Early detection of liver cancers is difficult because of the lack of early symptoms and the lack of diagnostic methods. A physician will take a medical history to note risk factors such as hepatitis, cirrhosis, diabetes and toxic exposure. During a physical examination a physician can seldom feel (palpate) a small tumor because the right rib cage covers most of the liver. A tumor may be large and hard to treat by the time it can be felt.

A special blood test for a protein called alpha-fetoprotein (AFP) can sometimes detect liver cancer. AFP is found in fetal blood but disappears after birth. Its recurrence may indicate liver cancer but can also suggest other diseases. In addition, some liver tumors do not produce much AFP, and when AFP is found the liver cancer is often advanced.

Patients with symptoms of liver cancers may receive:

• Ultrasound. A painless test using sound waves to create a picture of the liver.
  
  
• CAT scan. A type of x-ray test that creates cross-sectional images of the body. Often a dye is injected to better show the body’s structures.
  
  
• MRI. Use of a machine emitting radio waves and magnetism to create detailed images of internal organs such as the liver. A dye may be injected into the arm to highlight structures.
  
  
• Biopsy. Obtaining a tissue sample from the liver for microscopic examination. This is usually the only method that can prove liver cancer is present, but it may not be needed if the less invasive tests indicate cancer.