Whether or not liver secondaries are suspected, on the basis of symptoms and clinical examination, blood tests to check the liver’s function may still be recommended. This is because even a normal sized liver in a person who feels quite well may still contain small secondary deposits. The enzyme we mentioned before when talking about the bones—alkaline phosphatase—is one that would be checked. There are also other liver enzymes that can be measured. In addition, certain waste products are checked. These are the yellow substances that cause jaundice when they build up in the blood. Slight build ups that are not enough to be seen as jaundice can be picked up on blood tests. Slight reductions in the amount of albumin in the blood do not cause fluid problems. Thus, even if there is no swelling or ascites, it is worth checking the albumin level. Particularly if a liver biopsy may be needed, certain tests to check whether your blood is clotting normally may also be advised. This is because the liver produces some of the proteins which help the blood to clot.

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