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Primary liver cancer or hepatocellular carcinoma is classified in stages of 1 to 4 or A to D. A process known as staging is used to determine the stage of cancer and the extent of its spread through the body. Imaging tests such as CT scan, MRI, chest x-ray and bone scan are required to determine the stage of cancer. The stages of liver cancer are:

• Stage 1 -  Indicates the presence of 1 tumor
• Stage 2  - Indicate the presence of two or more small tumors or a single tumor that has spread to the surrounding blood vessels
• Stage 3 – Indicates the presence of more than one tumor larger than 5 cm. or that the cancer has spread to neighboring organs or the lymph nodes
• Stage 4 – The cancer has spread to other organs of the body such as the bones or the lungs

The prognosis for people with stage 4 liver cancer is very poor. Even in the earlier stages only 10% to 20% of liver cancers can be removed completely using surgery. The life expectancy for someone with stage 4 liver cancer is usually only a few months with six months being the upper limit although a few people have been known to survive for longer periods.

Most people do not exhibit any signs and symptoms in the early stages of liver cancer. Stage 4 liver cancer symptoms include:

• Abnormal weight loss
• Loss of appetite
• Pain in the upper abdominal region
• Nausea and vomiting
• Chronic fatigue and general weakness
• Abdominal swelling
• Enlargement of the liver
• Symptoms of jaundice including a yellow pallor and yellowish eyes
• Stools with a white, chalky appearance

Some of these symptoms may also appear in the earlier stages of liver cancer.

Treatment for stage 4 liver cancer will depend on a host of other factors including your age, overall health and personal preferences. The goal of the treatment will be more in the nature of comfort care that tries to help relieve the symptoms of the disease and make you as comfortable as possible.

Some of the treatments that your doctor may recommend include:

• Radiation therapy – This treatment uses high powered beams of energy from radioactive sources to shrink tumors. A technique known as stereotactic radiosurgery is sometimes used during which several beams of energy are focused on one point in the body. Side effects include fatigue, hair loss, nausea and vomiting.
• Chemotherapy – This treatment uses anti-cancer compounds to kill the cancer cells. Side effects include nausea and vomiting.
• Targeted drug therapy – This treatment uses a drug, sorafenib tosylate (Nexavar), to block the growth of the tumor. It has been approved for the treatment of advanced liver cancer.

References

• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001325/

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