Diagnosing liver cancer and accurately identifying all the characteristics of the tumor(s) are very important for determining prognosis and possible treatment options. The accuracy of testing and interpretation is essential because treatment is planned according to the final results.
Your liver cancer diagnosis is most often based on the careful examination of a tissue biopsy from a suspected tumor or of the entire tumor after definitive surgery (removal of the tumor with or without lymph nodes).
A pathologist who has special training in determining the nature and cause of disease will examine the tissue removed during a biopsy. Thin sections of tissue will be placed on slides, stained with dyes and examined under a microscope.
The pathologist then prepares a pathology report after examining the specimen with and without a microscope, documenting its size, describing its appearance and sometimes performing special testing. The final diagnosis is based on all the findings of the examination and is included in your pathology report.
Often, patients do not see their pathology reports, but you can request that your doctor share yours with you. Pathology reports may look different at different cancer centers and hospitals, but most of them include the same information. The details may seem overwhelming, and you will likely encounter unfamiliar terms. Ask your doctor to explain the information in it. Once you learn more, you will be more informed about your diagnosis and better able to discuss potential treatment options with your doctor.
A pathology report may include some of the following descriptions.
- Size and location of the tumor(s)
- Type of liver cancer (hepatocellular carcinoma, cholangiocarcinoma or angiosarcoma)
- Lymph node status
- Microscopic description, which compares it with normal cells
- Tumor margins (the healthy area around the tumor)
- Results of molecular diagnostic and cytogenetic studies, which look for biomarkers and genetic or molecular abnormalities in specimens
You may feel overwhelmed with the new information surrounding your diagnosis. To help ensure you understand the diagnosis and suggested treatment plan, consider seeking a second opinion from another doctor and pathologist who have experience with HCC. Other specialists can confirm your diagnosis and might suggest changes or alternatives to the proposed treatment plan. They can also answer any additional questions you may have.
Seeking a second opinion does not mean you question your doctor. Doctors in each oncology specialty bring different training and perspectives to cancer treatment planning. Another doctor’s opinion may change the diagnosis or reveal a treatment your first doctor was not aware of. A second opinion is also a way to ensure your pathology diagnosis and staging are accurate, and to make you aware of potential clinical trials. It is common for patients to request a second opinion, and you will not harm your relationship with your doctor by requesting a second opinion.