Stage 4 Liver Cancer: What to Expect

Stage 4 Liver Cancer: What to Expect

Stage 4 Liver Cancer: What to Expect

The liver is a football-sized organ that sits under the rib cage on the right side of the abdomen. Its primary duties are to rid the body of toxic substances and aid in the digestion of food. Liver issues usually develop due to genetic inheritances or over time due to unchecked viruses, alcohol abuse, and obesity.

Conditions that damage the liver often lead to scarring (cirrhosis), eventually leading to a life-threatening liver failure. Early treatment may give the liver time to heal and regrow. In this article, we will look at stage 4 of Liver cancer and how one can spot the symptoms and get treated for it.

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An Overview of Liver Cancer

Liver cancer is often referred to as Hepatoma or Hepatocellular Carcinoma (HCC). Liver cancer is categorized into stages based on its intensity, and the 4th stage is advanced of them all. In this stage, cancer has begun to spread to the nearby lymph nodes and or the distant lymph nodes and organs. Liver cancer cases are comparatively fewer and are more common in men than in women.

Stage 4 Liver Cancer

The intensity and degree of damage are indicated by the stage. It assists the doctor in making treatment decisions. It is different among the different kinds of cancer and is usually divided from 1 to 4. Stage 4 in Liver disease is divided further into two stages: 4A and 4B.

Stage 4A

Stage 4A cancer is of any size, and there may be more than one tumor present. The possibility of its growth into blood vessels or the organs around the liver cannot be ignored. Its presence is spread to lymph nodes but not yet to other parts of the body.

Stage 4B

Stage 4B cancer is also any size, and there may be more than one tumor present. The difference lies in the uncertainty of its presence in the lymph nodes, although it has spread to other parts of the body, such as the lungs or bones.

The Right Terminology

The substages of liver cancer are based on three variables:

  • T: Tumor size, tumor number, and if it has spread to nearby organs
  • N: The involvement of Lymph Nodes and if it has spread to any around the liver
  • M: Metastasis traces if the tumor has spread further away to other organs

The reason why the liver cancer stage is complex is the addition of stage grouping along with sub-staging. For instance, the addition of numerals in T states the number of tumors; T1 would mean one tumor.

While for N and M, “o” indicates there is no spread beyond the liver, and “1” or higher numerals would indicate the number of lymph nodes and their spread.

There are multiple staging systems in place for liver cancer, and it is advised to have a specialist explain the terms used to stay vigilant of the progress.

Stage 4 Liver Cancer Symptoms

The initial stages of liver cancer may not show any signs of the disease. After stage 3 liver cancer, as the disease extends its stay in the body, the signs and symptoms are more prominent and aren’t always directly related to the diagnosed cancer stage. The effects of cancer on a person is subjective, but some of the symptoms include

  • Abdominal pain
  • Abdominal swelling (ascites)
  • Appetite loss
  • Feeling full after eating only a little (early satiety)
  • Fluid in the abdomen
  • Generalized itching
  • Jaundice (yellowing of the skin and the whites of the eyes)
  • Liver enlargement
  • Nausea and vomiting
  • Pain in the right shoulder blade
  • Spleen enlargement
  • Unintended weight loss

Liver cancer tumors, in some cases, may begin to produce hormones. These hormones affect other parts of the body, in turn showcasing symptoms that could be deceiving.

  • Gynecomastia (male breast enlargement) or testicle shrinkage
  • Erythrocytosis: High levels of red blood cells
  • High cholesterol
  • Hypercalcemia: Increased calcium, leading to feeling confused, nauseous, or weak, or cause constipation or muscle problems
  • Hypoglycemia: Lowered blood sugar levels, causing fatigue or fainting
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Multiple risk factors contribute to the development of terminal liver cancer. These variables are conditions, behaviors, and other lifestyle-related reasons to develop a disease. An estimated 40% of cases are due to hepatitis B, another 40% due to hepatitis C, 11% cases begin with alcohol consumption, and about 10% have other causes.


Cirrhosis is liver damage that leads to scarring. It is usually tied to high alcohol intake, but there are other reasons to develop cirrhosis. Infections, along with hepatitis B or C, nonalcoholic fatty liver disease, hereditary liver diseases, long-term use of certain drugs, and chronic heart failure, can all cause scarring.

Cirrhosis is progressive and slowly develops over the years. Note that not everyone with scarring will develop stage 1 liver cancer.

Hepatitis B

Long-term Hepatitis B infection is a leading risk factor for liver cancer. It increases the risk of cancer by 12 times and can lead to a reduction in liver cancer survival rate without the presence of cirrhosis.

Hepatitis C

Long-term hepatitis C infections also lead to liver cancer even without the presence of cirrhosis. The risk, in this case, is nine times higher in people with hepatitis C

Nonalcoholic Fatty Liver Disease (NAFLD)

NAFLD frequently occurs in people who have a body mass index (BMI) over 30, with type 2 diabetes, with higher fat content in their blood, or with metabolic syndrome. This is the leading cause of liver cancer and may affect up to 25% of adults shortly.

Related Conditions

Numerous other conditions affect the bile ducts, and the liver also has a possibility of developing into liver cancer. These include Wilson disease, alpha-1 antitrypsin deficiency, hemochromatosis, glycogen storage disease, primary biliary cholangitis, porphyria cutanea tarda, and tyrosinemia.


These are poisonous, carcinogenic (causes cancer) mycotoxins that are produced by fungi growing on certain types of crops, including maize, peanuts, cottonseed, and tree nuts. Aflatoxin exposure is more common in the developing parts of the world. These crops are staple foods, and there is less ability to store foods without the risk of contamination, giving the fungi an ideal environment to grow.

Anabolic Steroid-Induced Liver Injury

Anabolic steroids are used and classified as “appearance and performance-enhancing drugs.” It is used by both amateur and professional athletes, even though they are only legal by prescription and highly frowned upon to use as ability enhancers.

The anabolic steroids cause liver injury and are rarely associated with angiosarcoma, a rare form of liver cancer.


When it comes to liver cancer prognosis, all the results will be relative to the survival rate. This means the number of people who survive a specific amount of time after being diagnosed with cancer. For liver cancer, this duration is five years. The survival rate is also different for different stages of cancer.

For stage 4 liver cancer, what to expect for the most prominent statistic is the distant grouping of the survival rate. Based on this, the five-year survival rate of liver cancer patients among males is 2.2%, while for women, this is 4%. In general, this comes down to about 3%. All this data is managed by the National Cancer Institute.

However, while statistics help understand the chances, they should also be seen for what they are: generalizations. The specific circumstances for every patient are different, and this should be made clear. It would be best if you talked to your healthcare professionals to see what the prognosis for stage 4 liver cancer is for your individual needs and circumstances.


Stage 4 cancer diagnosis brings up many complicated emotions. It will further affect family, friends, and lifestyle. It is therefore important to have coping mechanisms in place for both the patient and the family.

One of the steps is education; find out what is the survival rate for liver cancer and its treatments to reduce anxiety. Joining cancer support groups will provide a blanket of support and comfort from other people who seem to be in the same boat.

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Liver cancer is an extremely common and dangerous form of cancer that is tricky to find and treat. However, this does not mean that it is incurable.

If caught early, liver cancer can be cured, but in order to do that, there has to be greater awareness among the public about the disease, its symptoms, and its possible treatments. Knowledge is power, and it gives people the opportunity to help each other out by catching the warning signs. It is only through community and shared understanding that we will get over this hump.

That said, once you notice the signs, you will have to convince people, and even yourself, to get diagnosed so that treatment can begin. That is why it’s so very important to book an appointment with your primary care physician as soon as possible. And here, at All American Hospice, we would love to provide you or your loved one with compassionate care and support. Our expert caregivers are well versed in cancer symptoms and are here to do whatever they can to make you more comfortable. Reach out today to learn more.

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