Hepatic Cancer
Adult health nursing 2
Hepatic cancer
Hepatic Cancer (Liver Cancer)
Hepatic cancer, also known as liver cancer, is a malignant tumor that originates in the liver. It can
be primary (originating in the liver) or metastatic (spreading to the liver from another site).
Types of Liver Cancer
1. *Hepatocellular carcinoma (HCC)*: Most common type, often linked to cirrhosis, hepatitis B and c
2 : cholangiocarcinoma: Arises from bile duct cElls. 3*hepatoblastoma:: Rare, typically affects
children.
Causes and Risk Factors
1. *Chronic hepatitis B and C infection*: Increases risk of developing HCC.
2. *Cirrhosis*: Scarring of the liver, often due to alcohol abuse or hepatitis.
3. *Aflatoxin exposure*: Fungal toxin found in contaminated food.
4. *Alcohol consumption*: Heavy drinking increases risk.
5. *Nonalcoholic fatty liver disease (NAFLD)*: May increase risk
Sign and symptoms
1. Abdominal Pain
2. Weight Loss
- 3. Fatigue
- Feeling tired or weak, even after rest.
4. Jaundice
-5. Abdominal Swelling
-6. Loss of Appetite
- Reduced appetite, often leading to weight loss.
7. Nausea and Vomiting
- Feeling queasy or vomiting, especially after eating.
8. Dark Urine
- Urine may appear darker than usual due to bilirubin.
9. Pale or Clay-Colored Stoolsl
Hepatic cancer
Pathophysiology Flow chart
Liver cancer, particularly
hepatocellular carcinoma (HCC),
develops from a complex interplay of
genetic, inflammatory, and
environmental factors, primarily
leading to DNA mutations and
uncontrolled cell growth. Chronic
liver diseases, especially those
caused by hepatitis infections or
alcohol abuse, significantly increase
the risk due to persistent
inflammation, fibrosis, and cirrhosis,
which damage liver cells and create
a conducive environment for tumor
development.
Medical management
Medical Management of Liver Cancer
Medical management of liver cancer involves various treatments to control symptoms, slow disease
progression, and improve quality of life. Some options include:
1. *Targeted Therapy*: Medications that target specific cancer cells or proteins.
2. *Immunotherapy*: Treatments that stimulate the immune system to fight cancer.
3. *Chemotherapy*: Systemic treatment to kill cancer cells.
4. *Locoregional Therapies*: Treatments that target the liver directly, such as:
- *Transarterial Chemoembolization (TACE)*: Delivering chemotherapy and embolizing agents to the
tumor.
- *Transarterial Radioembolization (TARE)*: Delivering radioactive beads to the tumor.
- *Ablation Therapy*: Destroying cancer cells with heat (radiofrequency ablation) or cold
(cryoablation).
5. *Supportive Care*: Managing symptoms, pain, and side effects.
6. *Palliative Care*: Focusing on improving quality of life for patients with advanced disease.
Surgical management
Surgical management of liver cancer involves procedures to remove or destroy
cancerous tissue in the liver. Options include:
1. *Liver Resection*: Surgical removal of the tumor and surrounding liver tissue.
2. *Liver Transplantation*: Replacing the entire liver with a healthy donor liver.
3. *Ablation Therapy*: Minimally invasive procedures to destroy cancer cells using:
- *Radiofrequency Ablation (RFA)*: Heat to destroy cancer cells.
- *Cryoablation*: Cold to destroy cancer cells.
4. *Embolization Techniques*: Blocking blood flow to the tumor, such as:
- *Transarterial Chemoembolization (TACE)*: Delivering chemotherapy and
embolizing agents.
Surgical management options depend on the stage, size, and location of the
tumor, as well as the patient’s overall health
Nursing care plan
Assessment
1. *Physical Assessment*:
- Evaluate liver function, tumor size, and metastasis.
- Assess for symptoms like jaundice, ascites, pain, fatigue, and weight loss.
2. *Psychosocial Assessment*:
- Evaluate the patient’s emotional state, coping mechanisms, and support system.
- Assess the impact of the diagnosis on the patient and family.
Nursing Diagnoses
1. *Pain* related to tumor growth or procedures.
2. *Impaired liver function* related to cancer progression.3. *Risk for bleeding* due to coagulopathy.
4. *Risk for infection* due to immunosuppression.5. *Anxiety* or *fear* related to diagnosis and
treatment.6. *Nutritional imbalance* due to poor appetite, nausea
NCP
Interventions
1. *Pain Management*:
- Administer analgesics as prescribed. - Use non-pharmacological methods like relaxation techniques.
2. *Symptom Management*:
- Monitor and manage jaundice, ascites, and fatigue..Collaborate with the healthcare team to address complications.
3. *Nutritional Support*:
- Provide dietary recommendations. . Administer nutritional supplements or enteral nutrition if needed.
4. *Bleeding Precautions*:
- Monitor coagulation studies - Implement measures to prevent bleeding.
5. *Infection Prevention*:
- Monitor for signs of infection.
6. *Emotional Support*:
- Provide a safe space for the patient to express fears and concerns.
NCP
Evaluation
1. *Pain Control*: Assess the effectiveness of pain management interventions.
2. *Symptom Relief*: Monitor for improvement in symptoms.
3. *Nutritional Status*: Evaluate the patient’s nutritional intake and weight stability.
4. *Emotional Well-being*: Assess the patient’s coping mechanisms and emotional state.
Education
1. *Disease Process*: Explain liver cancer and its progression.
2. *Treatment Plan*: Educate the patient and family about the treatment plan, including potential side
effects.
3. *Self-Care*: Teach the patient and family about self-care measures, such as dietary modifications and
recognizing signs of complications.
Case study
Case Study: Liver Cancer
Patient Profile *Age*: 55 years *Gender*: Male
- *Symptoms*: Abdominal pain, jaundice, weight loss, fatigue
- *Medical History*: Chronic hepatitis B infection, cirrhosis
Assessment Findings
1. *Imaging Studies*: CT scan shows a large liver mass.
2. *Laboratory Tests*: Elevated alpha-fetoprotein (AFP) levels.
3. *Physical Examination*: Jaundice, ascites, and hepatomegaly.
Diagnosis
- *Liver Cancer (Hepatocellular Carcinoma, HCC)*: Diagnosed based on imaging studies and elevated AFP levels.
Treatment Plan
1. *Surgery*: Liver resection or liver transplant may be considered.
2. *Locoregional Therapies*: Transarterial chemoembolization (TACE) or radiofrequency ablation (RFA).
3. *Systemic Therapy*: Targeted therapy or immunotherapy
Case study
Nursing Care
1. *Pain Management*: Administer analgesics and monitor pain levels.2. *Symptom Management*: Manage
jaundice, ascites, and fatigue
3. *Nutritional Support*: Provide dietary recommendations and supplements.
4. *Emotional Support*: Offer counseling and support groups.
Follow-Up
1. *Monitoring*: Regular follow-up appointments to assess treatment response and manage side effects.
2. *Supportive Care*: Continue providing emotional and physical support to the patient and family.
