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Dr. Praveen Kammar


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Liver Cancer | 09 May 2022, Monday

What Is the Last Stage of Liver Cancer?


One of the largest organs of the body is the liver. It is located in the upper right upper abdominal region under the ribs.

The liver performs many important jobs, such as it filters harmful substances from the blood and converts food and fluid into nutrients and energy, and helps clot the blood to aid faster-wound healing.

Liver cancer can occur when the liver cells grow abnormally, out of control. In this blog, we shall discuss the last stage of liver cancer.

What is the last stage of liver cancer?

Liver cancers are staged based on their size, location, and spread. The last stage cancer or stage 4 liver cancer is the one that has spread to the nearby lymph nodes and/or distant sites within the body.

Lungs and bones are the most common sites of distant spread of liver cancer.

This end-stage liver cancer is complicated because most patients have significant liver damage that ultimately limits the organ’s function.

Reduced liver function may cause severe, even life-threatening conditions and have implications when choosing treatment options.

Stage 4 liver cancer is further divided into 2 stages – stage 4A and 4B. Knowing the cancer stage helps can help with choosing the right treatment option.

  • Stage 4A

In this stage, the cancer would have spread to the surrounding nodes but not to the other parts of the body.

  • Stage 4B

In this stage the liver cancer spreads to the other parts of the body, most commonly lungs and bones.

Causes and Risk factors of liver cancer

Although the exact cause of liver cancer is unknown, some studies have found the following factors that may raise the risk of liver cancer:

  1. Viral hepatitis
  2. Autoimmune disorders
  3. Alcohol addiction
  4. Drugs and toxins
  5. Genetics factor (family history of liver cancer)

Symptoms of last-stage liver cancer include:

Following are the signs & symptoms last stage liver cancer;
  1. Jaundice
  2. Bleeding from trivial injuries
  3. The buildup of fluid in the abdomen and legs
  4. Reduced brain function (problems with memory and concentration)
  5. Muscle cramps
  6. Trouble sleeping at night
  7. Extreme fatigue
  8. Intense itching
  9. Decreased appetite
When the liver function declines in end-stage liver cancer, certain medications further harm the liver or build up in the bloodstream, causing severe side effects. This requires immediate medical attention. If you experience any of the above symptoms, you can schedule an appointment with our doctor. Dr. Praveen Kammar is a well-known liver cancer specialist in Mumbai who can tell you everything you need to know about liver cancer

Survival rates in end stage liver cancer

According to the American Cancer Society, the relative 5-year survival rate for liver cancer spread to lymph nodes or other nearby tissues is 11 percent. However, when cancer has spread to the lungs, bones, or other organs, the relative 5-year survival rate is only 2 percent.

Please note that these numbers come from studies on large groups of people; your outlook may be very different.

End stage Liver Cancer Treatment

Unfortunately, for the last stage of liver cancer, treatment won’t cure it. Instead, it aims to control cancer, relieve symptoms and give you a good quality of life.

The treatment options for stage 4 liver cancer include:

– Targeted and immunotherapy cancer drugs

Targeted cancer drugs attack the specific receptors in cancer cells that help them grow and survive.

The following are the preferred drugs for stage 4 liver cancer.

  • Atezolizumab and Bevacizumab
  • Lenvatinib
  • Sorafenib

There are several other varieties of drugs available that can be used in case the above mentioned drugs are not effective or cause side effects. Your medical oncologist will be giving you more details about these options.

– Radiation therapy

It focuses high-energy beams on the tumor areas to achieve cell kill. Radiation therapy is used in stage 4 liver cancer in specific clinical scenarios.

E.g. Stage 4 liver cancer that has spread to the bones casuing significant pain. Here radiation is used to reduce pain. Radiation may also reduce the cahnces of fracture in the bones affected by cancer.

When liver cancer spreads to the brain, it may lead to swelling of the brain ( cerebral edema ) which may hamper the brain function and could be life threatening if not treated in time. Radiation helps by reducing the swelling caused by tumour deposits.


When the patient’s general health is too poor to withstand any type of cancer directed treatment,the focus should shift to “quality of life”. How can we make his remaining days pain free and better is an important question that needs to be answered.

The basic aim of supportive care is ,

  1. To keep the patient pain free
  2. To achieve adequate nutritional intake
  3. To manage minor complaints

You may have options of obtaining services of a palliative care team or end of life support team which may help your patient spend the rest of his days in peace.


The results of stage 4 liver cancers are not encouraging. Hence there are several clinical trials ongoing to improve the results of stage 4 liver cancer by using newer drugs and newer strategies. You can consider enrolling your patient in one of these trials.


Many patients of liver cancers have damaged liver due to cirrhosis. And sometimes it is the damaged liver that limits the treatment options.

It may also lead to liver failure. Hence treating and managing the damaged liver is also equally important. Several medicines and interventions are available to limit the progression of liver damage.


Liver Cancer becomes more challenging to treat; once it spreads beyond your liver. But there are different treatments to help slow it down and new therapies are being investigated.

In addition, many people with metastatic liver cancer also have other liver conditions, such as cirrhosis (scarring of the liver), that may affect the ability to treat your cancer. So keep in mind your cancer may have a different outlook. Discuss with your oncologist to get a better idea about your disease.

Book an appointment with us now to know more about last-stage liver cancer!



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