• Liver cancer' also known as hepatic

cancer and primary hepatic cancer, is cancer that starts in

the liver.
• Cancer which has spread from elsewhere to the liver; known
as liver metastasis,
 CAUSES AND RISK FACTORS
OF LIVER CANCER
• Anabolic steroids - used by athletes and weight lifters. These
male hormones, if used regularly and for long enough, can raise
the risk of
developing liver cancer; as well as some other cancers.
Aflatoxins - a substance made by a fungus and may be found in
moldy wheat, groundnuts, corn, nuts, soybeans and peanuts. For
liver cancer risk to increase there needs to be long-term
exposure. This is more of a problem in less wealthy countries.
• Cirrhosis - when liver cells are damaged and replaced with scar
tissue. People with cirrhosis of the liver have a higher risk of
developing liver cancer.
• Diabetes - patients with diabetes, especially if they also have
hepatitis, or regularly consume a lot of alcohol, are more likely to
develop liver cancer.

• Family history - people whose mother, father, brother, or sister

had liver cancer are at a higher risk of developing it themselves,
compared to others.
• Obesity - obesity raises the risk of developing many cancers,
including liver cancer
 Liver disease and inherited liver disease -people with
hepatitis B or C have a significantly higher risk of
developing liver cancer; compared to other healthy
individuals.

Low immunity - people with weakened

immune systems, such as those with HIV/AIDS have a risk of
liver cancer that is five times greater than other healthy
individuals.

・ Gender - a higher percentage of males get liver cancer

compared to females. Some experts
believe this is not due to gender; but to lifestyle characteristics.
On average, males tend to smoke and abuse alcohol more
than females.
• Smoking - individuals with hepatitis B or C have a higher risk
of liver cancer if they smoke.
 STAGES OF CANCER

Liver cancer is categorized into four stages:

• Stage 1 - the tumor is just in/on the liver and no where else

• Stage 2 - either there are several small tumors with little

increase in size, but all within the liver, or one tumor that has

reached a blood vessel

・ Stage III.
At this stage, the tumor extends beyond the liver to
the surrounding tissue and may also have spread to a
nearby lymph node.
・ Stage IV.
Cancer spreads outside the liver to multiple lymph
nodes or to distant parts of the body, such as the
lungs.
 Symptoms
Most people don’t have signs and symptoms in the early
stages of primary liver cancer. When signs and
symptoms do appear, they may include:
—Losing weight without trying
—Loss of appetite
—Upper abdominal pain
—Nausea and vomiting
—General weakness and fatigue

—Abdominal swelling

—Yellow discoloration of your skin and the whites of

your eyes (jaundice)

—White, chalky stools

 Diagnosis of liver cancer
• HCC screening - high risk individuals for HCC should
have regular screenings for liver cancer.
Liver cancer, if not diagnosed early is much more
difficult to remove.
The only way to know whether you have liver cancer
early on is through screening, because symptoms are
either slight or nonexistent.

High risk people include those with hepatitis

C and B, patients with alcohol-related
cirrhosis and other alcohol abusers.
• Blood test - AFP (alpha fetoprotein), a type of protein, is
produced by liver tumors and can be detected in a blood
test
• Imaging scans - either an MRI or CT scan
• Biopsy - a small sample of tumor tissue is removed and
analyzed. The analysis can reveal whether the tumor is
cancerous (malignant) or non-cancerous (benign).
TREATMENT
 Surgery

• In the early stages, when the tumor is small and occupies just
a small part of the liver, it can be surgically removed (surgical
resection).

・ Even if part of the liver is removed during this procedure,

the patient's health should not be significantly undermined

Liver transplant - candidates for a liver

transplant cannot have a tumor larger than 2 inches (5cm).

If the tumor is larger; the risk of the cancer coming back is

too high.
• Ablative therapy - substances are injected directly into the
tumor; such as alcohol. Lasers
and radio waves can also be used
• Radiation therapy (radiotherapy) - radiation is directed at
the tumor(s), killing a significant number of them. Patients may
experience
nausea, vomiting and fatigue.
Chemotherapy -

(chemoembolization). In chemoembolization the blood supply to

the tumor is blocked

anticancer drugs (chemotherapv) are administered directly into

the tumor
 Targeted drug therapy

・ Targeted drugs work by interfering with

specific abnormalities within a tumor.

・ They have been shown to slow or stop

advanced hepatocellular carcinoma from

progressing for a few months longer than with no treatment.

• such as the drug sorafenib (Nexavar), may be used to control

advanced liver cancer.

 Alternative medicines
Ask doctor about alternative treatments that may help you
cope with pain, such as:
• Acupressure
• Acupuncture
• Deep breathing
• Listening to music (music therapy)
• Massage
 NURSING MANAGEMENT
• Give analgesics as ordered and encourage the patient to
identify care measures that promote comfort.
• Provide patient with a special diet

• Monitor respiratory function.

• Explain the treatments to the patient and his family,
including adverse reactions the patient may experience.
Prepare the patient for surgery if indicated.
• Provide comprehensive care and emotional assistance.
• Monitor the patient for fluid retention and ascites.