### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi im a 34 year old male. I am 5 8 at 312 lbs. I dont have an active job and dont exercise. I recently got a mens exam and got some alarming news. My cholesterol is 160. Low hdl and high ldl . My eating habits are horrible to say the least. Everything came back fine on my blood work except the cholesterol and my liver enzimes. My ast was 44 and my alt is 95. I was a super heavy smoker for about 2 years but quit about 3 weeks before my check up. I was told it could be fatty liver but I read it could be cancer. I lose sleep every night and worry myself sick. Im scared its liver cancer. Im scheduled for a liver ultrasound tomorrow. My question is do you think it will be liver cancer and are ultrasounds accurate or could they miss something. Thank you for your time and expertise.

### output:

Hi, high cholesterol is not a risk factor for liver cancer. Many liver lesions or body changes could cause an increase in the levels of AST and ALT. A cause is usually sought to know exactly what causes this increase. Its worthwhile doing tests to for viral hepatitis, especially Hepatitis B and C which normally should be excluded in such cases. The increase in the liver enzyme levels in your case is not that alarming, and confronting these results with other results are required for any appropriate interpretation and adequate concluding clinical judgements could be made. A liver ultrasound shall give an idea about the structure of the liver and any possible nodules, cysts or collections. It orients the clinical to make a suspicion. Definitive diagnosis of liver cancer is usually based only on histologic/biopsy studies. However, specific blood markers could also help. I believe you should be patient for the results of the liver ultrasound. However, main risk factors for liver cancer are excessive intake of alcohol, liver hepatitis viruses (B and C), Chat Doctor.  Excessive smoking is instead a major risk factor in lung, esophageal and to a smaller extent, gastric cancer. Meeting a gastroenterologist AFER your ultrasound in case you are still very worried is a reasonable option.