Diagnosis

Liver Cancer Diagnosis

You may have multiple tests to confirm a diagnosis of liver cancer. These may be referred as red flag by your GP and happen within two weeks.

• Blood tests to assess your liver function (LFT) and measure tumour markers.
• Scans to assess pictures of your liver: ultrasound, CT or MRI.
• Liver biopsy- when a small collection of cells are taken from the liver with a needle procedure and assessed under a microscope for cancer.
• Laparoscopy- a surgical procedure when the liver is visualised and assessed. Samples of cells can be taken and assessed for cancer.

You may be seen at the hospital by a doctor who specialises in treating conditions of the stomach and bowel, a Gastroenterologist. Or you may be referred to Belfast to see a liver specialist, a Hepatologist. They will share the results of your diagnostic investigations, what it means and what the next steps will be. It may take a few weeks for all your results to come back.

Pancreatic Cancer Diagnosis

Your doctor may want to perform a physical exam to assess your skin, eyes and press on your abdomen to feel for changes.

They may send some blood, urine and faeces samples as these can also rule out other reasons for your symptoms.

You could be referred to the hospital for some scans to see pictures of your pancreas and other organs – ultrasound, CT, MRI or PET scans.

A tissue sample may be required from the pancreas to confirm a diagnosis. This is done by passing a camera down the throat and into the GI tract. This can often be done as a day procedure in the hospital and may be called an ERCP or EUS.

Sometimes the symptoms of pancreatic cancer appear quite suddenly and you may be admitted to the hospital and receive many of these investigations as an inpatient.

Biliary Cancer Diagnosis

You usually begin by seeing your GP, who will examine you and may take a blood test. They will refer you to a hospital specialist.

At the hospital, the doctor will ask you about your general health and any previous medical problems. They will also examine you and take blood samples to check your general health and that your liver is working properly.

The following tests may be used to diagnose gallbladder or bile duct cancer, you may not have all of them:

• Ultrasound scan
• CT or MRI scans
• A procedure involving a camera down the throat known as ERCP or EUS
• Biopsy – when a needle is passed through the abdomen under scanner guidance to take a sample of tissue from a mass

It can be difficult to get a specific diagnosis of bile duct cancer as it is often close to, or within the liver. You may require multiple investigations and biopsies/tissue samples to confirm diagnosis and for the specialists to decide the most appropriate treatment options for you.

Available treatment options will depend on:

• The position and size of the cancer
• Whether it has spread beyond the bile duct
• Your general health