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Gastroenterology and Hepatology

Liver Cancer

Liver cancer care at Virginia Mason in Seattle brings our team of specialists together to provide state-of-art, multidisciplinary care for patients with liver cancer.

For more information about liver cancer care at Virginia Mason, call (206) 223-2319. Read our frequently asked questions about liver cancer.

The liver cancer care team includes specialists in gastroenterology and hepatology, the Digestive Disease Institute, general surgery and oncology.

Newly Diagnosed?

We understand that a cancer diagnosis can be a life-altering event with many questions about treatment and quality of life. At Virginia Mason, our Liver Center is one of the leading programs for liver cancer in the United States. Patients come from all over the country to receive care from our team of board-certified physicians, nurses and caregivers with special interests in the diagnosis, treatment and research of liver cancer. Learn more.

About Liver Cancer

Signs and Symptoms
Liver cancer may not show any symptoms until late stages. When symptoms appear, they may include:

  • Loss of weight without trying
  • Loss of appetite
  • Upper abdominal pain
  • Nausea and vomiting
  • General weakness and fatigue
  • An enlarged liver
  • Abdominal swelling
  • Yellow discoloration of your skin and the whites of your eyes (jaundice)
  • Itching

Diagnosing Liver Cancer

Liver cancer is usually diagnosed using blood tests and/or imaging techniques such as ultrasound, CT scan or MRI. A biopsy may be necessary using a needle directed by CAT scan, ultrasound or an endoscope; however, most patients with liver cancer (hepatocellular carcinoma) do not require a biopsy for diagnosis. Newly diagnosed?

  • The purpose of the blood test is to determine the overall health of the liver. The AFP test measures the level of alpha fetoprotein (AFP) in the blood. High levels of AFP are present in patients that suffer from hepatocellular carcinoma.
     
  • A computed tomography (CT) scan is similar to an X-ray and creates a detailed cross-sectional image of the body. It is usually performed in two steps — first, the targeted area is scanned without a contrast agent, and second, after a contrast agent is administered. This is an effective test to reveal liver cancer tumors.
     
  • Magnetic Resonance Imaging (MRI) uses radio waves and strong magnets to reveal a complete image of the liver. The energy from the radio waves is absorbed by the tissues and then revealed into a recognizable pattern on a special monitor.
     
  • Ultrasound imaging uses high-frequency sound waves to create an image of internal organs. Abnormal tissue masses and organs reflect sound waves differently and therefore can detect liver tumors.

Treating Liver Cancer

Virginia Mason's approach coordinates consultations from the departments of hepatology, surgery, and oncology so that a personalized care plan can be designed for each individual patient. A number of therapies are currently available:

  • Surgery — Patients who are eligible for a liver resection will be evaluated by surgeons who have special expertise in liver surgery.
     
  • Chemo-embolization — A minimally invasive, laparoscopic procedure performed by radiologists through blood vessels to cut off the blood supply to the tumor and deliver chemotherapy directly to the tumor.
     
  • Ablation: microwave and radiofrequency — A technique which treats the tumor directly without extensive surgery.
     
  • Systemic therapy such as sorafenib, a new oral medication
     
  • In addition, some patients may be referred for liver transplantation.

For more information about the diagnosis or treatment of liver cancer at Virginia Mason, contact the Liver Cancer care team by calling (206) 223-2319.

Liver Tumor Board

The National Cancer Institute defines a tumor board as "a treatment planning approach in which a number of doctors who are experts in different specialties review and discuss the medical condition and treatment options of a patient." At Virginia Mason, we hold bi-weekly liver tumor boards, also known as cancer conferences, to review and discuss the most complex liver cancer cases. The patient is not present for these meetings. However, during the cancer conference, facts about the case are presented and discussed by members of the hepatology, radiology, surgery, oncology and pathology teams. The providers place significant emphasis on developing a suitable course of action, and the multidisciplinary involvement ensures that a full range of treatment options are considered.

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