a doctor and patient discuss a cancer cell

Hepatocellular Carcinoma Stages and Diagnosis

This article is not intended to give or replace medical advice from a qualified health practitioner and is to be used for informational purposes only. If you have concerns about your health, feeling unwell or have sudden new symptoms developing please contact a health professional you trust.

Life expectancy and prognosis for hepatocellular carcinoma

There are a few measurable factors that help doctors understand how dangerous or deadly different cancers are. Staging is possibly the most widely known of these tools. Staging cancers is a common way medical professionals can understand and explain to patients what is most likely to happen to their bodies while living with cancer.

Staging is a way of determining how dangerous a persons cancer has become as well as treatment options and mortality.8 Mortality and mortality rates are used to describe the amount of deaths that happen for a specific group of people, animals or other living beings over a specific period of time.  This is different from morbidity and morbidity rates which describe the amount of persons who have a specific disease/disorder or other defining characteristic and the rate at which persons contract, develop or are diagnosed with an illness.7

How is carcinoma measured?

What you may not know about staging and cancers is that different types of cancers use different staging tools. Hepatocellular carcinoma uses a specific staging tool called the "Barcelona Clinic Liver Cancer" (BCLC) system. In this system there are five stages, stage zero followed by stages A, B, C and D.6

With any type of cancer staging there are particular factors for each different method that are considered when determining how how deadly cancer can be. The different stages of the BCLC staging system are:

  • Child-Pugh classification score: This measures the amount of liver damage caused by scarring on the liver or cirrhosis.5
  • Measuring tumors: With tumors, it's important to know the number of tumors in the liver, tumor sizes, presence of symptoms and if, and how far the cancer has spread to other areas of the body (medical term: metastasis.)4

Your performance status is a measurement of the amount of help needed to carry out daily activities like dressing and feeding. Performance status is also called an ECOG score (Eastern Cooperative Oncology Group.) These things pare all taken into consideration when determining the stage of hepatocellular carcinoma.5

Hepatocellular carcinoma stages

Stage Zero: Very early stage cancer. At this stage the medical characteristics are there is only 1 tumor present that measures 2 cm (0.8 inches,) that does not cause symptoms and is not growing in one of the livers large blood vessels. It has not spread to other parts of the body or the lymphatic system.6

Stage A: Early stage. The characteristics of this stage are up to three tumors. All tumors are smaller than 3 cm (approximately 1.2 inches) and are not growing in the large blood vessels and are not causing symptoms. The tumors are not spreading to other areas of the body and are not spreading to the lymphatic system.

Stage B: Intermediate stage. At this stage there are more than 3 tumors in the liver OR 1-3 tumors in the liver with at least one larger than 3 cm. The tumors are not causing any symptoms at this stage and have not grown into the large blood vessels in the liver. The tumors are not spreading to other areas of the body and are not spreading to the lymphatic system.

Stage C: Advanced stage. At this stage the cancer has now grown into the large blood vessels in the liver or it has spread outside of the liver to other organs (medical term: metastasis) and may have spread to the lymphatic system. The tumors ARE causing symptoms at this stage.

Stage D: End stage. At this point the cancer has grown into the large blood vessels of the liver or has spread to other organs in the body. Symptoms are present and very severe at this stage.8

This is a difficult diagnosis to receive

Receiving a diagnosis that is statistically likely to be life-ending can be one of the most impactful moments in an individuals life. When the statistics do not reflect high likelihood of survival it is normal to be scared, confused, angry or sad. For many receiving a diagnosis like hepatocellular carcinoma can inspire drastic changes in lifestyle and perspective, and for some the focus is more on processing and acceptance. There is no right or wrong way to address a cancer diagnosis emotionally, physically or spiritually. Honoring yourself, your beliefs and what your goals are throughout your experience is what I have noticed to be the defining factor in successfully facing cancer, whether that concludes in recovery or not. Join us next time when we will be exploring life expectancy, prognosis and international support services.

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