Liver cancer checks are usually organised by your local hospital liver unit. You should get an invitation letter a few weeks before that tells you the time of your appointment and where you need to go. If you can’t go at the time in the letter, you can get in touch to change to a better time.
There are 2 tests that can form part of liver cancer checks.
- A liver ultrasound scan will normally be included.
- Some hospitals also carry out a blood test for alpha-fetoprotein (AFP).
Having an ultrasound
The ultrasound scan takes about 15 to 30 minutes and it doesn’t hurt. The scan will be of your tummy area. So it’s a good idea to wear something that makes it easy to take off or pull up your top, like a t-shirt with trousers or a skirt.
A doctor or a radiographer will do the scan. They hold a small probe, a bit like a microphone, against your tummy and move it around. You have some lubricating gel put on your tummy to help the probe move smoothly and stay in contact with your skin. The gel usually feels cold, but other than that and the probe moving you shouldn’t feel anything. Some people call this the ‘jelly scan’ because of the gel used on your skin.
It’s important not to eat or drink for a few hours before the scan. If this will be a problem, for example if you live with diabetes, contact the liver unit for advice. There should be a number in your invitation letter.
If you have been diagnosed with liver disease for a while, you’ve probably had an ultrasound scan before. The scan uses very high-pitched soundwaves to build up a computer picture of your liver and other organs. You can ask to see the scan on the computer screen if you want to.
You might also have blood taken to test for AFP. AFP is a chemical called a tumour-marker, which means that it can be found in the blood of people with cancer, including liver cancer. AFP isn’t a perfect test for liver cancer because levels can be normal in people with early liver cancer. And it can also be raised for reasons other than cancer.
Your results are sent to the doctor in charge of your care. They will let you know the results and if you need to have any more tests. You should get your results within 1 month, if this doesn’t happen contact your doctor.
If the ultrasound shows a new abnormality or there is a large increase in your blood AFP level you will be offered further tests. This will usually be a CT or MRI scan.
It’s important to remember that ultrasound and AFP tests aren’t perfect. Your doctor will explain what is happening and answer any questions you have. You can also call our nurse helpline on 0800 652 7330 if you have questions, worries or just want to talk.
You will be invited for regular liver cancer checks if you have been diagnosed with cirrhosis.
If you live with long-term hepatitis B then you will be invited for checks if you:
- have cirrhosis
- OR you have a first degree relative who has had HCC. First degree relatives are your parents, your children and your brothers or sisters.
If you have hepatocellular adenoma that does not need treatment you might be asked to have checks once a year for any signs of liver cancer.
People who are seriously ill with liver disease and are having end of life care aren’t invited for these checks. If you aren’t sure whether you should be having regular checks for liver cancer, talk to your clinical team.
In some places in England there is an NHS pilot programme offering liver health checks to look for signs of liver disease in people who are at higher risk. People who have signs they could have serious liver damage may be referred for regular liver cancer checks.
Liver cancer happens when the cells that make up your liver go out of control. They grow and multiply too much. Over time the cancer cells make a lump called a tumour. The tumour can grow into nearby areas and sometimes cancer cells can break off and spread to other parts of the body.
Damage to the genetic instructions inside the liver cells is what causes them to lose control. In cirrhosis, your liver gets damaged over and over again and has to grow more cells than usual to try to repair the damage. This increases the chances of something going wrong with the genetic information that could lead to cancer.
Up to 9 in 10 people who have hepatocellular carcinoma (HCC) liver cancer also have cirrhosis.
Liver disease and liver cancer share a lot of the same causes. Hepatitis B and C viruses, drinking too much alcohol and carrying extra bodyweight have all been shown to cause liver cancer as well as causing liver damage and cirrhosis. Smoking can cause liver cancer, as well as worsening the effect of other risks such as alcohol and viral hepatitis.