4 Different Stages in Liver Cancer and Treatment Options

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Dr. Manoj Gupta Senior Consultant

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 4 Different Stages in Liver Cancer and Treatment Options

A rare but dangerous form of cancer that starts in the liver is called primary liver cancer. This is a distinct situation from secondary liver cancer, which happens when the disease first manifests itself in another body organ and then progresses to the liver.

What is Liver Cancer and How Does it Progress?

A rare but dangerous form of cancer that starts in the liver is called primary liver cancer. This is a distinct situation from secondary liver cancer, which happens when the disease first manifests itself in another body organ and then progresses to the liver. Primary liver carcinoma is described in the remaining paragraphs and its stages.

Following a liver cancer diagnosis for liver cancer symptoms, medical professionals will attempt to determine whether and how far the disease has spread. The staging procedure is what it is. How much cancer is present in the body is determined by the cancer’s stage. It aids in determining the severity of the malignancy and the most effective course of treatment. When discussing statistics on survival, doctors also refer to the stage of a patient’s cancer.

The stages of liver cancer symptoms range from stage 1 to stage 4. The smaller the number, the less spread of cancer – generally speaking. A higher number, such as stage IV, indicates that cancer has progressed more widely. While every person’s experience with cancer is different, tumours at similar stages frequently have a similar prognosis and are treated similarly.

Choose the most qualified professionals when trying to identify liver cancer stages and make the most dependable decision. With your safety as their top priority, PSRI Hospital cancer department can effectively provide the most cutting-edge treatment options.

What Exactly is Liver Cancer?

One of the cancer forms with the quickest rate of growth is liver cancer, a potentially fatal condition. Liver cancer comes in two varieties: primary and secondary. Primary cancer develops in the liver. Your liver becomes the site of secondary malignancy that has spread from another organ. An overview of primary liver cancer is provided in this article.

Liver healthcare professionals have additional options for how to detect liver cancer early in its early stages, similar to how they do for other cancers. For liver cancer, unlike many other types of cancer, medical professionals are fairly certain of what factors contribute to an individual’s risk. In light of this, healthcare providers are focused on identifying individuals who may be at greater risk to detect and treat primary liver cancer as soon as possible.

What Generally Contributes to Liver Cancer?

When something alters the DNA of healthy liver cells, liver cancer results. The genes that instruct our cells on how to function are carried by DNA. The genes in each of us regulate how and when cells divide, grow, and expire. Oncogenes, as an illustration, promote cell division and growth. Tumour suppressor genes are other genes that maintain track of cellular activity, preventing uncontrolled cell growth and ensuring that cells pass away when they should.

Your cells receive new instructions whenever your DNA is altered or mutated. DNA alterations in HCC activate oncogenes and/or silence tumour suppressor genes. Studies, for instance, reveal that more than half of all instances of HCC are caused by cirrhosis brought on by the hepatitis B virus (HBV) and the hepatitis C virus (HCV). The DNA of liver cells that are infected by these viruses is altered, resulting in the transformation of normal liver cells into malignant ones.

How is Liver Cancer Identified by Medical Professionals?

how is liver cancer identified by medical professionals

The presence of liver cancer signs and liver cancer symptoms during your physical examination may lead your health care professional to believe you have the disease. For more information, they could request the following tests:

Ultrasound (sonography)

Your soft tissue architecture can be seen in photographs thanks to this exam. Ultrasound is a tool that medical professionals use to check for liver tumours.

Computerized Tomography (CT) scan

With the use of this unique kind of X-ray, your liver is captured in fine detail, revealing the size and location of any liver tumours.

The MRI Scan Uses Magnetic Resonance:

A big magnet, radio waves, and a computer are used in this exam to create extremely sharp photographs of your body.

Angiogram

Examining your liver’s blood arteries is made easier by this test for medical professionals. During this procedure, your healthcare professional injects dye into an artery to track blood vessel activity and look for blockages.

A Blood Test

Blood tests for cancer, such as a liver function test, may be performed by medical professionals to examine the liver’s proteins, enzymes, and other constituents, which can indicate whether the liver is healthy or damaged. Alpha-fetoprotein testing might be performed (AFP). Increased AFP levels may be a sign of liver cancer.

Biopsy

Medical professionals take liver tissue out to check for cancerous growth. The most accurate method for diagnosing liver cancer is through biopsies.

If your doctor suspects you have IHC, he or she may order the following tests:

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Your bile ducts are inspected with an endoscope and a catheter (thin, flexible tubes) during an ERCP procedure.

Transhepatic Cholangiography (PTC) via needle

A PTC, like an ERCP, produces X-rays of your bile ducts. Your healthcare practitioner administers contrast dye by putting a needle into your bile ducts and liver instead of using an endoscope and catheter. Those who are unable to get an ERCP usually only qualify for a PTC.

What Does Cancer Staging Mean?

Cancer’s location, whether or not it has spread, and whether or not it is impacting other body regions are all described under the term “staging.” The best forms of liver cancer treatment for a particular cancer are determined by its stage, which also provides information about the prognosis of the illness or the likelihood of recovery. Typically, only liver cancer that is in the early stages can be cured.

The stage of the cancer is determined by diagnostic testing, therefore staging may not be finalized until all of the tests have been completed. Knowing the stage aids in the doctor’s recommendation of the appropriate form of therapy and may aid in prognosis prediction for a patient. For various forms of cancer, there are many descriptions of the stages.

The Four Stages of Liver Cancer

First-stage Liver Cancer

Any primary tumour (any size) is the only one that has not invaded any blood vessels. There are no distant or close lymph nodes where the malignancy has disseminated. This level is divided into two subcategories.

  • A primary tumour in stage 1A has a diameter of 2 cm or less.
  • Greater than 2 cm in diameter is the main tumour in stage 1B.

Stage Two Liver Cancer

Blood vessels have been invaded by a single main tumour of any size, or there are several tumours (all smaller than 5 cm). There are no distant or close lymph nodes where the malignancy has disseminated.

Liver Cancer in The Third Stage

There are two subcategories under this stage:

  • Stage 3A: Numerous tumours have been discovered, at least one of which is more than 5 cm in size. Neither local lymph nodes nor distant locations have the malignancy spread to.
  • Stage 3B: Several tumours have been discovered, and at least one of them is expanding into a branch of the portal vein or the hepatic vein. Neither local lymph nodes nor far-off locations have seen liver cancer spread.

Liver Cancer in Stage Four

Stage 4 liver cancer might have distant metastases that have migrated to neighbouring lymph nodes or distant parts of the body. Even though advanced liver cancer seldom metastasizes, when it does, the lungs and bones are the most common sites of metastasis. There are two subcategories under this stage:

  • Stage 4A: One or more tumours of any size have been discovered, and while cancer has progressed to adjacent lymph nodes, distant locations have not yet been reached.
  • Stage 4B: There have been one or more tumours of any size discovered. Cancer has progressed to distant organs like the lungs or bones, albeit it may or may not have affected neighbouring lymph nodes first.

Contrary to other malignancies, liver cancer is compounded by the fact that the majority of patients already have damage that restricts the organ’s functionality. By assisting with digestion and liver detoxification, the liver performs a vital function for the body. Severe, potentially fatal diseases may be brought on by decreased liver function. When selecting a course of liver cancer treatment, the decreased liver function might potentially be a factor.

Depending on The Stage, Liver Cancer Treatment

Want to know what is the best treatment for liver cancer? Even though the AJCC (TNM) staging method (see Liver Cancer Stages) is frequently utilized to explain the progression of liver cancer, doctors employ a more practical system to decide on the best course of liver cancer treatment. Frequently used classifications for liver malignancies include:

  • Cancer that is potentially resectable or transplantable
  • Cancer that is unresectable (inoperable) but has not spread
  • Cancer that has progressed

Liver cancer that may be treated surgically or by transplantation (stage I and some stage II cancers)

Possibility of Resection

You may be cured by surgery (partial hepatectomy) if your cancer is in its early stages and the rest of your liver is healthy. This group only contains a small portion of liver cancer patients. The size of the tumour (s) and whether any surrounding blood vessels are damaged are significant factors that could have an impact on the outcome. A greater likelihood exists for larger tumours or those that infiltrate blood arteries to return to the liver or spread to other organs after surgery. Your general health as well as how effectively your liver functions are crucial. A liver transplant might be an additional choice for certain persons with early-stage liver cancer.

Clinical trials are currently examining whether giving patients who have had partial hepatectomy additional treatments may be beneficial. According to research, some individuals who have surgery and additional therapies like chemoembolization may survive longer. To determine the value (if any) of combining additional treatments with surgery, more research is required.

Possibility of Transplantation

You might be able to receive liver cancer treatment with a liver transplant if your cancer is still in its early stages but the rest of your liver is unhealthy. If the tumour is in a region of the liver that makes it difficult to remove, a transplant may potentially be an option (such as very close to a large blood vessel). Potential recipients of liver transplants may have to wait a long period for a liver to become available. They frequently receive additional therapies, including embolisation or ablation, while they wait to keep the cancer under control.

Inoperable Liver Cancer That Cannot be Resected

Cancers that have not yet progressed to lymph nodes or distant regions of the body but cannot be safely removed by partial hepatectomy are considered unresectable. This could be due to:

  • For safe removal, the tumour must be too huge.
  • The liver’s location of the tumour makes removal difficult (such as very close to a large blood vessel).
  • Either the liver is covered in tumours or cancer has spread there.
  • Surgery on the liver is not appropriate for this person’s health.

For liver tumours, various treatments are available, such as embolisation and ablation (s). Other alternatives can include radiation therapy, targeted therapy, immunotherapy, systemic chemotherapy, or chemotherapy administered via hepatic artery infusion. Some of these tumours may respond to liver cancer treatment by having the tumour (s) shrunk to the point that surgery (partial hepatectomy or transplant) is feasible.

Even though it is highly improbable that these treatments would be able to cure cancer, they can help patients live longer and lessen liver cancer symptoms. Liver cancer treatment costs and more modern therapies may frequently present a useful choice because these tumours can be challenging to treat.

Liver Cancer That Has Spread (advanced; Includes All N1 or M1 Tumors)

Either the lymph nodes or other organs have been affected by advanced liver cancer. These malignancies cannot be surgically removed due to their extensive nature. Initial treatments for patients whose livers are healthy enough (Child-Pugh class A or B) could include:

  • Tecentriq, a medication for immunotherapy, in combination with bevacizumab, a medication for targeting (Avastin)
  • Sorafenib (Nexavar) or lenvatinib are the two medications that are being studied (Lenvima)

Other specific medications like regorafenib (Stivarga), cabozantinib (Cabometyx), or ramucirumab (Cyramza) may be an alternative if these stop working. It may also be beneficial to take immunotherapy medications like pembrolizumab (Keytruda) or nivolumab (Opdivo) in combination with ipilimumab (Yervoy).

Similar to unresectable liver cancer that has not spread, clinical trials of more advanced targeted therapies, immunotherapy, new chemotherapy regimens (using new medicines and delivery systems), new radiation therapy modalities, and other novel therapies may be beneficial. For enhancing the results for the next patients, these clinical trials are equally crucial.

Radiation therapy is one type of liver cancer treatment that may be used to lessen pain and other liver cancer symptoms. Talk to the PSRI Hospital cancer treatment team about any liver cancer symptoms you experience so they can provide you with the best care possible.

Recurrent Liver Cancer

Recurrent cancer is cancer that returns after liver cancer treatment. The location of the recurrence can be local (at or close to where it first occurred) or remote (spread to organs such as the lungs or bone). Following initial therapy, the location of cancer’s recurrence, the nature of the initial therapy, and the liver’s state of function all affect how the disease is treated.

Potential candidates for further surgery or local therapies like embolisation or ablation include people with resectable cancer that returns to the liver. The use of chemotherapeutic medicines, immunotherapy, or targeted therapy may be a possibility if the disease is advanced. Additionally, patients might want to discuss the possibility of participating in a clinical trial with their physician.

Can Liver Cancer be Cured?

Wondering can liver cancer be cured? Well, liver transplants are successful and can cure patients with liver cancer, but not every patient in need of a transplant will be in good enough health or be able to find a donor. According to studies, those who undergo surgery to have a portion of their liver removed typically live longer than those whose disease prevents surgery. When that occurs, medical professionals concentrate on providing therapies that will assist patients to maintain a high standard of living as long as feasible.

Conclusion

A life-threatening condition is primary liver cancer. People frequently discover they have liver cancer after it has spread to an advanced stage, which reduces the range of available treatments. When that occurs, medical professionals concentrate on providing you with therapies that will reduce your symptom burden and slow the spread of cancer while preserving your quality of life.

Consult a qualified healthcare expert at PSRI Hospital if you have an advanced form of liver cancer to learn about your liver cancer treatment options, including advantages and disadvantages, so you can feel confident in your future decisions. Their team of skilled doctors will make sure that all of your needs are addressed while maintaining your safety and giving you a dependable experience while using their services.

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