Risk factors

4th most common cancer in the world

Cirrhosis – primary risk factor

Other risk factors: hepatitis C and B

Metastatic – more common than primary

Etiology & Pathophysiology

Why is the Liver a common site of cancer metastasis from other parts of the body?

Clinical manifestations Pain – a continuous dull ache in the RUQ,

epigastrium, or back

Weight loss

Loss of strength

Anorexia, nausea and vomiting

Anemia

Clinical Manifestations

As condition worsens will exhibit: Hepatomegaly and irregularly

shaped Jaundice Ascites, increase in abdominal

girth Pulmonary emboli

Diagnostic Tests

Laparoscopic liver biopsy – to minimize tumor spread. Complications – bleeding. Lie

on Rt. Side –pressure on site.

Serum alpha fetoprotein – protein produced by the liver and elevations detect some liver disorders and cancers in adults.

Goals of Care

PreventionPrevention Focused on identifying and

treatment of chronic viral hepatitis Treatment of chronic alcohol ingestion Surveillance of at risk patients: with

cirrhosis

Treatment and Nursing Care

Radiation TherapyRadiation Therapy ChemotherapyChemotherapy

Chemoembolization Chemotherapy by constant infusion to

the liver via the hepatic artery Produces anoxic necrosis Percutaneous Ethanol Injection (PEI) or Percutaneous acetic acid injection (PAI)

Treatment and Nursing CareSurgical intervention

LobectomyLobectomy – removal of lobe of liver to excise liver tumor

Radiofrequency ablation Radiofrequency ablation – used for both resectable tumors and

palliative - needle devices that contain multiple

curved, retractable electrodes. The electrodes are kept inside the needle until its tip is positioned within a tumor.

Electrical energyCreates heat

Treatment

Cryoablation: - used for unresectable tumors with

no s/s of metastasis - liquid nitrogen/argon flows thru cryoprobes directly into the liver and freezes it