Question

Liver cancer & liver transplant

• Brief description (what is it)
• List 3-5 causes (etiologies)
• Manifestations (assessment findings)
• Diagnostic/Laboratory findings (pertinent)
• List 3-5 potential complications
• Interventions (interprofessional & nursing management)

Answer 1

Liver cancer is the cancer of the liver affecting the cells of the liver. The most common type of liver cancer begins from the hepatocytes and thus it is called as hepatocellular carcinoma.

Causes of liver cancer:

Liver cirrhosis due to hepatitis B and hepatitis C or alcohol.

Non alcoholic fatty liver disease.

Exposure to aflatoxin leads to hepatocellular carcinoma.

Obesity.

Diabetes Increases risk hepatocellular carcinoma

Smoking also causes hepatocellular carcinoma

Manifestations:

Manifestations mainly depend on type of liver cancer. Mostly include;

#. Sweating,

#. Right side abdominal pain

#. Abdominal mass or lump.

#. Jaundice

#. Unintentional weight loss

#. Loss of appetite.

#. Nausea amd vomiting.

#. Liver enlargement

#. Back pain.

#. Itching due to accumulation of bile salts in the skin.

#. Bloat or shortness of breath due to ascites.

#. Fever.

Diagnosis;

Ultrasound,MRI and CT in the case of hepatocellular carcinoma.

Endoscopic retrograde cholangio pancreatography (ERCP)

Magnetic resonance cholangio pancreatography (MRCP)

High level of Alpha-fetoprotein in the blood can be found in the blood in the case of hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Complications:

Obstruction of bile duct

Bleeding due to insufficient clotting factors produced by liver.

Anemia due to low red blood cells

Portal hypertension

Hypercalcemia

Hepatic encephalopathy

Interventions: It is based on the stage of liver cancer and the underlying liver function.

Surgery: surgical removal of liver cancer is the treatment of choice.

Liver transplant: It is a curable treatment option. It is done mainly in the case of small tumor or in the case of liver surgery is not possible.

Non surgical procedures like ablation or embolization. This will destroy liver tumors. Ablation therapy is most frequently used treatment option.

Medication therapy also used in the case of advanced or late stage liver cancer.

Chemotherapy: may be administered directly to the liver via hepatic artery.

Immunotherapy.

Nursing management:

Encourage routine medical check up and screening

Ensure patient awareness regarding the symptoms of liver cancer

Monitor and manage complications associated with cancer treatment.

Advice to do screening test for other cancers like breast cancer, colon and rectal cancer, cervical cancer.

Promote well balanced diet especially with calcium and ion rich foods

Provide psychological support to cope up with body image disturbance.

Maintain a therapeutic interaction with family members.

Offer realistic hope that treatment will be successful.

Arrange for community resources for terminally ill.