example, people who dont have signs of liver cancer after treatment should plan on follow-up imaging and blood tests every three to six months for the first two years after treatment.

If youve been treated for liver cancer, here are some steps you can take that may reduce your risk for recurrent liver cancer:

A note from Cleveland Clinic

Primary liver cancer is a life-threatening illness. Often, people dont know they have liver cancer until the cancer is in an advanced stage, which limits treatment options. When that happens, healthcare providers focus on treatments to relieve symptoms and slow cancer growth while helping you maintain a quality of life. If you have an advanced form of liver cancer, talk to your healthcare provider about your treatment options, including benefits and side effects so you can feel confident about your choices going forward.

Screening For Liver Cancer & Liver Metastases

At NYU Langone, primary care doctors usually conduct blood tests at least once a year during routine checkups. They check the blood for high levels of liver enzymes, which can signal liver disease.

Liver enzymes are substances that help the liver function, including processing and storing nutrients that your body needs and filtering harmful substances from the blood.

High levels of certain enzymes in the blood, such as alanine aminotransferase and aspartate aminotransferase , may indicate a person has a liver condition such as cirrhosis, fatty liver disease, or hepatitis B or C. If you have high liver enzyme levels, a blood sample may be taken to test for hepatitis B or C.

Normally Where Are Ast And Alt

AST is normally found in a variety of tissues including the liver, heart, muscle, kidney, and brain. It is released into the serum when any one of these tissues is damaged. For example, the AST level in serum is elevated in heart attacks or with a muscle injury. It is, therefore, not a highly specific indicator of liver injury as its elevation can occur as a result of other injured tissues.

ALT is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in the liver, but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. Thus, it serves as a fairly specific indicator of liver status.

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What Other Liver Enzymes Cause Medical Problems

Aside from AST and ALT, there are other enzymes including alkaline phosphatase, 5′-nucleotidase , lactate dehydrogenase , and gamma-glutamyl transpeptidase that are often used to detect liver disease.

LDH is not specific to the liver and can be elevated in many diseases with inflammation in other tissues.

Alkaline phosphatase is another liver enzyme that is frequently measured. This enzyme is usually found in the walls of the bile ducts . Elevation of alkaline phosphatase may indicate an injury to the biliary cells. Common causes of biliary injury or biliary obstruction are gallstones and certain medications, although, some of the conditions listed previously can also raise the levels of this enzyme. Alkaline phosphate is also found in the bone and can be elevated in bone diseases. GGT and 5′ nucleotidase levels can be elevated in biliary conditions along with alkaline phosphatase.

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How Can I Prevent Liver Cancer

New Blood Test Developed to Improve Liver Cancer Screening

While you cant completely prevent liver cancer, you can do the following to lower your chances of getting liver cancer:

  • Avoid behaviors that lead to cirrhosis.
  • Reach or maintain a healthy weight.
  • Get a hepatitis B vaccine. This vaccine is safe for nearly everyone. Ask your doctor about the hepatitis A vaccine.
  • Avoid hepatitis C.
  • If you have any liver disease, have diabetes, obesity or are a heavy drinker, ask your healthcare provider about liver cancer screenings.

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What Are Some Of The Most Common Liver Tests

A series of special blood tests can often determine whether or not the liver is inflamed, injured, or functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis and cholestasis .

The most commonly performed blood tests include the following:

What Tests Are Most Often Used To Diagnose Kidney Cancer

Blood tests are not enough to diagnose kidney cancer. If your doctor suspects kidney cancer, youll likely have a range of other tests to confirm your diagnosis. This often includes:

  • CT scan. A CT scan uses multiple X-ray images to create detailed images of your kidneys so doctors can look for tumors and other issues.
  • MRI. An MRI uses magnetic imaging to create images of your kidney to check the size, shape, and location of any tumors.
  • Ultrasound. An ultrasound uses sound waves to create images of your kidneys. It can help locate tumors and whether they are benign or cancerous.
  • Bone scan. A bone scan can be done to see the inside of your bones. Your doctor might do this test if they suspect cancer has spread to your bones.
  • Biopsy. During a biopsy, a small piece of your kidney is removed with a needle so it can be tested in a lab. Biopsy results can confirm cancer and help diagnose the stage of the tumor.
  • Renal angiography.This test helps your doctor see the blood supply to your kidneys in detail. Blood supply to a tumor, if present, is also able to be seen here.
  • Intravenous pyelogram. This test requires dye to be injected into a vein so the kidneys are more visible via X-ray. This is another way an obstruction or tumor can be detected.

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What Are Some Common Reasons For Abnormal Liver Tests

Abnormal liver tests may be detected in the blood in a variety of liver conditions.

  • Mild to moderate elevations of the liver enzymes are common. They are often unexpectedly encountered on routine blood screening tests in otherwise healthy individuals. The AST and ALT readings in such cases are usually between twice the upper limits of normal and several hundred units/liter. One of the most common causes of mild to moderate elevations of these liver tests is a condition referred to as fatty liver . In the United States, the most frequent cause of fatty liver is alcohol abuse. Other causes of fatty liver include diabetes mellitus and obesity. Fatty liver tests are composed of several tests including blood tests, CT and/or MRI tests, and in some individuals, a liver biopsy.
  • Chronic hepatitis B and hepatitis C are other causes of chronic mild to moderate liver enzyme elevation. In these conditions, ALT and AST may be only slightly high and the degree of abnormality in liver function tests can indicate the degree of injury.
  • Chronic and acute alcohol use also can commonly cause abnormal liver blood tests. In alcoholic hepatitis, the range of liver tests can vary greatly. In chronic alcohol liver disease or alcoholic cirrhosis, slight elevation of ALT and AST may be observed, whereas, in acute alcoholic hepatitis, high liver enzyme numbers are often seen.
  • Many medications can be responsible for a mild to moderate increase in the liver enzyme tests .

Tests For Liver Cancer

Test to detect early signs of liver cancer

Blood tests

Hepatocellular carcinoma cannot be diagnosed by routine blood tests. There is only one specific blood test which can be used towards a diagnosis of HCC. This test specifically measures for the levels of the protein alfa-fetoprotein in serum .

Unfortunately only about half of all tumours will give a raised reading of AFP. So a normal AFP test does not exclude the presence of HCC. This is further complicated by the fact that AFP is also produced by proliferating liver cells so somebody with cirrhosis and liver regeneration is likely to have raised AFP levels already. As a consequence doctors will probably want to monitor whether the AFP levels are stable or not. Rising levels of AFP are more likely to indicate HCC.

Even where there is no detectable sign of HCC people with cirrhosis and an abnormal AFP still have a high risk of developing it. Anybody with cirrhosis and an elevated AFP, particularly with steadily rising AFP levels, will most likely either develop HCC or already have an undiscovered HCC.

Imaging studiesThere is no single imaging technique that will correctly identify all HCC’s. Current techniques each have their strengths and weaknesses.

Ultrasound

Computerised Tomography scans

Hepatic Angiography

Magnetic Resonance Imaging

Liver biopsy

Laparoscopy

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Is Liver Cancer Curable

Successful liver transplants can cure liver cancer, but not everyone who needs a liver transplant will be healthy enough to go through a transplant or able to find a donor. Studies show people who have surgery to remove part of their liver tend to live longer than people whose illness prevents surgery. When that happens, healthcare providers focus on treatments to help people live with quality of life for as long as possible.

Blood Test Results That May Indicate A Kidney Problem

Blood test results can indicate your kidneys arent working correctly and that more tests need to be done. Results that might prompt further testing include:

  • CBC. Its common for people with kidney cancer to have fewer red blood cells than is considered to be healthy or, rarely, more red blood cells than is considered to be healthy due to abnormal kidney function. Either of these results indicates the need for further testing.
  • Blood chemistry test. People with kidney cancer often have high levels of liver enzymes or calcium in their blood due to reduced kidney function. Youll need additional tests if your blood chemistry test shows high levels of these chemicals.

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What Is Liver Cancer

The liver is the second largest organ in the human body weighing about 1500 grams. When the cells in the liver undergo abnormal changes , this may lead to uncontrolled cell division that spreads to other body parts. These cancerous cells grow and divide quickly, which deprives healthy body cells of nourishment and oxygen. Ultimately, the healthy cells may die due to cancer. Primary liver cancer is cancer that starts in the liver. Metastatic or secondary liver cancer is cancer that spreads from other organs to the liver.

The main intervention to diagnose liver cancer is a computed tomography scan, magnetic resonance imaging or an ultrasound . The doctor will conduct the required tests based on the symptoms.

How Is Liver Cancer Usually Diagnosed

New Blood Test Developed to Improve Liver Cancer Screening

Besides, the doctor may order blood tests to look for a specific protein elevation in the blood. This protein or tumor marker is called alpha-fetoprotein and is a screening tool for liver cancer. However, it is not specific to liver cancer, so it is not the first test of choice.

The AFP is a protein that can be found in high levels in adults with liver disease, liver cancers, and testicular cancer. Again, many patients with early liver cancer have normal levels of AFP, so high AFP levels do not help determine if a liver mass is a cancer.

The AFP test is performed for the following reasons

  • In people already diagnosed with liver cancer, the AFP level can help determine treatment options.
  • A declining AFP level may help understand the effectiveness of treatment.
  • This test can also be used after treatment to check if the cancer is gone or is still inside the body.

Other blood tests performed for liver cancer patients include

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About Blood Tests And Kidney Cancer

A blood test is not enough on its own to confirm a diagnosis of kidney cancer. However, certain results could indicate kidney problems and a possible need for further testing.

Standard blood tests are often done during periodic health exams. Certain abnormalities could flag the potential for cancer.

There are a few types of blood tests that might be used in an initial cancer screening. These include:

  • Complete blood count. A CBC is a test that measures the levels of several types of cells in your body. People with kidney cancer often have abnormal levels of important cells.
  • Basic metabolic panel. This test checks for levels of specific compounds in your blood. For kidney cancer, your doctor will be interested in looking at liver enzymes, calcium levels, blood urea nitrogen, and glomerular filtration rate.
  • Serum creatinine.This test can help rule out kidney function issues that may be causing your symptoms. It measures how well your kidneys are filtering your blood. It can be a good indicator of overall kidney health.

What Conditions Can Cause Very High Ast Or Alt Levels

AST and ALT serum levels in some liver conditions can range anywhere from ten times the upper limits of normal to thousands of units/liter. The highest levels of AST and ALT are found with disorders that cause rapid death of numerous liver cells . Although this degree of liver enzymes elevation is not common, it can occur in such conditions as:

  • Acute viral hepatitis A or B
  • Profound liver damage inflicted by toxins as from an overdose of acetaminophen or mushroom poisoning
  • Prolonged collapse of the circulatory system when the liver is deprived of fresh blood providing oxygen and nutrients

Also, very high AST and ALT levels can be a result of severe muscle diseases.

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Possible Risks Of Having A Blood Test

Blood sampling is a safe test. There is a possibility of:

  • bleeding and bruising – pressing hard when the needle is removed can help to stop it
  • pain – this is normally mild and can last for a few minutes
  • swelling – ask your nurse, doctor or phlebotomist to avoid an arm that is swollen or has a risk of swelling
  • feeling faint or fainting – tell the person doing your blood test if you’re feeling lightheaded or dizzy at any time
  • infection – this is very rare

What Is The Life Expectancy Of Liver Cancer

How is Liver Cancer diagnosed? – Dr. Olithselvan

Healthcare providers are making progress on liver cancer treatment so people can live longer. But liver cancer remains a life-threatening disease.

Data show that 35% of people treated for early-stage hepatocellular carcinoma liver are alive five years after diagnosis. About 12% of people treated for HCC that has spread to nearby tissues organs or lymph nodes are alive five years after diagnosis. About 3% of people treated for HCC that has spread further are alive five years after diagnosis.

The five-year survival rates for intrahepatic bile duct cancer are 24% for bile duct that hasnt spread outside of your liver, 9% for cancer thats spread to nearby lymph nodes and 2% for cancer thats spread further.

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How Does The Doctor Know I Have Liver Cancer

Liver cancer often doesnt cause signs and symptoms until it has grown very large or spread.

Some symptoms of liver cancer are unplanned weight loss, dont feel like eating, feeling full after a small meal, belly pain and swelling, and itchy, yellow skin. The doctor will ask you questions about your health and do a physical exam.

How Are Healthy People Evaluated For Mild To Moderate Rises In Ast/alt Levels

Evaluation of healthy individuals with abnormal liver enzymes needs to be individualized. A doctor may ask for the patient’s blood test data from old records for comparison. If no old records are available, the doctor may repeat blood tests in weeks to months to see whether these abnormalities persist.

In the meantime, along with a physical examination, by performing thorough medical history the doctor will search for potential infectious and non-infectious causes and risk factors for liver disease such as:

  • Medications
  • History of injectable drug use
  • Occupational exposure to blood products
  • Family history of liver disease .

A complete list of routine medications including over-the-counter medications will be reviewed.

Signs and symptoms of liver disease may or may not be present in individuals with mild increase in liver enzymes. Signs of liver damage can include jaundice, easy bruising, ascites , enlarged spleen , and confusion. Symptoms of liver disease are non-specific and numerous. Some of the more common liver disease symptoms may include fatigue, itching, yellow skin, poor appetite, and abdominal discomfort.

The pattern of liver enzyme abnormalities can sometimes provide useful clues as to the cause of the liver condition. For example, in a majority of people with alcoholic liver disease, liver enzyme levels are not as high as the levels reached in acute viral hepatitis. In alcoholic liver disease, frequently AST tends to be higher than ALT .

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Liver Cancer Screening For Those At High Risk

If you receive a diagnosis of cirrhosis, fatty liver disease, or hepatitis B or C, you are at increased risk of developing liver cancer. You may need to consider frequent liver cancer screening.

Several other factors, such as having a family history of liver cancer, can also increase your risk. Asian Americans, African Americans, and men are more likely to develop liver cancer, as are people older than age 40, especially if they already have a condition that causes liver damage.

If your primary care doctor or other physician determines that you are at high risk for liver cancer, you may want to discuss the tests you need with a Perlmutter Cancer Center specialist. These experts may include a hepatologist, who is a doctor who specializes in liver diseases, or a gastroenterologist.

Your specialist may recommend having the following blood and imaging tests every 6 to 12 months.

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