This presentation provides information about liver cancer, including its signs and symptoms, causes, prevention, and treatment options. It includes a patient case study, diagnostic imaging studies, staging of liver cancer, nursing interventions, and references for further reading.
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LIVER CANCER
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LIVER CANCER: Signs and Symptoms Liver cancer is the second leading cause of death from cancer across the globe and is 6thmost common cancer. It is observed more in males particularly from the age group of 40 to 65 years. The common signs and symptoms are as follows: Sudden weight loss Abdominal pain and swelling Enlarged liver Vomiting and nausea Loss of appetite
Causes of Liver Cancer The chronic infection such as Hepatitis B virus and Hepatitis C virus Cirrhosis which is a progressive irreversible damage of tissues in the liver Inherited liver diseases such as Wilson’s disease Diabetes Excessive intake of alcohol Exposure to alfatoxins that are produced by molds grown on crops
Preventing Liver cancer
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Treatment of liver cancer The different treatment options for liver cancer are as follows: •Surgery :Partial hepatectomy, Liver transplantation, Cryosurgery and Laser therapy •Chemotherapy:Heaptic arterial chemotherapy, Hepatc arterial infusion pump and chemobilisation •Radiation therapy –Use of radiation to destroy cancerous cells •Targeted therapy –Use of pharmacologic agents that targets tissues, cells, genes, proteins that fosters cancer cell growth. •Immuno-therapy –Boosting the immune system to address the cancer and fight against the effects of cancer.
PATIENT CASE STUDY •Mr. R was referred to hospital from his GP for diagnosis of liver cancer based on patient history and social history. •The patient family history says, both of his grandparents died due to liver cancers and grandmother has a second diagnosis of colorectal cancer. •Patient has a 20 years history of smoking and alcohol. •Patient medical history says he has asthma , diabetes and hypertension. •Recently patient complained ofupper abdominal pain, loss of appetite, nausea and vomiting. •He was diagnosed with liver cancer six months ago. •Physical assessment of patient reported – yellowish of skin, increased fluid in the abdomen, general weakness and fatigue, enlarged liver and spleen. Other symptoms includes - weight loss, abdominal swelling and chalky coloured stools.
CASE STUDY BIOCHEMICAL, IMAGING AND OTHER DIAGNOSTIC RESULTS •Biochemical laboratory findings reports -haemoglobin was 122 g/L and haematocrit was 32.2%, leucocytes and platelets were elevated up to 18 x 109/L and 1000 x 109/L respectively, total bilirubin 2.8 μmol/L, albumin 33 g/L and AST/ALT 56/68 U/L •Cancer marker tests - Tumour markers like alpha-fetoprotein (α-FP), serum carcinoembryonic antigen (CEA) and CA 19-9 increased up to 558 ng/ml, 5.8 ng/ml, and 45 U/ml respectably. •Abdominal sonography report - abdominal ultrasound demonstrated a 7.2 cm mass in the left medial segment of the liver, Increased mass was observed in the right poster inferior segment, intrahepatic bile ducts of left lobe expanded. •Hepatic angiography report states - Hypervascularity of the tumour periphery, dot- like lesions around the left lobe. •Autopsy report shows - hepatocellular carcinoma and cholangiocarcinoma. •Magnetic resonance elastography (MRE) report shows stiffness of the liver indicating liver cirrhosis.
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PREFERRED DIAGNOSTIC IMAGING STUDIES •Ultrasonography- The imaging study can help in assessment of liver and further planning for surgery. The sensitivity is 60% warranting other techniques to be used for assistance. •Computed tomography – Triple phase computer tomography that can investigate arterial [phase, portal venous phase, late washout phase can help in accurate diagnosis of hepatocellular carcinoma. It has a specificity and sensitivity of 93% and 68% percent respectively. •Magnetic Resonance Elastography– Can help in facilitating characterisation of cancerous areas without radiation and iodonisation contrast. Increased specificity and reduced time. It has the highest sensitivity and specificity of 81% and 85% respectively.
LIVER BIOPSY PICTORIAL PRESENTATION
STAGING OF LIVER CANCER
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NURSING INTERVENTION- LIVER CANCER •Nursing intervention depends on in which stage the cancer is currently present
REFERENCES •Muriel, P. (2017). The liver: General aspects and epidemiology. InLiver Pathophysiology(pp. 3-22). Academic Press. •Kudo, M. (2015). Surveillance, diagnosis, treatment, and outcome of liver cancer in Japan.Liver Cancer,4(1), 39-50. •Bruix, J., Reig, M., & Sherman, M. (2016). Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma.Gastroenterology,150(4), 835- 853. •Pepin, K. M., Ehman, R. L., & McGee, K. P. (2015). Magnetic resonance elastography (MRE) in cancer: technique, analysis, and applications.Progress in nuclear magnetic resonance spectroscopy,90, 32-48. •Oliveira, I. S., Kilcoyne, A., Everett, J. M., Mino-Kenudson, M., Harisinghani, M. G., & Ganesan, K. (2017). Cholangiocarcinoma: classification, diagnosis, staging, imaging features, and management.Abdominal radiology,42(6), 1637-1649. •Tapper, E. B., & Lok, A. S. F. (2017). Use of liver imaging and biopsy in clinical practice.New England Journal of Medicine,377(8), 756-768.