Can stage 4 liver cancer be cured? (2023)


Posted: 18 April, 2023

Updated: 18 April, 2023 196 0

Can stage 4 liver cancer be cured? (1)

Vadim Berezhnoi (M.D.)

General practitioner, Medical expert, Head of the department of medical assistance.

1.About terminal liver cancer
2. Symptoms of the disease
3. Types of treatment
4.Prognosis of survival
5.Cancer survivor’s story

Reading time – 12 minutes

Stage 4 liver cancer is the most advanced form of the disease. At this point, the tumour has spread to neighbouring or distant lymph nodes and, in some cases, to other organs. It needs thorough treatment. Modern treatment options that are available abroad offer survival chances even in the most seemingly hopeless cases. Read more about treatment options abroad for stage 4 cancer in our article.

Can stage 4 liver cancer be cured? (2)

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Stage 4 liver cancer

Can stage 4 liver cancer be cured? (3)

More than 800,000 people worldwide are diagnosed with liver cancer each year, according to the American Cancer Society. This type of cancer kills more than 700,000 people a year. It affects men more often than women. The average age of diagnosis is 50-60 years. However, it is possible to develop the disease at an earlier or later age.

Liver cancer may be primary or secondary. The latter is a stage 3 or 4 cancer of another organ that metastases to the liver. Malignant tumours of the lung, stomach, rectum, breast or pancreas predominantly spread to this area.

The overwhelming majority of primary liver cancers are hepatocellular carcinomas. Somewhat less common are cholangiocarcinoma, angiosarcoma, epithelioid haemangioendothelioma, hepatoblastoma and embryonal sarcoma.

Stage 4 liver cancer is the most advanced form of cancer. It is the last stage of the disease and it carries the highest risk of death. It may be diagnosed years after cancer has been detected and treated, or at the initial screening.

According to Cancer Research UK, the world’s largest independent cancer research organisation, stage 4 liver cancer is divided into two subtypes:

    Stage 4A

    The tumour can be of any size. There may be several malignant nodes and cancer cells may have spread into blood vessels or neighbouring organs. Lymph nodes are affected but distant organs are not.

    Stage 4B

    The tumour is of any size. There may be several foci of cancer. Malignant cells can spread into blood vessels or neighbouring organs. Lymph nodes may or may not be affected, but there is damage to distant organs, particularly the lungs or bones.

For more information about grade 4 liver cancer with metastases, contact the coordinating doctors of the international MediGlobus platform. We will do our best to answer your medical questions and help you arrange your cancer treatment abroad.

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What are the symptoms of stage 4 liver cancer?

In the last stage of the disease, symptoms become more severe and intense. Patients with stage 4 liver cancer have severe pain on the right side of the abdomen, which can spread to the shoulder blade. The main signs of pathology also include:

    Can stage 4 liver cancer be cured? (4) Eye and skin jaundice,

    Can stage 4 liver cancer be cured? (5) itchy skin,

    Can stage 4 liver cancer be cured? (6) nausea and vomiting,

    Can stage 4 liver cancer be cured? (7) loss of appetite,

    Can stage 4 liver cancer be cured? (8) white faeces,

    Can stage 4 liver cancer be cured? (9) a feeling of a lump in the right side of the abdomen,

    Can stage 4 liver cancer be cured? (10) elevated body temperature,

    Can stage 4 liver cancer be cured? (11) dark urine,

    Can stage 4 liver cancer be cured? (12) bloated abdomen,

    Can stage 4 liver cancer be cured? (13) severe weight loss,

    Can stage 4 liver cancer be cured? (14) constant fatigue.

Can stage 4 liver cancer be cured? (15) Read: Techniques for fighting liver cancer

What is the treatment for stage 4 liver cancer?

Can stage 4 liver cancer be cured? (16)

In terminal liver cancer, treatment is usually aimed at prolonging the patient’s life, improving their condition and alleviating their symptoms. The choice of specific treatments will depend on many criteria, such as the patient’s age and health, previous treatment options and the characteristics of the tumour.

Usually, a liver transplant is not performed for stage 4 cancer. By this point the disease usually metastasizes to distant organs, rendering transplantation ineffective.

Surgery for end-stage liver cancer is also rarely used. It involves removing parts of the liver that are affected by the tumour (for example, a partial hepatectomy or segmentectomy). This will not remove cancer completely, but it will alleviate the symptoms and prolong the patient’s life.

The following treatments for grade 4 liver cancer are more effective and more commonly used:

    Can stage 4 liver cancer be cured? (17) radiation therapy,

    Can stage 4 liver cancer be cured? (18) immune therapy,

    Can stage 4 liver cancer be cured? (19) targeted therapies,

    Can stage 4 liver cancer be cured? (20) chemotherapy.

There are also clinical trials abroad for new drugs and methods of oncotherapy for malignant liver tumours.

Can stage 4 liver cancer be cured? (21) Read: What should I do if I have liver metastases?

Radiotherapy for stage 4 liver cancer

Radiotherapy for liver cancer can be done in several ways. The first option is classical radiotherapy. It involves irradiating the tumour externally with a special machine. The treatment takes 5-20 minutes per session. It is carried out several times a week for 1,5-2 months.

The second treatment option for stage 4 liver cancer is stereotactic radiotherapy (SBRT). During the procedure, several beams of high-dose radiation are delivered to the tumour from different angles. The impact on neighbouring tissues is minimal. The best candidates for SBRT are inoperable patients with small tumours that have clear borders.

    The third treatment for metastatic liver cancer is embolisation with Yttrium-90 (Y-90) microspheres. The microspheres are injected into the liver, which allows the affected organ to be irradiated with little or no damage to healthy systems and tissues.

According to leading Turkish interventional radiology specialist Prof. Adem Uçar from Liv Hospital, microsphere therapy has been used successfully in recent years for inoperable liver cancer patients and those who have not responded to chemotherapy. This treatment has the potential to slow down the progression of the disease and prolong the patient’s life by 1,5 years for primary tumours and 2-3 years for metastatic tumours.

Immunotherapy for advanced liver cancer

Can stage 4 liver cancer be cured? (22)

Immunotherapy is often used for stage 4 liver cancer. The monoclonal antibodies atezolizumab and bevacizumab are considered first-line drugs. They help the patient’s immune system to fight the malignant cells. These drugs can be used together. They are administered intravenously according to a schedule, about once every 2-4 weeks.

If the first-line drugs do not work, other immune drugs can be prescribed. This method of treatment can also be combined with targeted therapy.

In 2022 the US Food and Drug Administration (FDA) approved the combination of the immunotherapy drugs durvalumab and tremelimumab for the treatment of patients with unresectable hepatocellular cancer. This treatment improves survival and can reduce the risk of death by 22%.

Targeted therapy for liver cancer

    Several targeted drugs are used to treat terminal liver cancer. These drugs target cancer cells and do little to no damage to healthy tissue. They are not as toxic as standard chemotherapy and cause fewer side effects.

    Targeted drugs block the production of a protein that helps malignant tumours grow. This slows down the progression of the disease and relieves symptoms. These drugs are usually taken as tablets 1-2 times a day for 3-4 weeks. Then a break of about a week is taken and the treatment is repeated.

Chemotherapy for terminal liver cancer

Chemotherapy for stage 4 liver cancer is a viable treatment option. It is often used in combination with other therapies (targeted therapy, immunotherapy, radiation therapy) or surgery. A combination of 2 or 3 drugs is typically prescribed. The main regimens are GEMOX and FOLFOX.

    Chemotherapy is prescribed in cycles, with periods of medication and rest alternating. Generally, the cycle depends on the drug and lasts for about 2-3 weeks. The administration of chemotherapy can be intravenous or oral. It is also possible to deliver the drug directly into the hepatic artery. This option is more effective than traditional chemotherapy.

    Liver artery infusion is different from chemoembolization (blocking the artery supplying blood to the tumour with a chemical). It involves placing a catheter with an infusion pump under the skin of the abdomen. Chemotherapy drugs are injected into the hepatic artery with a special needle. This allows higher doses of medicine to be delivered directly to the mass.

Liver artery infusion can be used for patients with large and inoperable liver tumours. It is also prescribed in cases where liver cancer cannot be cured by chemoembolization or other methods.

Can stage 4 liver cancer be cured? (23) Read: Chemoembolization for liver cancer

The prognosis for stage 4 liver cancer

According to the American Cancer Society (ACS) and the International Agency for Research on Cancer, in malignant liver tumours that have spread to surrounding tissues or organs and/or regional lymph nodes, the 5-year relative survival rate for patients is 13%. If cancer has metastasised to distant parts of the body, the 5-year survival threshold is about 3%.

Even in the advanced stages of liver cancer, there are treatments available that can help patients to reduce symptoms, slow down the progression of the disease and maintain a decent quality of life. To travel abroad for Stage 4 hepatocellular liver cancer treatment or any other type of advanced cancer of this organ, click on the button below and fill in the feedback form.

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Andrea’s story of recovery from cholangiocarcinoma

Andrea was only forty years old when a tumour in her liver was discovered. Up until then, she had led an active and healthy lifestyle, exercised regularly and was raising three children. The diagnosis came as a shock. The woman was told that she had only a few weeks to live. However, six years have passed and Andrea is still living.

In the summer of 2015, Andrea was on holiday in Wales with her family. At this time she felt excruciating pain in her chest. She sought medical help, but it took six weeks for her to get a proper diagnosis. Initially, Andrea was told she had pulled a muscle or had an upset stomach.

The pain became unbearable and the woman was taken to the ER twice. On her second visit, she refused to leave the ward until she had a more detailed examination. The doctors took tests, which came back “clean”, and followed with an ultrasound. This test showed a tumour the size of a pineapple.

Andrea was relieved to know the cause of the pain. But this relief was short-lived. She was told that there was nothing to be done about the disease and that she had to get her affairs in order as she had about 6 weeks to live. However, Andrea decided not to give up and got a second medical opinion. She went to another hospital where she was told that she could have emergency surgery.

Can stage 4 liver cancer be cured? (24)

The surgery was difficult but successful. After the tumour tissue was sent to the lab, the doctors confirmed the cholangiocarcinoma diagnosis. The woman spent three weeks in the hospital. She then went to a specialised cancer centre for chemotherapy treatment. It lasted for six months. The process was not easy, but it allowed her to go into remission for six years.

    Andrea continues to have regular check-ups, as cholangiocarcinoma has a high recurrence rate. However, this doesn’t stop her from living a full life. She has climbed Mount Kilimanjaro, cycled through Vietnam and Cambodia and visited Everest base camp.

Andrea recommends seeking a “second” or even a “third” opinion from doctors. After all, it has helped her to survive and may help other patients with stage 4 cholangiocarcinoma.

The story is published on the British Liver Foundation website.


    Can stage 4 liver cancer be cured? (25) Stage 4 liver cancer is the most dangerous stage of cancer of this organ, with a high risk of death. It is divided into 2 subtypes – stages 4A and 4B. At this stage of the disease, it metastasizes to distant organs.

    Can stage 4 liver cancer be cured? (26) End-stage liver cancer has the following symptoms: abdominal pain, nausea and vomiting, dark urine, white stool, fever, bloating, weight loss, constant weakness, etc.

    Can stage 4 liver cancer be cured? (27) The main methods of treatment for advanced liver cancer are chemotherapy, radiotherapy, immunotherapy and targeted therapy. Surgery to remove a part of the diseased liver is rarely performed. Patients with stage 4 cancer are even less likely to be suitable for an organ transplant.

    Can stage 4 liver cancer be cured? (28) Approximately 13% of patients with stage 4 liver cancer who have no distant metastases meet the 5-year survival threshold. For patients whose tumour has spread to distant organs, the figure is around 3%.

To undergo diagnosis and treatment of liver cancer abroad, contact the specialists at MediGlobus. We will help you in choosing a clinic and doctor and will take you on a medical trip as soon as possible.

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  1. American Cancer Society
  2. Mayo Clinic
  3. Cancer Research UK
  4. HealthMatch
  5. Аmerican Society of Clinical Oncology (ASCO)
  6. British Liver Trust
  7. Verywell Health
  8. American Cancer Society
  9. Тhe U.S. Food and Drug (FDA)

Good to knowOncology

Can stage 4 liver cancer be cured? (29)

Vadim Berezhnoi (M.D.)

General practitioner, Medical expert, Head of the department of medical assistance.

Can stage 4 liver cancer be cured? (30)

Victoria Kulyk

Works in field of medical copywriting since 2019. Has an degree in clinical psychology. Since 2010 has been studying medicine and finished medical school preparatory courses. She devotes her free time to studying the current state of the medical sphere in the world and scientific innovations. Her interests include neuroscience, biology, genetics, physiology and medical technology. She is fluent in Ukrainian, English, Russian and studies German.

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