Blood Tests

A series of blood test are ordered to determine your general state of health and the health of your liver. A Complete Blood Count is a standard series and includes the following tests:

Hematocrit - measures the volume of red blood cells as a percent of the total blood volume.

Hemoglobin - measures the number of grams of red blood cells in a sample of blood.

Platelet Count - measures the number of platelets and reflects your ability to clot.

White Blood Count - measures the number of white blood cells.

Additional blood tests, usually referred to as Liver Function Tests, may be used to determine the overall functional condition of your liver. Your liver must be in satisfactory functional condition to be able to tolerate treatment.

Blood is drawn for a series of blood tests and a urine sample may be collected. Other tests, like a chest x-ray, CT scan, Ultrasound, or MRI, may be scheduled for the near future. All of these results along with your overall health during your first and subsequent visits will help your physician to accurately diagnose your condition.

Other blood tests may also be ordered to determine specific information about your liver cancer. A CEA test will detect the level of carcinoembryonic antigen (CEA), or AFP test which will measure the level of alpha fetoprotein (AFP).

CEA is a protein that is normally produced in the fetus during the first two trimesters of pregnancy. It is also produced by adenocarcinomas of the digestive system (such as the colon and rectum, pancreas, stomach), lung, and breast. The highest levels of CEA are seen in patients with liver metastases from colon cancer. Serial measurements of CEA during treatment provide important information on the efficiency of treatment. After undergoing treatment for colon cancer the CEA level should return to normal. If the treatment is incomplete, the CEA will not become normal.

The most common use for CEA is to monitor patients for the early detection of recurrent or metastatic cancer. By detecting metastatic cancer early, the treatment options are greater and more successful. Unfortunately, not all patients with cancer will have elevated CEA levels. Discuss your CEA results with your physician and determine if CEA monitoring can be helpful in your care. A normal level for a non-smoker is <~3 ng/ml and 3 - 5 ng/ml for a smoker.

AFP is also produced in the fetus but decreases steadily and becomes normal by 6 - 12 months of age. This substance is produced by patients with hepatocellular carcinoma or germ cell tumors. Approximately 70 - 90% of patients with hepatocellular carcinoma will have levels that range from above normal (greater than 20 ng/ml) to 10,000,000 ng/ml. A small elevation in AFP may occur in patients with non-malignant disease such as cirrhosis or viral hepatitis. Like CEA, AFP is used to monitor the effectiveness of cancer treatment in patients with hepatocellular carcinoma and germ cell tumors. Increasing levels of these markers is associated with tumor growth, but the absence of an elevation can not be interpreted as an absence of tumor.