Liver Cancer

The information on this page is for patients with primary liver cancer (hepatocellular carcinoma). Patients with bile duct cancer can learn more here.

Hearing you have liver cancer is never easy. But getting a diagnosis is an important first step towards feeling better. Once you have a diagnosis, your doctors can make a treatment plan for you.

At Siteman, we’ll ensure that you have an accurate diagnosis. That way, your treatments will work better. 

You don’t need a referral to come to Siteman. You can make an appointment with us yourself. Many patients come to Siteman for a second opinion.

The First Step in a Liver Cancer Diagnosis

Many patients with liver cancer already have liver problems caused by the viruses hepatitis B or hepatitis C. They find out they have cancer after getting tests to check on how their liver is doing.

Symptoms of Liver Cancer

Common signs of liver cancer include:

• A swollen belly 
• Feeling pain or discomfort in the upper belly on the right side 
• Pain near the right shoulder blade or in the back 
• Yellowing of the skin and whites of the eyes (jaundice) 
• Easy bruising or bleeding 
• Feeling tired or weak for no reason 
• Nausea and vomiting 
• Itchy skin 
• Not feeling hungry, or feeling full after eating a small meal 
• Losing weight without trying  
• Stools that look pale and chalky 
• Dark urine 
• Fever 

Why Choose Siteman

At Siteman Cancer Center, WashU Medicine physicians are experts at diagnosing liver cancer correctly, the first time.

When you come to Siteman, WashU Medicine physicians will study your tumor. They will take samples of the cells and look at them under a microscope. They will find out how far liver cancer has spread in your body. As they gather information, they will plan how best to help you.

What to Expect During a Liver Cancer Diagnosis

WashU Medicine physicians at Siteman use a number of tests to diagnose and stage liver cancer.

At Siteman, we understand that many patients feel anxious about having medical tests. This is a normal feeling. If there is anything you need to feel safe or comfortable, please let us know. We are happy to answer questions and address concerns.

If your doctors believe you may have liver cancer, you will probably have several of the following tests.

• Physical exam: Your doctor will ask you how you’ve been feeling. They’ll listen to your heart and lungs, check for swelling, and feel your belly.  
• Blood tests:  Blood tests can tell doctors about how well your liver is working. Your care team will check samples of your blood to see if there are substances that show the liver is stressed.  
• Imaging tests: Imaging tests take pictures of the inside of your body. They can show whether you have a liver tumor and, if so, how far it has spread. Imaging tests to diagnose liver cancer include CT scans, MRIs (magnetic resonance imaging), PET scans, and ultrasounds. Sometimes, your doctors will use a special dye to help your organs show up more clearly in the pictures. You’ll swallow the dye or have it injected into a vein before the procedure.  
• Biopsy: During a biopsy, your doctor will take a sample of tissue from your liver. They will use a needle to collect the sample. You’ll get medicine so you don’t feel it. Then, another doctor called a pathologist will look at the tissue under a microscope to check for signs of cancer.  
• Laparoscopy: A laparoscopy is a type of surgery. While you are asleep, your doctor will make several small cuts (incisions) in your belly. They will place a camera called a laparoscope through the incisions to look at your liver and the surrounding organs. They may also collect samples of tissue so they can be tested for cancer cells (a biopsy). 

Staging Liver Cancer

If you are diagnosed with liver cancer, your WashU Medicine physicians will see how far it has spread. This is called “staging” the cancer. The stage will help your care team choose the right treatments for you.

To stage liver cancer, WashU Medicine physicians use rankings from The Barcelona Clinic Liver Cancer (BCLC) Staging System. They will consider:

• Whether the cancer has spread within the liver or to other parts of the body 
• How well the liver is working 
• Your general health and wellness 
• Your symptoms

BCLC staging system has five stages:

• Stage 0: Very early 
• Stage A: Early 
• Stage B: Intermediate Stage 
• Stage C: Advanced Stage 
• Stage D: End-stage