BCLC stage C: what advanced liver cancer means | CION Cancer Clinics

BCLC stage C, called advanced stage, means the liver cancer has grown into a main blood vessel of the liver, has spread outside the liver, or is already causing symptoms that affect your day. The liver itself is usually still working reasonably well. Treatment at this stage is mainly with medicines that work through the whole body.

This page is about primary liver cancer

BCLC is used for hepatocellular carcinoma (HCC), the cancer that starts in the liver's own cells. If your report says a cancer from the bowel, breast, lung or stomach has spread to the liver, you are reading about a different disease that is staged and treated differently. Start with primary versus secondary liver cancer.

Advanced does not mean untreatable

Stage C is the stage where treatment has changed most in recent years. The aim is control: slowing the cancer, easing symptoms and protecting the liver so that you can keep living the life you want for as long as possible. Supportive care runs alongside from the start.

Immunotherapy is the usual first step, but it does not suit everyone with stage C. The board weighs your other illnesses and your liver as carefully as the cancer. The page on who cannot have atezolizumab plus bevacizumab goes into detail.

People with a high bleeding risk

Untreated varices, a recent bleed or a recent clot can make bevacizumab unsafe. Varices can often be banded first through a partner hospital, but sometimes a different medicine is chosen instead.

People with autoimmune disease or an organ transplant

Immunotherapy releases the brakes on the immune system. In someone with an active autoimmune illness, or a transplanted organ, that can be dangerous. Tablets may be preferred.

People whose liver is failing

If jaundice, fluid or confusion show the liver is no longer coping, cancer medicines can do more harm than good. The focus then moves to comfort and symptom care, which is still active treatment.

It cannot tell you your own stage or which medicine you should have. That needs recent scans read by a radiologist who knows liver cancer, your blood results, an endoscopy where bleeding risk matters, and an oncologist who has examined you.

It cannot tell you how long anyone will live

Published figures come from trials of selected patients, often abroad, and describe groups rather than people. They cannot be applied to your father, mother or yourself. If you want to talk about outlook, ask your oncologist directly. They can say what your own results suggest.

Who this does not apply to

Cancer that spread to the liver from another organ, bile duct cancer (cholangiocarcinoma) and liver cancer in children are staged and treated differently, and this page does not apply to them.