LIVER CANCER

MR. POORAN SINGH BHATI

ASSISTANT PROFESSOR
MEDICAL SURGICAL NURSING
SMT. D.S.S.N.I
LIVER CANCER/HEPATOMA/HEPATIC CELLULAR CARCINOMA
LIVER CANCER/HEPATOMA/HEPATIC CELLULAR CARCINOMA
• Liver cancer also known as hepatic cancer or primary hepatic cancer is cancer that start in the liver.
• Cancer which has spread from elsewhere to the liver known as metastasis is more common than that which
starts in the liver.
ETIOLOGY & RISK FACTORS-
• The exact cause is known.
• Cirrhosis of liver.
• Alcohol abuse.
• Liver disease & inherited liver disease (Hepatitis-B & Hepatitis-C).
• Hemochromatosis.
• Aflatoxins- A substance made by a fungus & may be found in moldy wheat, groundnuts, corn, nuts, soya-beans
& peanuts.
• Diabetes.
• Family history.
• Obesity.
• Low immunity.
• Smoking.
 STAGES OF CANCER
• Stage-I- The tumor is just in/on the liver & no elsewhere.
• Stage-II- there several small tumors with little increase in size but all within the
liver & one tumor that has reached a blood vessels.
• Stage-III- There are various large tumors or there is just one that has reached the
main blood vessels. Cancer may also have reached the gallbladder.
• Stage-IV- The liver cancer has spread to other parts of the body.
STAGES OF CANCER
 CLINICAL MANIFESTATIONS
• Pain in the right upper abdomen, the pain may extent to the back & shoulder.
• Swollen right upper abdomen (Bloating).
• Enlarged liver.
• Abdominal lump.
• Fatigue.
• Unexplained weight loss
• Anorexia
• Feeling of fullness
• Weakness
• Yellow skin, eyes & dark urine from jaundice
• Nausea & Vomiting
• Fever
• Fluid retention (Ascites)
• Steatorrhea. (To much fat in feces)
• Metabolic disturbances.
• Pruritus
• Splenomegaly.
 DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• Blood test – AFP (Alpha fetoprotein) is a type of protein is produced by liver
tumors & can be detected in a blood test.
• LFT, KFT, CBC
• MRI
• CT Scan
• PET Scan
• Liver biopsy
• ultrasonography
 MANAGEMENT
Surgical management-
• In early stages when the tumor is small & occupies just a small part of liver, it can
be surgically removed.
• Example- Partial Hepatectomy/complete hepatectomy with liver transplant.
• Lobectomy
Ablative therapy- A substances are injected directly into the tumor such as
alcohol, laser & radio-waves can also be used.
Radiation therapy-
Cryosurgery- It involves the placement of a stainless steal probe into the center
of the tumor. The probe freez the cancer cells & killing them.
 MANAGEMENT
Chemotherapy-
• Hepatic Arterial Infusion- It uses an anticancer drug injected into a catheter
that has been placed in the major artery supplying blood to the liver (Hepatic
artery).
• Trans-catheter arterial chemoembolization (TACE)-
TACE is done by injecting an antineoplastic drug (Cisplatin) mixed with a radio-
opaque contrast (Lipidol) & an embolic agent (Gelfoam) into the right & left
hepatic artery via the groin artery.

Nursing management- Assignment