Follow-up after treatment for liver cancer
Follow-up after treatment is an important part of cancer care. Follow-up for liver cancer is often shared among the cancer specialists (oncologists), liver specialists (hepatologists) and your family doctor. If you have a liver transplant, your transplant team will also be involved in your follow-up care. Your healthcare team will work with you to decide on follow-up care to meet your needs.
Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:
- new pain or pain that gets worse
- swelling in the abdomen or legs
- yellowing of the eyes and skin (called jaundice)
The chance of liver cancer coming back, or recurring, is greatest within 2 years, so close follow-up is needed during this time.
Schedule for follow-up visits
The first follow-up visit after any type of treatment for liver cancer is based on the type of treatment you had.
If you had a liver resection or radiofrequency ablation (RFA), the first follow-up visit is 4 weeks after treatment. Then follow-up visits are scheduled every 3 months for 2 years. If there is no recurrence after 2 years, visits are then scheduled every 6 months.
If you had transarterial chemoembolization (TACE), the first follow-up visit is 4 to 6 weeks after treatment. Then follow-up visits are scheduled every 3 months.
If you are being treated with targeted therapy, you will have follow-up visits every 2 or 3 months.
If you had a liver transplant, you will be followed by your transplant team. They will schedule tests and visits for follow-up care at the transplant centre or with your family doctor.
During follow-up visits
During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. Your doctor may do a physical exam, including:
- feeling the abdomen to check if the liver or spleen is larger than normal, or enlarged
- feeling the abdomen for a buildup of fluid (called ascites)
- examining the skin and eyes for yellowing (called jaundice)
- looking at the legs for swelling (called edema)
- looking for skin problems such as rash or peeling and asking if you have itchy skin
Tests are often part of follow-up care. You may have:
- CT scan to look at the liver and other parts of the abdomen
- blood chemistry tests, including liver function tests
- tests to look for alpha-fetoprotein (AFP), which is a tumour marker
Doctors only test for AFP during follow-up if it was high at the time of diagnosis and it was lower after treatment.
If a recurrence is found, your healthcare team will assess you to determine the best treatment options.
Questions to ask about follow-up
To make the decisions that are right for you, ask your healthcare team questions about follow-up.
A condition in which the skin and whites of the eyes become yellow and urine is dark yellow.
Jaundice may be caused by high levels of bilirubin (a substance formed when red blood cells break down) in the blood. It can also result from liver problems or a blocked bile duct.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.