Diagnosing liver cancer involves a thorough evaluation by medical professionals, utilising a combination of medical history, physical examination, imaging studies, laboratory tests, and sometimes biopsy. Here’s an overview of how liver cancer is diagnosed:

1. Medical History and Physical Examination: Medical professionals begin by gathering a detailed medical history, including any symptoms the patient may be experiencing and risk factors such as chronic liver disease, hepatitis B or C infection, alcohol abuse, or family history of liver cancer. A thorough physical examination may reveal signs such as abdominal tenderness, palpable liver enlargement, or jaundice.

2. Imaging Studies: Imaging techniques play a critical role in diagnosing liver cancer. Ultrasound is often the initial imaging modality used to detect liver tumours and assess their size and location. CT scans and MRI scans provide detailed images of the liver and surrounding structures, helping to determine the extent of the tumour and whether it has spread to nearby organs or lymph nodes.

3. Blood Tests: Blood tests, including liver function tests (LFTs) and tumour markers such as alpha-fetoprotein (AFP), are important in diagnosing and monitoring liver cancer. Elevated levels of AFP can indicate the presence of liver cancer, though not all liver cancers produce AFP.

4. Biopsy: A liver biopsy may be performed to confirm the diagnosis of liver cancer and provide information about the type and grade of the tumour. During a biopsy, a small sample of liver tissue is obtained using a needle inserted through the skin into the liver. The tissue sample is then examined under a microscope by a pathologist to determine if cancer cells are present.

5. Scoring Systems and Staging: Once liver cancer is diagnosed, medical professionals use scoring systems such as the Barcelona Clinic Liver Cancer (BCLC) staging system or the TNM (Tumour, Node, Metastasis) staging system to assess the extent of the cancer and guide treatment decisions. Staging helps determine the best treatment approach, including surgery, ablation therapies, chemotherapy, targeted therapy, or liver transplantation.

6. Consultation with Specialists: Diagnosis and treatment planning often involve consultation with a multidisciplinary team of specialists, including hepatologists, oncologists, radiologists, and surgeons. This collaborative approach ensures comprehensive evaluation and personalised management tailored to the patient’s specific condition and needs.

Early diagnosis of liver cancer is critical for improving treatment outcomes and overall prognosis. Patients experiencing symptoms such as abdominal pain, jaundice, unexplained weight loss, or other concerning signs should promptly seek medical attention for thorough evaluation and timely intervention.

Liver cancer treatment is tailored to the specific characteristics of the tumour, the overall health of the patient, and the extent of the disease. The goal of treatment is to eliminate or shrink the cancerous growths in the liver, alleviate symptoms, and improve the patient’s quality of life. Here’s an overview of how liver cancer treatment works:

1. Surgical Treatment: Surgery may be an option for patients with localised liver cancer and sufficient liver function. Liver resection involves removing the part of the liver affected by cancerous tumours. In cases where the tumour is smaller and located in a favourable position within the liver, surgery offers a chance for cure. For patients with more advanced liver cancer, liver transplantation may be considered, where the entire liver is replaced with a healthy donor liver.

2. Ablation Therapies: Ablation techniques are used to destroy liver tumours without removing them surgically. This may include techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), or cryoablation. These procedures are suitable for smaller tumours and can be performed using minimally invasive techniques guided by ultrasound or CT imaging.

3. Radiation Therapy: External beam radiation therapy (EBRT) or stereotactic body radiation therapy (SBRT) may be used to deliver high doses of radiation directly to liver tumours. This approach is effective for targeting tumours that cannot be treated surgically or with ablation techniques.

4. Targeted Therapy: Targeted therapies involve medications that specifically target certain molecular pathways or proteins involved in cancer growth. Drugs like sorafenib and lenvatinib are examples of targeted therapies approved for the treatment of advanced liver cancer. These drugs can slow tumour growth and improve survival in some patients.

5. Chemotherapy: Traditional chemotherapy is less commonly used for liver cancer due to the liver’s limited tolerance for these medications and the poor response rates observed historically. However, some chemotherapy drugs may be used in combination with other treatments or in specific cases where targeted therapies are not effective.

6. Immunotherapy: Immunotherapy drugs, such as immune checkpoint inhibitors, are being investigated in clinical trials for the treatment of liver cancer. These medications help stimulate the body’s immune system to recognize and attack cancer cells.

7. Palliative Care: For patients with advanced liver cancer or those who are not candidates for curative treatments, palliative care focuses on symptom management, pain relief, and improving quality of life. Palliative treatments may include medications to control pain, relieve nausea, manage ascites (fluid buildup in the abdomen), and provide emotional and psychological support.

In conclusion, liver cancer treatment strategies are evolving rapidly, with a focus on personalised medicine and improving outcomes through early detection, targeted therapies, and multidisciplinary care.