Stage 4
The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide which treatment you need.
Staging looks at the size of the cancer (tumour) and whether it has spread to other parts of the body. There are different staging systems doctors can use for liver cancer. The Number staging system is one of these. It divides liver cancer into 4 main stages, from 1 to 4.
Stage 4 liver cancer is divided into 2 further stages - stage 4A and 4B.
Knowing the stage of your cancer helps you and your doctors plan the best treatment for you.
Stage 4A
The cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It has spread to lymph nodes but not to other parts of the body.
Stage 4B
The cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It may or may not have spread into lymph nodes, but has spread to another part of the body such as the lungs or bones.
TNM stages
Doctors may use another staging system called the TNM staging system.
- T describes the size of the tumour
- N describes whether there are cancer cells in the lymph nodes
- M describes whether the cancer has spread to a different part of the body
Your doctor gives each letter a number depending on how far the cancer has grown.
Stage 4A is the same as Any T, N1, M0 in the TNM staging system.
Stage 4B is the same as Any T, Any N, M1.
Other staging systems
The Number and TNM staging systems describe the size and position of liver cancer. However, because people with liver cancer often have scarring of the liver (cirrhosis), doctors also need a system that describes how well your liver is working and your general health (your performance status). Then they can decide what treatment would be best. For this, doctors use a system such as the Barcelona Clinic Liver Cancer (BCLC) staging system.
Treatment
Unfortunately when liver cancer is advanced, treatment won't be able to cure it. It aims to control the cancer, relieve symptoms and give you a good quality of life.
Targeted and immunotherapy cancer drugs
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. They are called immunotherapies.
You might have a combination of these drugs, or treatment with a single drug. Examples include:
- atezolizumab and bevacizumab
- lenvatinib
- sorafenib
Treating symptoms
You can also have other treatments to control specific symptoms such as sickness and pain.
Research and clinical trials
Researchers are always trying to improve the treatment and quality of life for people with liver cancer. This includes the care of people with advanced cancer.
