When talking about cancer of the liver it is very important to be clear about the difference between primary and secondary cancer.

A primary cancer is one which starts in a particular part of the body, a secondary cancer is one which spreads to that part of the body from a cancer elsewhere. Primary liver cancers are quite uncommon in the UK, with less than 1,000 new cases each year, making up fewer than 1 in every 100 cancers diagnosed.

About 6 out of 10 primary liver cancers produce a substance called alpha fetoprotein (AFP). AFP passes into the bloodstream and can be measured by a simple blood test.

Finding a raised level of AFP in the blood does not necessarily mean someone has a primary liver cancer. The AFP level can also be raised during a normal pregnancy and when there is inflammation of the liver (hepatitis). Some other types of cancer can also cause a rise in AFP, these include some testicular cancers, and some cancers of the pancreas or stomach.

Although it can be elevated in other illnesses a high AFP level in the blood can help in making a diagnosis of primary liver cancer.

For those people with primary liver cancer who have raised AFP level the chemical can be used as a ‘tumour marker’ to monitor the progress of the condition, a falling level would suggest things are improving whereas a rising level would suggest the cancer is progressing.

The AFP level also has a bearing on the outcome of treatment, those people with lower levels of AFP generally tend to do better than those with much higher levels.