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Liver Cancer Stage 4

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Last Updated: 02 July 2021

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General | Latest Info

The liver is the largest organ inside the body and is located under the right ribs and beneath the right lung. Liver has several functions. It secretes bile into intestines to absorb fats, breaks down and stores nutrients, manufactures clotting factors needed to stop bleeding, and breaks down toxic agents, like alcohol and drugs. Once toxic agents are broken down, they can be eliminated from the body through urine or stool. One of the causes of cirrhosis, scarring of the liver, is alcoholism. A person cannot live without a liver, so liver shut down or liver failure is fatal. Hepatitis is inflammation of the liver, which can progress to scarring or Liver Cancer. Hepatitis can be caused by toxic substances, infection, or autoimmune diseases. Common viruses that cause hepatitis are referred to as types, B, C, D, and E. It's possible to prevent hepatitis with vaccines available for types, B, and E. Metastatic Cancer is cancer that has spread from the place where it first starts to another place in the body. Metastatic Cancer in the liver is a condition in which cancer from other organs has spread through the bloodstream to the liver. Here, liver cells are not what have become cancerous. Livers have become the site to which cancer that starts elsewhere has spread. Metastatic Cancer has the same name and same type of cancer cells as the original Cancer. The most common cancers that spread to the liver are the breast, colon, bladder, kidney, ovary, pancreas, stomach, uterus, and lungs. Metastatic Liver Cancer is a rare condition that occurs when cancer originates in the liver and spreads to other organs in the body. Some people with metastatic tumors do not have symptoms. Their metastases are found by X - rays, CT scans, ultrasounds, or other tests. Enlargement of the liver or jaundice can indicate cancer has spread to the liver. Most people who get Liver Cancer get it in the setting of chronic liver disease, which scars the liver and increases the risk for Liver Cancer. Conditions that cause cirrhosis are alcohol use / abuse, hepatitis B, and hepatitis C. Causes of Liver Cancer may be linked to environmental, dietary, or lifestyle factors. For example, in November 2014, researchers at University of California, San Diego School of Medicine, found that long - term exposure to triclosan, common ingredient in soaps and detergents, causes Liver fibrosis and Cancer in laboratory mice. Although triclosan has not been proven to cause human Liver Cancer, it is currently under scrutiny by FDA to determine whether it has negative health impacts. Incidence rates of hepatocellular cancer are rising in the United States due to the increasing prevalence of cirrhosis caused by chronic hepatitis C and steatohepatitis. Cirrhosis of the liver due to any cause is a risk factor for Liver Cancer.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Liver Cancer Staging

Different types of treatments are available for patients with adult primary liver cancer. Some treatments are standard, and some are being tested in clinical trials. Treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that new treatment is better than standard treatment, new treatment may become standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

CT Scan vs. MRI

Because CTs use ionizing radiation, they could damage DNA and may very slightly raise the risk of developing cancer. The Food & Drug Administration estimates that the extra risk of any one person developing fatal cancer from a typical CT procedure is about 1 in 2 000. People with MRIs do not use ionizing radiation, so there is no issue of raising cancer risk. But they take much longer to complete than CTs. Mris require person to lie still within a closed space for about 20 to 40 minutes. This can affect some people with claustrophobia, and the procedure is noisy, which is why we provide ear protection. Both CT and MRI commonly require injection of contrast dye before or during procedure. This helps radiologists see organs and other tissues within the body more clearly.


Imaging tests

Your doctor may draw blood to determine whether you have high levels of alpha - fetoprotein, which can be a sign of liver cancer. High levels of this protein can indicate if other forms of liver disease are present. For this reason, your doctor may also perform imaging tests, such ultrasound or CT or MRI scan, to see whether you have a tumor. Your doctor may test your blood for presence of tumor markers. If you have a history of other cancers, particularly colon cancer, your doctor may test your blood for CEA, substance that is made by cancer and therefore a tumor marker. Ct or MRI scans may be performed to check the liver for cancer. Doctors may also use blood tests to measure liver function. These tests can reveal elevated levels of enzymes, such as alanine aminotransferase and aspartate aminotransferase, as well as high levels of bilirubina substance found in bile that is produced by the liver. Results of these tests can help doctors diagnose fatty liver disease, hepatitis B or C, or cirrhosis and determine how severe they are. These conditions may need to be managed in addition to cancer.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Continued

Cancer survival by stage at diagnosis for England, 2019 Office for National Statistics these Statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer. Cancer survival in England: adults diagnosed from 2009 to 2013, follow up to 2014 Newport, ONS; 2015. The Office for National Statistics these statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Treatment for common types

Unresectable cancers include cancers that haven't yet spread to lymph nodes or distant sites, but that ca be removed safely by partial hepatectomy. This might be because: tumor is too large to be removed safely. A tumor is in the part of the liver that makes it hard to remove. There are several tumors or cancer has spread throughout the liver. Person isn't healthy enough for liver surgery. Treatment options might include ablation, embolization, or both for liver tumor. Other options may include targeted therapy, immunotherapy, chemotherapy, and / or radiation therapy. For some of these cancers, treatment may shrink the tumor enough so that surgery may become possible. These treatments are very unlikely to cure cancer, but they can reduce symptoms and may even help people live longer. Because these cancers can be hard to treat, clinical trials of newer treatments may offer good option in many cases.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Prognosis and life expectancy

The median survival rate for Stage 4 mesothelioma is approximately 12 months with treatment. For pleural mesothelioma patients, Stage 4 survival rate is approximately 14. 9 months. At Stage 4, cancer is likely to continue to spread, which can lead to respiratory failure. If tumors spread to the heart, patient may experience heart failure. Patients with good prognostic factors often live longer than average. Prognostic factors associated with better survival include having epithelioid cell type, being in good overall health, younger in age, female and having no signs of blood disorders. Mesothelioma is considered variable cancer and no two cases are the same. For this reason, survival statistics cannot predict how long someone with mesothelioma will live. Some people have particularly slow - developing mesothelioma, and some respond surprisingly well to treatment.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Complications

Table

Edema and ascitesWhen liver damage progresses to an advanced stage, fluid collects in the legs, called edema, and in the abdomen, called ascites. Ascites can lead to bacterial peritonitis, a serious infection.
Bruising and bleedingWhen the liver slows or stops producing the proteins needed for blood clotting, a person will bruise or bleed easily.
Portal hypertensionNormally, blood from the intestines and spleen is carried to the liver through the portal vein. But cirrhosis slows the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension.
Esophageal varices and gastropathyWhen portal hypertension occurs, it may cause enlarged blood vessels in the esophagus, called varices, or in the stomach, called gastropathy, or both. Enlarged blood vessels are more likely to burst due to thin walls and increased pressure. If they burst, serious bleeding can occur in the esophagus or upper stomach, requiring immediate medical attention.
SplenomegalyWhen portal hypertension occurs, the spleen frequently enlarges and holds white blood cells and platelets, reducing the numbers of these cells in the blood. A low platelet count may be the first evidence that a person has developed cirrhosis.
JaundiceJaundice occurs when the diseased liver does not remove enough bilirubin from the blood, causing yellowing of the skin and whites of the eyes and darkening of the urine. Bilirubin is the pigment that gives bile its reddish-yellow color.
GallstonesIf cirrhosis prevents bile from flowing freely to and from the gallbladder, the bile hardens as gallstones.
Sensitivity to medicationsCirrhosis slows the liver's ability to filter medications from the blood. When this occurs, medications act longer than expected and build up in the body. This causes a person to be more sensitive to medications and their side effects.
Hepatic encephalopathyA failing liver cannot remove toxins from the blood, and they eventually accumulate in the brain. The buildup of toxins in the brain-called hepatic encephalopathy-can decrease mental function and cause coma. Signs of decreased mental function include confusion, personality changes, memory loss, trouble concentrating, and a change in sleep habits.
Insulin resistance and type 2 diabetesCirrhosis causes resistance to insulin-a hormone produced by the pancreas that enables the body to use glucose as energy. With insulin resistance, the body's muscle, fat, and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more, but excess glucose builds up in the bloodstream causing type 2 diabetes.
Liver cancerHepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis. Hepatocellular carcinoma has a high mortality rate, but several treatment options are available.
Other problemsCirrhosis can cause immune system dysfunction, leading to the risk of infection. Cirrhosis can also cause kidney and lung failure, known as hepatorenal and hepatopulmonary syndromes.

Stage 4 breast Cancer means that cancer cells that first show up in the breast have metastasize, or spread, to other areas of the body. Common areas for metastases include lymph nodes, bones, lungs, liver, and brain. Other terms for stage 4 breast Cancer include advanced or metastatic breast Cancer. By definition, stage 4 breast Cancer involves complications, as it has already moved beyond the original cancer site. But additional complications can occur from cancer itself or due to treatments. These complications may vary depending on the type of cancer, where it has spread, and what treatment methods are in use. Here are some potential complications you may face with advanced breast cancer, and how to manage them.


Symptoms

Initially, person may have no symptoms at all. This is called c ompensated cirrhosis. In fact, person may live many years with cirrhosis without being aware that his or her liver is scar. This is because pressure in portal vein is not yet too high and there are still enough healthy liver cells to keep up with the body's need. However, if nothing is done about the cause of cirrhosis, or if underlying disease such as hepatitis goes untreated, pressure in portal vein may increase to point where few remaining worker cells are overwhelm. As cirrhosis progress, most common symptoms are: weakness, fatigue, loss of appetite, nausea, vomiting, weight loss, abdominal pain and bloating when fluid accumulates in abdomen itching spiderlike blood vessels on skin


Liver cirrhosis

Prognostic models and staging systems are inevitable for adequate management of patients with Liver cirrhosis, especially when it comes to selecting patients for Liver transplantation. 19 Several classifications and prognostic models have been proposed in recent years of which three most widely used staging systems are subsequently described briefly. The Child - Pugh score was initially developed about 50 years ago to predict prognosis after surgery for portal hypertension in patients with liver cirrhosis. 20 original score was slightly modified later on and since then includes the following five variables: grade of encephalopathy and ascites as well as serum Bilirubin, albumin and prothrombin time. 21 Sometimes the prothrombin index or international normalised ratio are used instead of prothrombin time. 19 One to three points can be assigned for each variable and according to the sum of these points, patients can be divided into three prognostic subgroups: Child - Pugh classes, B, and C. 19 21 1 - year survival rate for stages, B and C is approximately 95%, 80% and 44%, respectively. The 14 main limitations of the Child - Pugh score are empirical cut - off values of laboratory parameters and inclusion of clinical variables needing subjective assessment. 19 Model for End - Stage Liver Disease score was originally designed to assess outcome after transjugular portosystemic intrahepatic shunt implantation in patients with Liver cirrhosis. 22 slightly modified version was proposed shortly thereafter aiming to assess early mortality risk for patients on liver transplantation waiting list. 23 simplified version was finally proposed and its ability to estimate 3 - month mortality in Liver transplant candidates with chronic Liver Disease was prospectively evaluate. 24 Using three variables serum Bilirubin, creatinine and INR score can be calculated by means of formula: 9. 57log e + 3. 78log e + 11. 20log e + 6. 43. 24 Bilirubin, creatinine and INR levels below 1 are rounded off to 1 in order to avoid negative logarithmic values, creatinine is limited to a maximum of 4 mg / dL to limit ranking advantage granted to patients with End - Stage renal Disease, and score was empirically capped at 40 for Liver transplantation listing purposes. Consequently, MELD score can achieve values between 6 and 40. The 19 24 MELD Model was implemented for Liver allocation to patients list for Liver transplantation in the United States and with Modifications in several European countries in 2002 and 2006, respectively. 25 26 Among patients with MELD < 15 1 - year, survival rate is lower in patients receiving transplantation compared to those who were not transplant. 18. Consequently, MELD score of 15 is recommended for listing patients with End - Stage Liver Disease. 26 main advantage of MELD Model compared to Child - Pugh class is the fact that only objective variables are used for its calculation and lack of upper limit for disease severity. Limitations include the need for computation, making it less user - friendly than Child - Pugh score in daily clinical practice, and the lack of well - defined subcategories to assess individual mortality risk.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

Common Causes of Cirrhosis

Alcohol-related liver disease.Most people who consume alcohol do not suffer damage to the liver. But heavy alcohol use over several years can cause chronic injury to the liver. The amount of alcohol it takes to damage the liver varies greatly from person to person. For women, consuming two to three drinks-including beer and wine-per day and for men, three to four drinks per day, can lead to liver damage and cirrhosis. In the past, alcohol-related cirrhosis led to more deaths than cirrhosis due to any other cause. Deaths caused by obesity-related cirrhosis are increasing.
Chronic hepatitis CThe hepatitis C virus is a liver infection that is spread by contact with an infected person's blood. Chronic hepatitis C causes inflammation and damage to the liver over time that can lead to cirrhosis.
Chronic hepatitis B and DThe hepatitis B virus is a liver infection that is spread by contact with an infected person's blood, semen, or other body fluid. Hepatitis B, like hepatitis C, causes liver inflammation and injury that can lead to cirrhosis. The hepatitis B vaccine is given to all infants and many adults to prevent the virus. Hepatitis D is another virus that infects the liver and can lead to cirrhosis, but it occurs only in people who already have hepatitis B.
Nonalcoholic fatty liver disease (NAFLD)In NAFLD, fat builds up in the liver and eventually causes cirrhosis. This increasingly common liver disease is associated with obesity, diabetes, protein malnutrition, coronary artery disease, and corticosteroid medications.
Autoimmune hepatitisThis form of hepatitis is caused by the body's immune system attacking liver cells and causing inflammation, damage, and eventually cirrhosis. Researchers believe genetic factors may make some people more prone to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are female.
Diseases that damage or destroy bile ductsSeveral diseases can damage or destroy the ducts that carry bile from the liver, causing bile to back up in the liver and leading to cirrhosis. In adults, the most common condition in this category is primary biliary cirrhosis, a disease in which the bile ducts become inflamed and damaged and, ultimately, disappear. Secondary biliary cirrhosis can happen if the ducts are mistakenly tied off or injured during gallbladder surgery. Primary sclerosing cholangitis is another condition that causes damage and scarring of bile ducts. In infants, damaged bile ducts are commonly caused by Alagille syndrome or biliary atresia, conditions in which the ducts are absent or injured.
Inherited diseasesCystic fibrosis, alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases are inherited diseases that interfere with how the liver produces, processes, and stores enzymes, proteins, metals, and other substances the body needs to function properly. Cirrhosis can result from these conditions.
Drugs, toxins, and infectionsOther causes of cirrhosis include drug reactions, prolonged exposure to toxic chemicals, parasitic infections, and repeated bouts of heart failure with liver congestion.

Table2

Bleeding VaricesInternal bleeding from large blood vessels in the esophagus
AscitesA buildup of fluid in the belly. (pronounced "a-sigh-tees")
EncephalopathyConfusion from the buildup of toxins in the blood. (pronounced "en-sef-a-lop-a-thee")
JaundiceYellowing of the eyes and skin
* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Stage 4A

Table

Bleeding VaricesInternal bleeding from large blood vessels in the esophagus
AscitesA buildup of fluid in the belly. (pronounced "a-sigh-tees")
EncephalopathyConfusion from the buildup of toxins in the blood. (pronounced "en-sef-a-lop-a-thee")
JaundiceYellowing of the eyes and skin

The number of stage 4 mesothelioma patients have far outlived average prognosis. Andy Ashcraft lived with stage 4 pleural mesothelioma for seven years. He joined clinical trial combining immunotherapy with chemotherapy. Andy responded better than anyone else in the trial. He continued to take just immunotherapy drug for more than three years. When it stopped working, he used medicinal cannabis to manage symptoms and lived several more years. Lannie Chitwood lived for 10 years with stage 4 pleural mesothelioma. He received treatment at Duke University Medical Center in Durham, North Carolina, including experimental chemotherapy. Lannie and his wife enjoyed traveling together during those years and took their second honeymoon in 2015. Comedian Quincy Jones was diagnosed with stage 4 peritoneal mesothelioma in 2015 at the age of 31. Doctors told him that he might have only one year to live. He has lived more than three years thanks to chemotherapy and his love for laughter.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Overview

Table

Bleeding VaricesInternal bleeding from large blood vessels in the esophagus
AscitesA buildup of fluid in the belly. (pronounced "a-sigh-tees")
EncephalopathyConfusion from the buildup of toxins in the blood. (pronounced "en-sef-a-lop-a-thee")
JaundiceYellowing of the eyes and skin

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

How does liver cancer spread?

Table

Bleeding VaricesInternal bleeding from large blood vessels in the esophagus
AscitesA buildup of fluid in the belly. (pronounced "a-sigh-tees")
EncephalopathyConfusion from the buildup of toxins in the blood. (pronounced "en-sef-a-lop-a-thee")
JaundiceYellowing of the eyes and skin

To understand liver metastasis, it is important to understand the role of the liver in your body. The liver is the largest organ inside the body, and it is vital to life. The liver is divided into two lobes and is located under the right ribcage and lung. Cleansing blood of toxins making bile, which helps in digesting fat, making many types of proteins used throughout the body for fuel and cell regeneration, making enzymes that initiate and participate in numerous body metabolic functions, storing glycogen, which the body uses for energy, liver is one of the most important organs in body. It is impossible to live without a functioning liver.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Outlook

Table

Bleeding VaricesInternal bleeding from large blood vessels in the esophagus
AscitesA buildup of fluid in the belly. (pronounced "a-sigh-tees")
EncephalopathyConfusion from the buildup of toxins in the blood. (pronounced "en-sef-a-lop-a-thee")
JaundiceYellowing of the eyes and skin

Once cancer spreads beyond your liver, it isnt curable. But there are treatments to help slow it down, and new treatments are being investigated in clinical trials. Survival time for liver cancer that has spread to distant organs is sometimes measured in months, which can be scary. Remember that youre not a statistic,s and you might do much better than the numbers suggest. Certain factors contribute to your outlook. Many people with metastatic liver cancer also have other liver conditions, such as cirrhosis. Having cirrhosis could affect your ability to treat your cancer. Also, keep in mind that statistics you read about this cancer are based on large groups of people. To get a better idea of your outlook, talk to your oncologist. If you have already been treated for liver cancer, tell your doctor about any new symptoms you have. The sooner you start on treatment again, better your long - term outlook will be.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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