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Stage four cancer is a serious stage where the cancer has spread to other parts of the body. It can be hard to cope with a diagnosis of this stage. Support groups, clinical trials and palliative care can all help.
When a person is diagnosed with stage 4 cancer, they are often told that the disease cannot be cured. However, that doesn’t necessarily mean the end is near.
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A loss of appetite is one of the most common symptoms of cancer. It can occur due to the cancer itself, or as a result of certain treatments. Many chemotherapy drugs can trigger the vomiting centers of the brain and damage the digestive tract, causing nausea and loss of appetite. It is important to eat as much as possible, even when you do not feel hungry, in order to receive the nutrients your body needs.
If you are experiencing a loss of appetite, try eating small amounts throughout the day to ensure you receive enough calories and protein. You can also drink liquid protein drinks to get the nutrition you need. A doctor may be able to prescribe medication to help increase your appetite.
Fatigue is another common symptom of cancer, and it can lead to a loss of appetite. If your fatigue is caused by a physical condition, such as an enlarged spleen or liver, or a side effect of medications you are taking, it should go away once the condition is treated.
In some cases, a loss of appetite is caused by the stress and emotional turmoil of dealing with cancer. Talking to a counselor or psychologist, practicing relaxation techniques, and spending time with supportive friends and family can help relieve stress.
In stage four, cancer has spread to distant organs from the original tumor site. This is called metastasis. The prognosis for cancer at this stage is often poor. However, treatment can slow the growth of the cancer, reduce side effects and improve quality of life for patients.
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Breathing difficulty, or dyspnea, is often a sign of advanced cancer. It can occur when cancer has spread from the lung, where it originated, to other areas of the body. It can also be caused by inflammation, fluid that has built up between the lungs’ membranes, obstruction of the upper airway and more.
The lungs, which are located in the center of the chest, are responsible for taking oxygen in and out of the body. When you breathe in, air comes down through your windpipe, or trachea, into two tubes called bronchi that attach to your lungs. The bronchi then break off into smaller branches, known as bronchioles, which lead to tiny, balloonlike air sacs called alveoli. The lungs take in the oxygen from these sacs, and exhale carbon dioxide, which rids the body of waste products.
When a cancer has reached stage four, it has spread from the original site to other parts of the body, a process called metastasis. The cancer cells can then travel through the bloodstream and lymphatic system to other organs, including the brain, bones, liver and adrenal glands where they may form new tumors.
If you know someone with stage 4 cancer, try to stay in touch and help them when you can. Listen to them and give them your undivided attention, as they may feel like they’re being ignored. Don’t compare your own experience with theirs, as this can make them feel worse. Consider getting them palliative care, or supportive care, which helps with medication side effects and improves quality of life. This is available at home, in a hospital or at hospice care centers. It’s sometimes referred to as end-stage or terminal cancer, which indicates that the cancer can’t be cured.
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In this stage, cancer has spread from the original location to other parts of the body. The most common type of cancer that reaches this stage is lung cancer. Breast cancer can also reach this stage, which is sometimes referred to as metastatic cancer.
Many of the same tests and procedures used to diagnose cancer at earlier stages can be used to determine if a patient has stage four cancer. These include imaging tests and biopsy, which involves removing a small amount of tissue from the suspected tumor and examining it under a microscope.
For patients with stage 4 cancer, the presence of a cancerous lump or mass can cause chest pain. The severity of the pain can vary depending on the type and location of the tumor.
The onset of chest pain in cancer patients and survivors should prompt consideration for cardiovascular side-effects related to cancer therapy. In particular, cancer patients have a sevenfold increased risk of venous thromboembolism (VTE) compared with the general population.
When a patient experiences chest pain, he or she should see a doctor immediately for further evaluation and management. Ideally, the patient should be referred to a cardio-oncology team who can help them manage these symptoms.
Palliative care is offered alongside cancer treatment at this stage and can help alleviate pain, relieve chemotherapy side-effects, and improve overall quality of life. The patient may want to consider speaking with a counselor independently or with his or her family members. They can offer advice and support on how to cope with the stress of this diagnosis and treatment.
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Breathing is a natural, necessary process that helps deliver oxygen to the cells of your body and remove carbon dioxide. But it isn’t always easy to do. Sometimes factors such as strenuous exercise, extreme temperature change, poor air quality and high altitudes can make it difficult to breathe. But if you are short of breath on a regular basis, that’s a sign you need to talk to your doctor about it.
If you have breathing problems that worsen with activity, are accompanied by chest pain or blue skin, lips or nails (cyanosis) or don’t go away even with rest, you should see a healthcare provider right away. Your healthcare provider may ask questions about when it started, what makes it better or worse and whether you hear grunting sounds or wheezing when you breathe.
Stage four cancer refers to an advanced cancer that has spread from the original location to other parts of the body. Usually, this is lung cancer that has spread to other organs or tissues in the lungs. But it can also be cancer that has spread to other parts of the body from a different part of the original tumor.
If you have stage four cancer, your healthcare team can offer medications to manage the symptoms that cause your breathing difficulties. They can also run tests to help make a diagnosis and recommend lifestyle changes or breathing exercises that can improve your ability to breathe. If you are a friend or family member of someone with stage 4 cancer, you can support them by staying in touch and listening without interruptions. Try not to compare their situation with yours or the experiences of others.
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Memory problems are often a sign of cancer that has spread to the brain. These can include difficulty remembering things like names and dates or feeling like you’re in a “mental fog.” Some people may experience more serious memory changes, such as delirium or paranoia, while others are affected by less severe symptoms such as confusion or unsteadiness on their feet.
Some people find that these symptoms get better after getting treatment for the condition causing them. For example, treating anemia or electrolyte imbalances can help alleviate these symptoms. Others, such as those caused by medication side effects, may not go away completely, but can be managed with different medications or adjusted dosages.
The loss of memory can be very distressing for a person with stage four cancer. It’s important to have a support system to help manage these symptoms, so it’s a good idea to seek out counseling or participate in a cancer-related support group. If you’re a friend or family member of someone with stage four cancer, try to be as available as possible and offer a sympathetic ear. But, be sure to avoid asking personal questions that could cause them distress. For instance, don’t ask about the specific lab results or how long they think they have to live; instead, focus on letting them know that you care about them and want to hear all of their feelings without comparisons. You can also keep in touch with them by visiting, calling or sending emails, and by staying active through social activities. This will keep them from feeling isolated and can also help with their cognitive and emotional well-being.
Hepatocellular carcinoma (HCC) is a highly malignant neoplasm and the most common cause of liver cancer. HCC typically occurs in patients with cirrhosis related to chronic hepatitis B virus infection, hepatitis C virus (HCV) or non-alcoholic steatohepatitis.
Healthcare providers diagnose HCC by doing a physical exam and asking about your health history. They may also test your blood and urine for certain substances. They can also do a triphasic contrast CT or MRI.
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Hepatocellular carcinoma is the most common type of primary liver cancer. It happens when cancer cells form in the liver, rather than spreading from other parts of the body to the liver like most other types of cancer. HCC is two to three times more common in men than women and most often develops in people aged 60 or older. It is also more common in people whose race or ethnicity is Asian/Pacific Islander, Hispanic or American Indian/Alaska Native.
The symptoms of hepatocellular carcinoma depend on the stage of the disease. In early stages, the cancer may be small and not cause any symptoms. But if the cancer grows larger, it can spread to other parts of the body through the bloodstream and cause more serious symptoms.
Some of the most common symptoms of hepatocellular carcinoma include fullness or a knot under the ribs on the right side (a sign that your liver is enlarged), pain in the upper abdomen, and jaundice (yellowing of the skin and eyes). You may also have fluid collecting in your tummy or abdomen. This is called ascites and can make you feel puffy or uncomfortable. You may need to take water tablets or diuretics to help control the fluid accumulation. You may also have a loss of appetite or weight loss and fatigue.
If you have hepatitis B virus or hepatitis C virus infection, or non-alcoholic fatty liver disease, you are at higher risk of developing hepatocellular carcinoma. You should visit your doctor regularly, and let them know if you have any new or worsening symptoms.
Liver function tests such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase, can show signs of liver damage. Liver cancer can also cause these proteins to rise. Another test, serum alpha fetoprotein (AFP), is used to diagnose HCC. High levels of AFP are typical of advanced HCC, but not all advanced cancers produce AFP.
If your doctor suspects hepatocellular carcinoma, you will undergo imaging studies of the liver to look for any abnormal masses or lumps. These can be ultrasound, computed tomography scan (CT scan), or magnetic resonance imaging (MRI). A biopsy will be done to confirm the diagnosis and get a sample of tissue for further examination under a microscope.
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HCC is usually diagnosed based on symptoms and results of blood and imaging tests. Blood tests often show high levels of a protein called alpha-fetoprotein (AFP). High AFP can indicate that you have HCC or conditions that lead to it, like hepatitis infection or cirrhosis.
Your provider may also use a liver biopsy to check for HCC. The biopsy involves removing a small amount of liver tissue to test for cancer cells. It’s only used when your doctor has reason to suspect that you have HCC. For example, if you have cirrhosis and a nodule on an ultrasound or CT scan that is bigger than 5 cm, your provider might do a biopsy to confirm the diagnosis.
Other tests can help your provider find out how serious the HCC is and if it has spread to other parts of your body. These include liver function tests, computed tomography (CT) scans, magnetic resonance imaging (MRI), and hepatic angiography.
MRI can be more accurate than CT for finding small hepatic nodules, especially when a nodule has features that suggest it is HCC, such as a rim of hepatocellular proliferation around the margin and a pattern of vascular invasion. However, MRI is more expensive than CT and requires longer test times.
Hepatic angiography is an imaging technique that involves injecting a contrast dye into the hepatic artery or portal vein. The dye highlights the blood vessels in your liver and helps your doctor see the location and size of a tumor. It’s more accurate than a CT scan or MRI and can help your doctor decide on the best treatment for you.
Your provider can also use a needle to remove a sample of the HCC for testing. This test can help your provider know if the cancer cells are normal or if they have changed and become resistant to treatment. Other types of tests, such as genetic and molecular tests, can look for certain mutations that are common in HCC. They can also help your provider figure out whether a specific medication or lifestyle factor caused the cancer, such as non-alcoholic steatohepatitis (NASH) or tobacco.
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A person with hcc liver usually needs to be treated by a team of doctors that includes hepatologists (liver doctors), surgeons, and oncologists (cancer doctors). Some treatment options include surgery, radiation therapy, chemotherapy, and targeted therapies. People with hepatocellular carcinoma may also benefit from being part of a clinical trial that is testing new medications or procedures.
The most common symptom of HCC is a pain in the upper right abdomen. The pain may be mild or severe, and it usually comes and goes. Some people may have jaundice, which is yellowing of the skin and whites of the eyes. Others may have itching or a feeling that something is stuck in their throat. Hepatocellular carcinoma often spreads to the blood vessels that carry nutrients to the liver. This can cause them to narrow or rupture. The cancer can also spread from the liver to other parts of the body. This is called extrahepatic metastasis. It is more common in advanced HCC.
Doctors diagnose hepatocellular carcinoma by doing a physical exam and asking about your symptoms. They may also ask about your past health problems and family history of hepatitis or liver disease. Your doctor will order lab tests to look for signs of liver damage, such as a high level of bilirubin in the blood and high levels of the enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Doctors use imaging techniques to check for liver cancer. They can see the tumor in a CT or an MRI scan. The tumor is usually clear on the first image, but it may become more apparent in later images. The test results tell your doctor if the tumor is growing and whether it’s Stage I or II.
Treatment for hepatocellular carcinoma usually starts with chemotherapy or radiotherapy. Chemotherapy can stop the growth of cancer cells and prevent them from spreading. It can also kill cancer cells that have already spread. A type of chemotherapy called chemoembolization uses drugs and tiny beads to block the blood supply to tumors. This can be used for people with hepatocellular carcinoma who aren’t candidates for surgery or while they wait for a liver transplant.
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Hepatocellular carcinoma (HCC) can be prevented in most patients by avoiding exposure to risk factors and making lifestyle changes. The major causes of HCC are chronic hepatitis B or C virus (HBV or HCV) infection, and cirrhosis of any cause. HCC can also be caused by excessive alcohol consumption, diabetes or obesity-related nonalcoholic fatty liver disease (NAFLD) and hereditary hemochromatosis.
In developed countries, hepatitis B can be prevented with a vaccine that is recommended for all adults. There is no vaccine for hepatitis C, but there are effective treatments that can prevent progression to cirrhosis and cancer. Infection with the hepatitis viruses is spread by touching or reused dirty needles and unprotected sex. The best way to avoid hepatitis is to use only clean, new needles and always use a male condom during vaginal, oral or anal sex.
Cirrhosis can be prevented by treating chronic HBV or HCV infection, avoiding excessive alcohol intake and losing weight. In addition, there are a number of medications that reduce the risk of cirrhosis, including ACE inhibitors, statins and thiazolidinediones.
Several studies show that screening of people who have HCC can find early tumors in people with minimal symptoms, which can lead to successful treatment. However, it is important to keep in mind that screening does not reduce the risk of death in people who already have HCC.
A recent study showed that a combination of ultrasound and alpha-fetoprotein every 4 months can improve the ability to identify small, noncancerous tumors in people with cirrhosis. This is especially important in older adults, because the majority of HCC cases occur in this population.
Hepatocellular carcinoma is the fifth most common cause of cancer and the second leading cause of cancer deaths worldwide. In the United States, about 780,000 people died of hepatocellular carcinoma in 2018. It is important to get tested for hepatitis B and C and to have regular screenings for liver cancer. People at high risk of hepatocellular carcinoma should talk to their doctor about getting vaccinated against hepatitis B and C. The PDQ cancer information summaries are written by experts at the National Institutes of Health (NIH). These summaries provide current information about prevention, diagnosis and treatment of cancer.
