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Medical Author:

Keith E. Stuart, MD

Keith E. Stuart, MD

Dr. Keith E. Stuart is a medical oncologist specializing in the study and treatment of cancers involving the gastrointestinal tract, with a special interest in tumors involving the liver. He was educated at Harvard University (graduating magna cum laude) and Albert Einstein College of Medicine and did his medical training at the New England Deaconess Hospital.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The diagnosis of liver cancer is usually made incidentally, by noticing abnormal blood tests of liver function. Increasingly, people who are known to be at risk (such as people with active hepatitis B or C, or alcoholics with cirrhosis) are being screened by their doctors with periodic blood and imaging tests. Once a cancer is suspected, further studies can be done to find out how much of the liver is involved. The most common radiologic tests used are CT scans (computerized tomography, in which X-ray pictures are reassembled into body images), ultrasound (using sound waves to create pictures), and MRI (magnetic resonance imaging, which uses magnetic fields to get pictures of different body tissues). Other, more specialized tests are sometimes needed, such as an angiogram (taking X-ray pictures of the blood vessels within the liver and the tumor) or laparoscopy (inserting a small scope into the abdomen in the operating room to get a closer view of the liver). There are also certain tests of proteins made by the tumors that can be measured in the blood, such as AFP (alpha-fetoprotein) and CA19-9.

In order to make sure of the diagnosis, it may be necessary to remove a piece of the tumor in order to study it under the microscope and figure out exactly what kind of cancer it is. This is called a biopsy and can be done by placing a needle into the liver during ultrasound or CT scanning or during laparoscopy or surgery.

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