The invisible burden - The challenge of untreated hepatocellular carcinoma.

This editorial explores the situation of patients with hepatocellular carcinoma (HCC) who, due to advanced frailty, multiple health conditions, personal choice, or terminal disease stage, are not candidates for active cancer treatment. Despite progress in early diagnosis, a notable percentage of these individuals receive only comfort-oriented care. The article reviews how their prognosis is largely determined by the severity of liver failure and overall health status, while tumor features such as extent and vascular invasion, along with high tumor markers, further diminish survival prospects. It also discusses the influence of social context and patient decisions on outcomes. The editorial advocates for a care model focused on alleviating symptoms, respecting patient preferences, and improving quality of life through palliative interventions. It calls for more inclusive research and healthcare strategies that address the specific needs of these patients, emphasizing the importance of compassion, respect, and tailored support during the final stages of illness.