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 3 liver cancer is divided into 2 further stages - stage 3A and 3B.
There is more than one tumour, and at least one of them is larger than 5cm. At this stage the cancer has not spread to the lymph nodes or any other part of the body.
The cancer has grown into one of the main blood vessels of the liver (the portal vein or hepatic vein).
Or the cancer has spread into organs close to the liver (not including the gallbladder), or through the lining that wraps around the internal organs of the abdomen (the visceral peritoneum). It has not spread to the lymph nodes or any other part of the body.
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 3A is the same as T3, N0, M0 in the TNM staging system.
Stage 3B is the same as T4, N0, M0.
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.
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
- where the cancer is
- how well your liver is working
- other health conditions
You might have:
Chemoembolisation is also called trans arterial chemoembolisation (TACE). It means having chemotherapy directly to the area of your liver that contains the cancer and then blocking off the blood supply to the tumour.
Radiofrequency ablation (RFA and microwave ablation (MWA)
These treatments use heat to destroy cancer cells in the liver. You can have ablation to treat more than one liver tumour.
Targeted and immunotherapy cancer drugs
Targeted 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
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.