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:
- pain or an increase in pain
- swelling in the abdomen (called ascites) or legs (called edema)
- yellowing of the eyes and skin (called jaundice)
The chance that liver cancer will come back (recur) is greatest within 2 years, so you will need close follow-up during this time.
Schedule for follow-up visits @(Model.HeadingTag)>
The first follow-up visit after any type of treatment for liver cancer is based on the type of treatment you had.
Liver resection or radiofrequency ablation (RFA) @(Model.HeadingTag)>
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 to 6 months for 2 years, then every 6 to 12 months.
Transarterial chemoembolization (TACE) @(Model.HeadingTag)>
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.
Targeted therapy @(Model.HeadingTag)>
If you are being treated with targeted therapy, you will have follow-up visits at least every 4 weeks.
Liver transplant @(Model.HeadingTag)>
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 @(Model.HeadingTag)>
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
- feeling the abdomen for a buildup of fluid (called ascites)
- looking at the skin and eyes for yellowing (called jaundice)
- checking for swelling in the legs (called edema)
- looking for skin problems such as a rash or peeling and asking if you have itchy skin
Tests are often part of follow-up care. You may have:
- a CT scan or an MRI of the liver and other parts of the abdomen to look for cancer that may remain after treatment or that has spread
- blood chemistry tests, including liver function tests to see how well your liver is working
- blood tests to check tumour marker levels of alpha-fetoprotein to see if they lowered after treatment
If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.
Kelly W Burak, MD, FRCPC, MSc(Epid)
Vincent Tam, BSc(Hon), MD, FRCPC
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Marrero JA, Kulik LM, Sirlin CB, et al . Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases . Hepatology . 2018 : 68(2):723–750 .
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers (Version 3.2021). 2021.
Sherman M, Burak K, Maroun J, Metrakos P, Knox JJ, Myers RP, Guindi M, et al . Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma. Current Oncology. 2011: http://www.current-oncology.com/index.php/oncology/article/view/952/737.