Hi, Alpha feto protein (AFP) is a substance produced by the liver, normally in very small amounts. But the levels go up in cases of hepato cellular cancer (HCC). The CT report is suggestive of HCC and is probably the reason why the AFP levels are high. The term multi focal HCC suggests there are more than one lesion in the liver. The most curative form of therapy for HCC is surgery. But given that there is background cirrhosis of the liver, this might not be feasible in your patient. The best treatment in this scenario would be a Liver transplant (provided the HCC meet certain criteria). This would not only get rid of all the cancer, but also replace the cirrhotic liver with a new healthy liver. if a liver transplant is not feasible, either because of patient factors (age, other health conditions, cost) or because of extensive disease, then other choices for treatment include radio frequency ablation of the cancer, Trans cutanous chemo- embolisation (TACE - where the blood supply to the tumor is selectively cut off) or per cutanous injection of alcohol into the lesions. once the cancer gets treated, the AFP levels will spontanously decrease and then the levels can be used to monitor for recurrence of cancer. Hope this helps and please do not hesitate to contact me for further details - rxsuresh@gmail.com