Materiały źródłowe

• #1 Symptom Management in Hepatocellular Carcinoma | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/12/5/symptom-management-hepatocellular-carcinoma

  Hepatocellular carcinoma (HCC) annually causes about one million deaths. […] Because of limitations in the efficacy of current treatment options, aggressive symptom management is key to preserving physical functioning and quality of life in patients with HCC. […] A multidisciplinary team approach to symptom management of patients with HCC is critical, with oncology nurses playing an integral role.

• #2 Liver Cancer – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/liver-cancer

  Primary liver cancer (cancer that begins in the liver) typically affects individuals who already have advanced liver disease or cirrhosis, usually as a result of hepatitis B or C, alcoholic liver disease or fatty liver disease. […] Because patients are battling two competing diseases advanced liver disease and liver cancer care and treatment is complex and requires an experienced team. […] The UChicago Medicine Liver Tumor Program brings together specialists from our cancer and digestive disease programs two programs ranked among the best in the nation by U.S. News World Report. […] Our team includes transplant oncologists who are experts in determining which liver cancer patients may benefit from liver transplant. […] Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is often associated with advanced liver disease or hepatitis B. […] There is effective surveillance available for HCC and early detection is key in offering a cure. […] The Center for Liver Diseases is nationally recognized for expertise in liver disease care.

• #3 Hepatic Cancer: Present Scenario, Treatment Options and Nursing Management – Biomedical and Pharmacology Journal

  https://biomedpharmajournal.org/vol16no1/hepatic-cancer-present-scenario-treatment-options-and-nursing-management/

  Hepatocellular carcinoma (HCC) is the most common type of liver cancer, accounting for nearly 90% of cases. […] Hepatocellular carcinoma frequently arises in the liver of people with advanced chronic hepatitis, and the presence of fibrosis and inflammation is a common characteristic. […] Hepatocellular carcinomas can look different histologically. […] Hepatocellular carcinoma has two distinct subtypes: sclerosing hepatocellular carcinoma and fibrolamellar carcinoma (FL-HCC). […] The role of the oncology nurse is crucial in advocating for the inclusion of palliative care early on in the patients experience when preparing for and to care for patients with HCC. […] Proficiency in managing symptoms (such as pain, exhaustion, anorexia, and gastrointestinal distress) and improving quality of life is crucial for HCC patients and their carers.

• #4 Liver cancer – hepatocellular carcinoma – UF Health

  https://ufhealth.org/conditions-and-treatments/liver-cancer-hepatocellular-carcinoma

  Hepatocellular carcinoma is cancer that starts in the liver. […] Hepatocellular carcinoma is the most common type of liver cancer. It occurs more often in men than women. It is most often diagnosed in people age 50 or older. […] People with hepatitis B or C are at high risk for liver cancer, even if they do not develop cirrhosis. […] Your health care provider will perform a physical exam and ask about your symptoms. The physical exam may show an enlarged, tender liver or other signs of cirrhosis. […] Treatment depends on how advanced the cancer is. […] A liver transplant may be recommended. […] If the cancer can’t be surgically removed or has spread outside the liver, there is usually no chance for long-term cure. Treatment instead focuses on improving and extending the person’s life.

• #5 Holistic Management of Hepatocellular Carcinoma: The Hepatologist’s Comprehensive Playbook

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10878125/

  Hepatocellular carcinoma (HCC) is a common complication in patients with chronic liver disease and leads to significant morbidity and mortality. […] The management of patients with HCC requires treatment of the malignancy and adequate control of the underlying liver disease, as preserving liver function is critical for successful cancer treatment and may have a relevant prognostic role independent of HCC management. […] Hepatologists are the ideal providers to guide the care of patients with HCC as they are trained to identify patients at risk, apply appropriate surveillance strategies, assess and improve residual liver function, evaluate candidacy for transplant, provide longitudinal care to optimize and preserve liver function during and after HCC treatment, survey for cancer recurrence and manage its risk factors, and prevent and treat decompensating events.

• #6 The Role of Oncology Nurse Navigators in Hepatocellular Carcinoma Treatment – Journal of Oncology Navigation & Survivorship

  https://www.jons-online.com/special-issues-and-supplements/2020/best-practices-in-patient-navigation-the-role-of-oncology-nurse-navigators-in-hepatocellular-carcinoma-treatment/the-role-of-oncology-nurse-navigators-in-hepatocellular-carcinoma-treatment

  Oncology nurse navigators eliminate barriers to timely care and coordinate care across multiple treatment modalities and care path transitions. […] Oncology nurse navigators must tailor their expertise to meet the needs and challenges specific to patients with HCC. […] The oncology nurse navigator performs many key functions essential for the delivery of optimal patient care. […] A primary role of the oncology nurse navigator is to serve as a clinically informed liaison between the patient and the healthcare team throughout treatment and survivorship. […] Oncology nurse navigators play an important role in ensuring oral medication compliance in patients with HCC. […] The nurse navigator plays an important role in helping patients with HCC maintain their psychosocial well-being throughout treatment and survivorship.

• #7 The Role of Oncology Nurse Navigators in Hepatocellular Carcinoma Treatment – Journal of Oncology Navigation & Survivorship

  https://www.jons-online.com/special-issues-and-supplements/2020/best-practices-in-patient-navigation-the-role-of-oncology-nurse-navigators-in-hepatocellular-carcinoma-treatment/the-role-of-oncology-nurse-navigators-in-hepatocellular-carcinoma-treatment

  Oncology nurse navigators play an essential role in the management of treatment-related adverse events. […] Following the development of a treatment plan, the oncology nurse navigator must explain to patients the therapy that is being recommended based on the stage of HCC and provide information specific to each situation. […] To preserve physical functioning and quality of life in patients with HCC, the aggressive management of symptoms related to treatment or the disease process itself is vital. […] An important component of the shared decision-making model is ongoing education regarding the treatment plan.

• #8 Nursing Care Plan for Liver Cancer | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-liver-cancer

  By the end of this nursing care plan lesson for Liver Cancer, students should be able to: […] Possess comprehensive knowledge on caring for patients with liver cancer. […] This plan focuses on understanding the pathophysiology, recognizing symptoms, and delivering interventions to manage the disease effectively and support the patients overall well-being. […] Effective management of symptoms such as pain, fatigue, and gastrointestinal disturbances. […] Minimization of liver function deterioration. […] Adequate nutritional support and maintenance of body weight. […] Patient and family education on disease process and treatment options. […] Pain related to liver distension or metastasis. […] Imbalanced Nutrition: Less Than Body Requirements related to altered metabolism and decreased appetite.

• #9 Liver Cancer Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/liver-cancer-nursing-diagnosis/

  Liver cancer, also known as hepatocellular carcinoma (HCC), is a serious malignancy that requires comprehensive nursing care and management. This nursing diagnosis guide focuses on identifying key symptoms, providing appropriate interventions, and managing complications associated with liver cancer. […] Understanding the manifestations of liver cancer is crucial for proper nursing assessment and care planning. […] The following outcomes indicate effective management of liver cancer: The patient will report adequate pain control, The patient will maintain optimal nutritional status, The patient will demonstrate improved energy levels, The patient will show no signs of complications, The patient will understand disease management strategies, The patient will maintain a quality of life, The patient will adhere to the treatment plan.

• #10 Liver Cancer Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/liver-cancer-nursing-diagnosis/

  Nursing Assessment: Monitor Vital Signs and Physical Status, Evaluate Liver Function, Assess Nutritional Status, Monitor for Complications, Review Treatment Response. […] Nursing Care Plan 1: Acute Pain. Nursing Diagnosis Statement: Acute Pain related to tumor mass effect and liver capsule distention as evidenced by reported right upper quadrant pain, guarding behavior, and facial grimacing. […] Nursing Care Plan 2: Impaired Nutrition. Nursing Diagnosis Statement: Imbalanced Nutrition: Less than Body Requirements related to decreased appetite and tumor effects as evidenced by weight loss, decreased muscle mass, and reduced intake. […] Nursing Care Plan 3: Risk for Impaired Skin Integrity. Nursing Diagnosis Statement: Risk for Impaired Skin Integrity related to ascites, edema, and nutritional deficits as evidenced by skin tension and compromised circulation.

• #11 Nursing Care Plan for Liver Cancer | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-liver-cancer

  Risk for Fluid Volume Excess related to compromised liver function and ascites. […] Anxiety related to the diagnosis of cancer and uncertainty about the future. […] Monitor Liver Function: Regularly monitor liver enzymes, bilirubin, and albumin levels to assess liver function and progression of the disease. […] Rationale: Identifies the extent of liver damage and guides treatment. […] Pain Management: Administer prescribed analgesics and implement non-pharmacological pain relief methods. […] Rationale: Provides comfort and improves quality of life. […] Nutritional Support: Collaborate with a dietitian to provide a balanced diet, potentially including supplements. […] Rationale: Ensures adequate nutrition, which is vital due to malabsorption and increased metabolic needs. […] Infection Prevention: Employ aseptic techniques and monitor for signs of infection.

• #12 Role of Supportive Care for Terminal Stage Hepatocellular Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4284220/

  Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. […] Delivery of supportive care for HCC includes pain management, nutrition management, symptom management, psychosocial needs and advanced disease issues. […] Pain in HCC can be either from disease or treatment, but irrespective of the cause it is very common and significant cause of morbidity. […] The choice of appropriate analgesic agents requires a thorough understanding of their pharmacokinetic and side effect profiles. […] In palliative care, glucocorticoids are often used to alleviate symptoms such as pain, nausea, fatigue, anorexia, and malaise, and improve overall quality of life.

• #13 Integrating Palliative Care Into Hepatocellular Carcinoma Treatment – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/features/integrating-palliative-care-into-hepatocellular-carcinoma-treatment/

  These data suggest that the event of waitlist removal may mean patients have a greater need for palliative care, both for their disease severity and resulting symptom burden, and for support during a time of uncertainty and distress over their inability to receive curative therapies, stated the review authors. […] In later stages of HCC, the emphasis of palliative care may shift to care coordination among the growing number of specialists who become involved in HCC treatment as the illness progresses and to management of the worsening symptom burden and complications of the disease. […] Among other aspects of care throughout the disease course, pain management is an area where palliative care can complement the management of HCC specialists because of the complexity of dosing analgesics for patients with hepatic impairment (most patients with HCC), prevalent history of substance use among patients with chronic liver disease, and the opioid addiction epidemic in the US, Woodrell and colleagues noted.

• #14 Role of Supportive Care for Terminal Stage Hepatocellular Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4284220/

  Malnutrition is commonly encountered in patients with liver disease, especially those with end-stage processes. […] Routine artificial nutrition is not justified in patients in the terminal stage HCC. In individual cases, dietary counseling and artificial nutrition can slow down nutritional deprivation, avoid dehydration and improve the quality of life. […] Symptom management in terminal stage HCC includes management of anorexia, fatigue, ascites, nausea/vomiting, pruritus and constipation. […] Management of psychosocial and spiritual issues should be a part of the care of terminal HCC patients.

• #15 Liver Cirrhosis: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/liver-cirrhosis-nursing-diagnosis-care-plan/

  The treatment of liver cirrhosis is serious and complex. Nurses will be involved in the symptom management of patients with cirrhosis including paracentesis procedures, controlling cognitive manifestations of hepatic encephalopathy, promoting proper nutrition, and preparing for liver transplantation. Patients with liver cirrhosis often require education and emotional support in managing the complications of their disease. […] Nursing interventions and care are essential for the patients recovery. In the following section you’ll learn more about possible nursing interventions for a patient with liver cirrhosis. […] Nursing Diagnosis: Acute Confusion […] Related to: Hepatic encephalopathy (HE) […] As evidenced by: Confusion […] Nursing Diagnosis: Ineffective Breathing Pattern […] Related to: Disease process […] Nursing Diagnosis: Ineffective Tissue Perfusion […] Related to: Disease process […] Nursing Diagnosis: Risk For Impaired Skin Integrity […] Related to: Accumulation of bile salts causing jaundice

• #16 FF #348 Treatment Options for Hepatocellular Carcinoma | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/treatment-options-for-hepatocellular-carcinoma/

  Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. This Fast Fact provides an overview of staging and treatment options for generalist and palliative care clinicians who are often asked to navigate complicated decision making in HCC patients. […] HCC patients often suffer from pain, jaundice, anorexia, and depression as well as ascites, fatigue and edema from coexisting cirrhosis. This debilitating symptom burden leads to a diminished health-related quality of life (QoL). […] The goal of this therapy is to improve QoL, prolong survival, and in some cases, downstage the tumor in hopes of making the mass surgically resectable. […] Studies have demonstrated survival benefits as well as improvements in patient-reported outcomes including QoL, pain, function, and emotional well-being with cTACE, DEB-TACE, and Y-90 in patients with BCLC B or C disease. […] However, QoL, not just prognostic, concerns need to be elicited before deciding about sorafenib.

• #17 Liver Cancer Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/liver-cancer-nursing-diagnosis/

  Nursing Care Plan 4: Fatigue. Nursing Diagnosis Statement: Fatigue related to disease process and treatment effects as evidenced by decreased energy, increased rest requirements, and reduced activity tolerance. […] Nursing Care Plan 5: Anxiety. Nursing Diagnosis Statement: Anxiety related to disease progression and uncertain prognosis as evidenced by expressed concerns, restlessness, and increased tension.

• #18 Nursing Care Plan for Liver Cancer | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-liver-cancer

  Rationale: Patients with liver dysfunction are at increased risk for infection. […] Patient Education: Educate the patient and family about disease progression, treatment options, and lifestyle modifications. […] Rationale: Enhances understanding and involvement in care, promoting better outcomes. […] Psychological Support: Provide emotional support and refer to counseling services if needed. […] Rationale: Addresses the psychological impact of cancer diagnosis and treatment.

• #19 Hepatocellular Carcinoma: Risks, Symptoms & Treatments

  https://liverfoundation.org/liver-diseases/cancer/hepatocellular-carcinoma/

  If you are diagnosed with hepatocellular carcinoma, you will be referred to a liver cancer specialist. […] Key steps you can take to keep your risk for liver cancer low include: Preventing exposure to hepatitis B and speaking to your doctor about getting the hepatitis B vaccine. […] Remember people with cirrhosis should speak to their doctors about recommendations for regular surveillance and screenings for liver cancer. […] If you have been diagnosed with hepatocellular carcinoma or liver cancer, you may feel shocked and scared. […] You will want to get as much information as you can from your doctor so that you will understand what is going on. […] A successful liver transplant, also called a surgical resection, can cure liver cancer, but it is an option for only a small percentage of patients.

• #20 Hepatocellular Carcinoma: Risks, Symptoms & Treatments

  https://liverfoundation.org/liver-diseases/cancer/hepatocellular-carcinoma/

  Learn how the Liver Cancer Program at the National Institutes of Health, National Cancer Institute’s Center for Cancer Research can help all liver cancer patients. […] If you have been diagnosed with hepatocellular carcinoma, you may feel shocked and scared. […] You will want to get as much information as you can from your doctor so that you will understand what is going on. […] Here are some questions that you can ask when you have your appointment. […] Can you recommend any support groups for me, my caregivers, and my family?

• #21 Hepatocellular Carcinoma: Causes, Symptoms, Treatment, and More

  https://www.webmd.com/cancer/hepatocellular-carcinoma

  There are many treatments for hepatocellular carcinoma. It’s a big decision, so work closely with your doctor to make the right plan for you. […] While you’re getting treatment, there are lots of things you can do to manage side effects and stay healthy. […] Reach out to family and friends who can give you emotional support when you need it. […] You don’t have to face things alone. Consider joining a support group, where you can you share your feelings with others who understand what it’s like.

• #22

  https://journals.lww.com/cancernursingonline/fulltext/2022/11000/experiences_of_symptoms_and_impact_on_daily_life.4.aspx

  The incidence of hepatocellular cancer (HCC) has continually increased. To achieve optimal supportive cancer care for HCC patients, it is important to consider patients experiences and preferences. […] It is important to identify the patients physical, psychological, social, and existential needs during the investigation of their condition, during any curative treatment, and at the palliative stage of the disease. […] Promoting health-related quality of life and providing good symptom relief is important when caring for patients with HCC. […] Compromised physical health may be a consequence of severe HCC symptoms or treatment adverse effects, especially pain, loss of appetite, and fatigue. […] Multidisciplinary teamwork can mitigate both general cancer-related symptoms as well as more specific HCC symptoms such as ascites and encephalopathy.

• #23 Holistic Management of Hepatocellular Carcinoma: The Hepatologist’s Comprehensive Playbook

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10878125/

  We highlight the need for a team-based holistic approach to the patient with liver disease and HCC and identify necessary gaps in current care and knowledge. […] Managing patients with HCC and their co-existing liver disease is complex and includes optimizing liver function; evaluating and treating the underlying etiology of liver disease; preventing further hepatotoxicity; managing liver disease decompensation both before and after treatment; assessing eligibility for liver transplantation; and coordinating care among various providers. […] Therefore, we recommend that hepatologists who are trained in the diagnosis and management of advanced liver disease and liver transplantation and well-versed in all HCC treatment options and their adverse effects and toxicities serve a central role in the backbone of this complex care.

• #24 Hepatocellular Carcinoma: Risks, Symptoms & Treatments

  https://liverfoundation.org/liver-diseases/cancer/hepatocellular-carcinoma/

  Get screened and talk to your doctor today about Hepatocellular Carcinoma treatment alternatives. […] Hepatocellular carcinoma is the most common type of cancer among adults in the USA. […] We encourage adults living with Hepatocellular Carcinoma to visit our Clinical Trials page to learn more about opportunities in the area. […] There are treatment options for people with liver cancer. Doctors suggest treatments based on type of cancer present, stage of cancer, and other information obtained through medical test results. […] People with any risk factor, or those who have been diagnosed with cirrhosis, should speak with their doctors about cancer screening and surveillance so that should cancer develop, it may be diagnosed sooner rather than later. […] If you have a known liver disease, it is important to make and keep regular appointments with a medical provider who specializes in this field.

• #25 Hepatocellular Carcinoma | Liver Cancer | Center for Liver Care

  https://www.upmc.com/services/digestive-disorders-center/services/liver-diseases/conditions/liver-cancer/hepatocellular-carcinoma

  HCC is a type of liver cancer. It’s a primary liver cancer and is the most common form of cancer that starts in the liver. […] Our doctors at the UPMC Center for Liver Care are experts in diagnosing and treating all liver conditions, including HCC. […] Doctors might suggest making certain lifestyle changes to support your liver’s overall health, such as: Avoiding alcohol. Being more active. Eating a healthy diet. Quitting smoking. […] Medicine and other medical therapies to fight HCC include: Doctors prescribe sorafenib, lenvatinib, atezolimumab bevacizumab, or other PD-1 checkpoint inhibitors to treat HCC. […] Sometimes, surgeons will operate to remove tumors in treating HCC. In a partial hepatectomy, surgeons remove the tumor and some of the nearby tissue, leaving the liver’s healthy tissue intact.

• #26 A narrative review of supportive and end of life care considerations in advanced hepatocellular carcinoma – Hashmi – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/116672/html

  While PC is not routinely integrated into HCC care, recent guideline recommendations and a growing number of studies may change this over time. Although further evidence is needed, PC and hepatology teams partnering together can explore ways to improve the care of this patient population. PC consultation early in HCC care could assist in management of symptom relief, psychosocial and spiritual support, and caregiver support. […] Palliative intervention may improve quality of life and assist in management of symptom relief. Symptoms reported range from physical (pain, fatigue, and nausea) to psychological (depression, anxiety) which can lead to reduced function. […] Quality of life is an important aspect of care in every illness, and caring for the HCC patient is no exception. Many aspects of HCC contribute to the need for complete assessment of quality of life, including physical symptoms, psychological well-being, social aspects, and spirituality.

• #27 Hepatic Cancer: Present Scenario, Treatment Options and Nursing Management – Biomedical and Pharmacology Journal

  https://biomedpharmajournal.org/vol16no1/hepatic-cancer-present-scenario-treatment-options-and-nursing-management/

  Oncology nurses may launch a nationwide education campaign to raise awareness of this possibly curable illness and encourage preventive habits. […] It is crucial to advocate for the inclusion of palliative care early on in the patients experience when preparing for and to care for patients with HCC. […] For HCC patients and their carers, proficiency in managing symptoms (such as pain, exhaustion, anorexia, and gastrointestinal distress) and improving quality of life is crucial. […] Additionally necessary is the provision of emotional support for family caregivers who take on the majority of a loved ones care while remaining apart from the oncology team.

• #27 Hepatic Cancer: Present Scenario, Treatment Options and Nursing Management – Biomedical and Pharmacology Journal

  https://biomedpharmajournal.org/vol16no1/hepatic-cancer-present-scenario-treatment-options-and-nursing-management/

  Hepatocellular carcinoma (HCC) is the most common type of liver cancer, accounting for nearly 90% of cases. […] Hepatocellular carcinoma frequently arises in the liver of people with advanced chronic hepatitis, and the presence of fibrosis and inflammation is a common characteristic. […] Hepatocellular carcinomas can look different histologically. […] Hepatocellular carcinoma has two distinct subtypes: sclerosing hepatocellular carcinoma and fibrolamellar carcinoma (FL-HCC). […] The role of the oncology nurse is crucial in advocating for the inclusion of palliative care early on in the patients experience when preparing for and to care for patients with HCC. […] Proficiency in managing symptoms (such as pain, exhaustion, anorexia, and gastrointestinal distress) and improving quality of life is crucial for HCC patients and their carers.

• #28

  https://www.accc-cancer.org/home/learn/cancer-types/gastrointestinal-cancer/liver-cancer/multidisciplinary-hepatocellular-carcinoma-care

  Hepatocellular Carcinoma (HCC) accounts for about 75% of primary liver cancers. […] Treatment tends to be multi-modal when HCC is considered loco-regional, which often includes interventional radiology and surgical interventions. […] a multidisciplinary approach is critical. […] Learn how multidisciplinary providers can optimize care for patients with hepatocellular carcinoma by building greater care capacity and improving coordination of clinical and supportive care services. […] This report highlights effective practices in care coordination in action and provides valuable insights for cancer programs to consider. […] Understanding practices and gaps in multidisciplinary hepatocellular carcinoma (HCC) care within the community oncology setting.

• #29 Hepatocellular Carcinoma (HCC) Treatment & Management: Approach Considerations, Nonoperative Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/197319-treatment

  Management of hepatocellular carcinoma (HCC) is best performed in a multidisciplinary setting. Patients should be cooperatively managed by hepatologists, transplant and hepatobiliary surgeons, medical oncologists, interventional radiologists, and palliative care specialists. Specifically, this is crucial to ensure that patients who are candidates for liver transplantation are referred in a timely manner, while their tumors are within the Milan criteria. […] Surgical resection and liver transplantation provide the only chances of cure but have limited applicability. The main prognostic factors for resectability are tumor size and liver function. […] In patients who are not candidates for liver transplantation or resection, tumor ablation can be offered to extend life and potentially to downstage the tumor so as to permit transplantation or resection. Alternatively, patients who have advanced disease may benefit from palliative care interventions rather than be subjected to often ineffective therapies.

• #29 Hepatocellular Carcinoma (HCC) Treatment & Management: Approach Considerations, Nonoperative Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/197319-treatment

  The most common complication is postembolization syndrome, which is characterized by fever, elevated alanine aminotransferase (ALT), and abdominal pain; it occurs in 32-80% of treated patients. […] For most patients, treatment options other than palliative care are limited. For patients with Child-Pugh class C cirrhosis and contraindications for transplantation, any intervention has the potential to result in progressive hepatic decompensation. In these patients, treatment focuses on pain control, ascites, edema, and portosystemic encephalopathy management. […] In terminal patients, hypoglycemia can be confused with hepatic coma and can be managed with glucose infusions. Patients with large tumors have a short life expectancy, and every effort should be made to preserve and enhance quality of life. Early referral to palliative care practitioners should be considered.

• #30 Multidisciplinary approach for hepatocellular carcinoma patients: current evidence and future perspectives

  https://www.e-jlc.org/journal/view.php?number=558

  Management of hepatocellular carcinoma (HCC) is challenging due to the complex relationship between underlying liver disease, tumor burden, and liver function. […] In this complex situation, multidisciplinary approach or multidisciplinary team care has been suggested as a valuable strategy to help cope with escalating complexity in HCC management. […] Although evidence suggests that multidisciplinary care can enhance outcomes of HCC patients, robust data from randomized controlled trials are currently lacking. […] This collaborative strategy covers all aspects of patient care from initial diagnosis and tumor staging to the development of treatment plans. […] Research indicates that patients managed by MDTs tend to have higher survival rates and are more likely to receive curative treatments.

• #31 Holistic Management of Hepatocellular Carcinoma: The Hepatologist’s Comprehensive Playbook

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10878125/

  Hepatologists are specialized providers well versed in the understanding and treatment of various forms of chronic liver disease which often coexist and precede the develop of HCC. […] Additionally, thorough assessment of risk factors and etiologies of underlying liver disease is imperative, as the majority are either preventable or treatable. […] Once diagnosed with HCC, hepatologists should work promptly to stage patients and evaluate their underlying liver function and performance status which are critical elements in assessing treatment candidacy. […] After treatment has been implemented, hepatologists are key players for longitudinal care to help manage complications of liver disease, assess for disease recurrence, evaluate for transplant candidacy, and integrate palliative care services when necessary.

• #32 Addressing Palliative Care in Hepatocellular Carcinoma – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/features/addressing-palliative-care-in-hepatocellular-carcinoma/

  The goals of palliative care interventions for people with HCC would be to provide psychosocial support, specialized symptom management, advance care planning and care coordination, and help with therapeutic decision making. […] Integrating palliative care into this management model would complement HCC-directed treatment delivery and ensure good communication and collaboration between palliative care and HCC-treating clinicians. […] Palliative care specialists could contribute to the multidisciplinary HCC team by initiating discussions about advance care planning and establishing a relationship among providers, patients, and their families early in the course of illness. […] This would mean better and longer benefits for patients with HCC and their families, including identification of symptoms and other problems before they evolve into crises. […] One solution is to ensure that all healthcare providers have training to address the basic palliative care needs of their patients, and in those cases when additional support is needed, can refer patients and families for specialty-level palliative care consultations.

• #33 Multidisciplinary approach for hepatocellular carcinoma patients: current evidence and future perspectives

  https://www.e-jlc.org/journal/view.php?number=558

  Patients in MDT care were more likely to undergo curative treatment, although there were discrepancies in results from several studies. […] The adjusted hazard ratio (HR) for mortality in MDT patients was found to be between 0.39-0.83, with statistical significance in most studies. […] To date, it remains uncertain which patient demographics are most likely to benefit from multidisciplinary care, the ideal composition of such teams, the specific topics that should be prioritized during discussions, and the optimal frequency of these collaborative meetings. […] The role of MDTs extends beyond traditional clinical expertise, evolving with the integration of innovative technologies. […] Yang et al. demonstrated the role of coordinators in providing comprehensive support to HCC patients post-surgery.

• #34 Multidisciplinary approach for hepatocellular carcinoma patients: current evidence and future perspectives

  https://www.e-jlc.org/journal/view.php?number=558

  This improved outcome is attributed to the efficient exchange of clinical information among team members, which helps in reducing treatment delays and ensures adherence to up-to-date treatment protocols. […] International guidelines on HCC consistently underline the significance of MDT approach. […] The Barcelona Clinic Liver Cancer (BCLC) and American Association for the Study of Liver Diseases (AASLD) guidelines emphasize the importance of such teams for evaluating specific liver lesions and in conducting thorough patient evaluation. […] These guidelines collectively endorse the creation of individualized treatment plans via MDT. […] Several clinical studies have investigated the effects of MDT in HCC. […] Studies examining the effects of MDTs often compare outcomes of HCC patients before MDT implementation or with those who did not receive MDT care.

• #35 Qualitative evaluation of barriers and facilitators to hepatocellular carcinoma care in North Carolina | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287338

  On a patient level, having strong social support and access to resources such as transportation are key elements of receiving HCC care. […] While healthcare systems cannot create social support for those who do not have it, they can offer resources such as transportation vouchers or coordination of social services to help remove transportation as a barrier to care. […] Patient navigation for HCC starting at the time of diagnosis might similarly improve treatment rates and would provide the clear point of contact that patients seek and specifically mentioned in our interviews. […] This qualitative evaluation of barriers and facilitators to HCC care in North Carolina should serve as the basis for tailored interventions aimed at improving access to appropriate, life-prolonging care for patients with HCC.

• #36 PRIME® Online Activity – Improving Real-World Care For Veteran Patients With Hepatocellular Carcinoma: Strategies for Patient-Centered, Teams-Based Approaches

  https://primeinc.org/online/improving-real-world-care-veteran-patients-hepatocellular-carcinoma-strategies

  Assess considerations of care in veterans with hepatocellular carcinoma (HCC) to overcome barriers to appropriate treatment and ongoing management […] Employ interprofessional strategies to support evidence-based integration of best practices into HCC management based on current VA policies, application of guideline recommendations for treatment, and patient counseling on the benefit-risk profile of various treatment options. […] Tune in for an engaging discussion that will delve into real-world data and insights gleaned from Veterans Affairs (VA) care teams across the US who participated in a quality improvement initiative aimed at enhancing personalized treatment and guideline-recommended care for patients with hepatocellular carcinoma (HCC). […] Expert faculty will reflect on findings from patient and provider surveys, provider workshops, and action plans developed by clinical teams to advance risk-based, personalized care for patients with HCC. […] Gain a firsthand look at the strategies implemented by clinicians who care for veterans with HCC and engage with expert faculty in live QA.

• #37 Addressing Palliative Care in Hepatocellular Carcinoma – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/features/addressing-palliative-care-in-hepatocellular-carcinoma/

  Research shows that palliative care can help with symptom management, care coordination, therapeutic decision making, and the psychosocial aspects of living with hepatocellular carcinoma. […] Palliative care is specialized, interdisciplinary care for people living with a serious illness that focuses on improving quality of life. It is appropriate for any stage of illness, and at any age. […] Palliative care offers an additional layer of support to help these patients and their families navigate HCC diagnosis and treatment and maintain an acceptable quality of life. […] More research is needed to help us integrate palliative care services into the landscape of HCC treatment, so that we can best address palliative care needs of both patients and families symptom management, psychosocial support, and assistance with treatment decision making throughout their entire experience.

• #38 Integrating Palliative Care Into Hepatocellular Carcinoma Treatment – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/features/integrating-palliative-care-into-hepatocellular-carcinoma-treatment/

  The review authors used existing evidence to recommend a new model of palliative care integration in patients with hepatocellular carcinoma. […] In addition to the central involvement of hepatologists and other specialists in the management of patients with HCC, the review authors explained that early and consistent palliative support could enhance their care throughout the disease course. […] Palliative care clinicians are uniquely suited to help patients navigate the process of treatment decisions while considering how to best define and maintain quality of life while living with a serious illness like HCC, wrote Woodrell and colleagues. […] They provided an algorithm to help guide the integration of palliative care at each stage of HCC treatment, according to the Barcelona Clinic Liver Cancer (BCLC) staging system.

• #39

  https://journals.lww.com/cancernursingonline/fulltext/2022/11000/experiences_of_symptoms_and_impact_on_daily_life.4.aspx

  Through effective symptom relief and psychosocial interventions to reduce negative feelings, patients health-related quality of life may increase. […] It is important to pay attention to symptoms for optimal and individualized support for HCC patients. […] Therefore, optimal supportive cancer care for patients with HCC is very important. […] However, during the last year, research often focus on tumor response or survival time. […] Although patients experiences and preferences are important in a holistic care approach, and HCC has a great impact on the patients health and well-being, physical, psychological, social, and existential needs should be identified during the investigation period, during any curative treatment, and at the palliative stage of the disease. […] Important clinical implications for nurses are active interventions for their symptoms and person-centered and individualized information based on needs to obtain the best possible health and quality of life over time.

• #40 Treatment Management – Liver Central

  https://livercentral.org/experienced-patient/treatment-management/

  Hepatocellular carcinoma treatment is guided by several factors including the size of the tumor, number of tumors, location of tumor(s), overall liver function and other health factors. […] Choosing a doctor and healthcare team is an important and very personal decision. […] A multidisciplinary team is a group of health care professionals from different specialties working together to suggest a treatment and care plan based on your diagnosis, personal health, and preferences. […] Each treatment is different and most treatments have some side effects that affect people differently. […] It is important to remember that while people may have some side effects from treatment, most people do not experience all of the potential side effects. […] Talk often and openly about what to expect for treatment and plan to manage side effects before and when they happen.

• #40 Treatment Management – Liver Central

  https://livercentral.org/experienced-patient/treatment-management/

  Many people do not report side effects from cancer treatment because they fear their treatment team will stop that particular treatment. […] Do not hide side effects from the doctor, most side effects can be managed safely and easily so the course of treatment can be maintained. […] Cancer care is both an art and a science. […] The treatment team will review complex clinical information, study results and their experience to help each individual patient. […] The intent of the guidelines is to assist in the decision-making process of individuals involved in cancer care—including physicians, nurses, pharmacists, payers, patients and their families—with the ultimate goal of improving patient care and outcomes.

• #41 Hepatocellular Carcinoma | Guide for Patients

  https://www.esmo.org/for-patients/patient-guides/hepatocellular-carcinoma

  The medical information described in this document is based on ESMO clinical practice guidelines for the management of hepatocellular carcinoma. […] This guide has been prepared to help you, your friends, your family and caregivers better understand the nature of hepatocellular carcinoma and the treatments that are available. […] We recommend that you ask your doctor about the tests and types of treatments available in your country for your stage of hepatocellular carcinoma.

• #42 Hepatocellular Carcinoma (HCC): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21709-hepatocellular-carcinoma-hcc

  Hepatocellular carcinoma (HCC) is cancer in your liver. Although it can be life-threatening, catching it early can mean successful treatment with surgery or a liver transplant. Other treatments ease your symptoms and help you live longer. If you’re at high risk for HCC, you should see your provider regularly to check for signs of HCC. […] Given how serious it is, you should receive regular checks for signs of HCC if you have cirrhosis or MASLD. […] If you belong to a high-risk group, your healthcare provider may suggest regular screenings to catch HCC early, when it’s treatable. They can also help you take steps to reduce risk factors, like helping you quit smoking or drinking. They can help you manage chronic conditions that put you at risk, like hepatitis infections and diabetes. […] Your healthcare provider may suggest participating in a clinical trial to try new HCC treatments. They may also recommend palliative care to help you manage cancer symptoms and treatment side effects. Palliative care can improve your experience whether you’re living with long-term disease or receiving treatment for early-stage, curable HCC.

• #43 Liver cancer – hepatocellular carcinoma – UF Health

  https://ufhealth.org/conditions-and-treatments/liver-cancer-hepatocellular-carcinoma

  You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. […] Preventive measures include: Preventing and treating viral hepatitis may help reduce your risk. […] Screening for liver cancer in people who have hepatitis B or C or cirrhosis. […] Surgical resection and liver transplantation are the primary curative treatments for hepatocellular carcinoma (HCC). However, many patients are ineligible for these treatments due to advanced disease, social factors, or limited availability of liver.

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