1. Initial investigation and referral
Your general practioner (GP) will assess your symptoms (for example a hard lump or pain on right side of abdomen), conduct a physical examination and arrange blood tests if needed.
Your GP should also discuss your needs (including physical, psychological, social and information needs) and recommend sources of reliable information and support.
If liver cancer is suspected, you will be referred to a specialist for further testing. Your GP will provide the specialist with information about your medical history, whether there is a history of cancer in your family, and your test results.
Tests you may have:
- Ultrasound: This uses high-frequency sound waves to make an image of a person's internal body structures.
- Assessment of liver and renal function: A blood test to see how well your liver and kidneys are working.
It can be helpful to bring a family member or friend with you to your appointments.
2. Diagnosis and staging
The specialist will discuss your test results with you and options for further testing. This is to find out whether cancer is present, and if it is, its stage of development and if it has spread.
Tests you may have:
Computed tomography (CT) scan
Computer technology and x-rays are used to create detailed images of the liver.
In an MRI scan magnetic fields and radio waves are used to take pictures of inside the body.
3. Further referral and testing
Some people have further tests such as a biopsy.
It can also be helpful to contact cancer peer support groups and support groups for carers.
Here is a list of questions to ask your doctor.
To ensure you receive the best care, your specialist will arrange for a team of health professionals to plan your treatment based on your preferences and needs.
The team will be made up of health professionals who have experience managing and supporting a person with liver cancer. Your specialist will tell you when the team will be discussing your case.
Your team should discuss the different treatment options with you including the likely outcomes, expected timeframes, possible side effects, and the risks and benefits. Your doctor may also suggest you consider taking part in a clinical trial. You might want to ask for more time before deciding on your treatment.
There are a number of ways to treat liver cancer. In some cases, more than one type of treatment could be used to get the best outcome.
Treatment options for early liver cancer:
Local ablative therapies
Radio waves are used to heat and destroy a tumour without removing it from your body.
Surgery: Liver surgery
Surgery may benefit people with early liver cancer. It is important that this surgery is performed by a surgeon who is very experienced in performing liver surgery and performs several operations every year.
Surgery: Liver transplant
This surgery replaces your whole liver with a donor liver and may benefit those with cirrhosis whereby the liver has stopped functioning properly.
Treatment options for advanced liver cancer (if the cancer has spread to other organs):
Treatment for advanced liver cancer may include chemotherapy, surveillance and managing your underlying liver disease, or a combination of surveillance and surgery.
For more information about treatment and treatment side effects ask your doctor or visit our treatment section.
Your doctor should discuss your needs with you during and after treatment (including physical, psychological, social and information needs) and may refer you to another service or health professional for different aspects of your care.
5. After treatment
After treatment is completed, your doctor should provide you with a treatment summary which details the care you received, including:
- diagnostic tests performed and their results
- types of treatment used and when they were performed
- treatment plans from other health professionals
- support services provided to you.
To monitor your health, and make sure the cancer has not returned, you will need regular check-ups.
You and your GP should receive a follow-up care plan that tells you about:
- the type of follow-up that is best for you
- care plans for managing any side effects of treatment, should they occur
- how to get specialist medical help quickly if you think the cancer has returned or got worse.
Your doctor should:
discuss your needs with you and refer you to appropriate health professionals and/or community organisations, if support is required
provide information on the signs and symptoms to look out for that might mean a return of the cancer
provide information on prevention and healthy living
6. If cancer returns
Sometimes liver cancer can come back after treatment. This is why it is important that you have regular check-ups. Usually this will be detected at your routine follow-up appointments or if you notice symptoms are coming back.
7. Living with cancer
Some people experience side effects (for example, tiredness) that continue beyond the end of treatment. Sometimes side effects don’t begin until months after treatment has finished. For more information about side effects ask your doctor.
Advance care plan:
Your doctor may discuss with you the option of developing an advance care plan. An advance care plan is a formal way of setting out your wishes for future medical care. For more information about advance care planning ask your doctor or visit advancecareplanning.org.au.
This type of treatment could be used at different stages to help you with pain relief, to reduce your symptoms or help improve your quality of life. For more information about palliative care ask your doctor or visit palliativecare.org.au.
8. Questions of cost
There can be cost implications at each stage of the cancer care pathway, including costs of treatment, accommodation and travel. There can be substantial out-of-pocket costs if you are having treatment in a private health service, even if you have private health insurance.
You can discuss these costs with your doctor and/or private health insurer for each type of treatment you may have. If you are experiencing financial difficulties due to your cancer treatment you can contact the social worker at your local hospital.
For more information visit costs of treatment.
For more information about accommodation and travel costs visit our support section.
9. Further support
Liver cancer support
For information about liver cancer or where to go for support call Cancer Council 13 11 20.
specially trained staff can answer your questions about the effects of cancer, explain what will happen during treatment or link you to support groups and other community resources.
If you need an interpreter, call TIS (the Translating and Interpreting Service) on 13 14 50.
For support and advice for carers, call the Carers Association on 1800 242 636.
More support options
Australian Cancer Survivorship Centre
Has general and tumour-specific information, primarily focused on the post-treatment survivorship phase
• Telephone: (03) 9656 5207
• Website: www.petermac.org/cancersurvivorship
beyondblue: the national depression initiative
Information on depression, anxiety and related disorders, available treatment and support services
• Telephone: 1300 22 4636
• Website: www.beyondblue.org.au
Information on cancer prevention, screening, diagnosis, treatment and supportive care for Australians affected by cancer, and their families and carers
• Telephone: 1800 624 973
• Website: www.canceraustralia.gov.au
Care Search: Palliative Care Knowledge Network
Information for patients and carers on living with illness, practical advice on how to care, and finding services
• Telephone: (08) 7221 8233
• Website: www.caresearch.com.au
National Health Services Directory
A directory providing information on local hospital and community services
• Website: www.nhsd.com.au
NEMICS A common path: Liver cancer
Videos offering support and advice from people who have been through cancer.
• Visit: www.youtube.com/c/ACommonPathCancersupportandadvice
Clinical versions of the optimal care pathways have been developed for clinicians and general practitioners here.