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Hepatocellular carcinoma is one of the most dangerous of all cancers. Also known as liver cancer in simple terms, it is generally called a silent killer. This is because the patient shows no or very little symptoms of the cancer during the initial stages. This gives the cancer a chance to spread and grow. There are four stages of liver cancer that help determine the spread of cancer within the liver. Of these stages, the last stage, i.e., stage 4 is the fatal one.
What Leads to Liver Cancer?
Liver cancer depends on the age, gender, family history, ethnicity and other health factors of an individual patient. A person who is a chronic smoker or an alcoholic is more prone to developing liver cancer. People who have repeated infections of hepatitis B, hepatitis C, liver cirrhosis, etc. are also at a risk of liver cancer. People who drink water contaminated with arsenic or are exposed to aflatoxins and are on anabolic steroids, too have chances of developing liver cancer.
Symptoms of Stage 4 Liver Cancer
Liver cells are called hepatocytes that help detoxify the body and process harmful chemicals. When these normal hepatocytes start growing rapidly, uncontrollably and proliferate abnormally, it leads to formation of cancer or tumor. During the final stage (stage 4) of cancer, these cancerous cells migrate to other parts of the body and spread cancer. This is known as metastasis. Symptoms of stage 4 liver cancer are as follows:
Cirrhosis
Liver cirrhosis indicates that the cancer has reached its final stage. Liver ceases to carry out its normal function during cirrhosis. The only cure for cirrhosis at this stage is liver transplantation. Cirrhosis leads to portal hypertension. This causes an increase in blood pressure between spleen and liver. Thus, more blood flows through the esophagus and stomach. This increases the chances of internal bleeding, enlargement of spleen, low platelet count, etc. Cirrhosis causes insulin resistance and this leads to type 2 diabetes.
Hepatic Encephalopathy
As the normal functions of liver are no longer performed, it leads to hepatic encephalopathy. The toxins and waste within the body increase and cause confusion, loss of memory, changes in personality, agitation, sleep disturbances, poor concentration, coma, etc. It will further lead to lung and kidney failure.
Esophageal Varices
The veins in the lower part of the esophagus i.e., esophageal varices become abnormally large. A blockage in the normal blood flow to liver leads to esophageal varices. This leads to back flow of blood into the smaller esophagus vessels, stomach, rectum, etc. leading to swelling. These blood vessels are very fragile and can rupture under pressure. This will lead to internal bleeding that can turn into a life-threatening situation. One may observe blood in stool, blood in vomit, lightheadedness and shock due to internal bleeding.
Ascites
Acute swelling in the abdomen is known as ascites. This occurs due to liver failure and leads to upper right quadrant abdominal pain. There is excessive fluid retention that causes the abdominal girth to increase. This leads to pressure on the upper body thus causing pain in the shoulders and back. The patient is more prone to developing bacterial peritonitis due to excessive fluid retention in the stomach.
Jaundice
One of the stage 4 cancer symptoms is jaundice that is hard to miss. The skin and the whites of the eyes turn yellow due to jaundice. This occurs due to the inability of the liver to remove bilirubin from the body. The red blood cells die and are broken down into bilirubin. When this bilirubin is not excreted from the body, it leads to dark urine and systemic toxins resulting in itchy skin and yellowing of the skin.
Spontaneous Bleeding
Spontaneous bleeding from various parts of the body is a sign of end stage liver cancer. The liver fails to clean the blood and this causes accumulation of the dead cells in the body. This leads to increase in prothrombin in the blood that increases the chances of sudden, unexplained bleeding. One starts bleeding from the nose, gums, oral mucosa, etc.
Decreased Lung Capacity
The stage 4 liver cancer is metastasized to other parts of the body like lungs. These cancerous cells travel through the blood or lymph vessels throughout the body. When these cells colonize themselves in the lung, it leads to secondary tumors. This causes disruption of normal lung function and decrease in air capacity. This leads to breathing difficulty and shortness of breath.
Bone Pain
The cancer cells can metastasize to bones and lead to severe pain. The patient experiences stabbing pain in the joint and other parts of the body. This leads to many problems in performing daily activities.
Stage 4 Liver Cancer Prognosis
The stage 4 liver cancer treatment involves chemotherapy, radiation therapy and liver transplantation (rare cases). However, these treatments are not very effective as the cancer has already spread all over the body. They just help in prolonging the life of the patient. The stage 4 liver cancer prognosis shows that this condition is beyond any cure. Only palliative care will help ease the discomfort, pain and help the patient to get some relief.
Stage 4 Liver Cancer Survival Rate
The survival rate is calculated according to the number of patients who survive cancer for a 5 year period after diagnosis. The stage 4 liver cancer survival rates are very poor and only 4% patients survive for 5 years. The survival rate for metastatic liver cancer is unfortunately 0%, even after liver transplantation.
As you can see, the stage 4 liver cancer symptoms are very painful and discomforting. Each patient is different and so is the survival rate. It is important to diagnose liver cancer during the initial stages. Stage 4 cancer is the final stage and only palliative care, love and support from friends and family will help make the transition of life to death peaceful and easy.