Multidisciplinary care of hepatocellular carcinoma

Janet Van Cleave, Pamela Devine, Pam Odom-Ball

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Multidisciplinary care of cancer patients in varied settings is well described in the literature, but there is little specifically describing the multidisciplinary care of the patient with hepatocellular carcinoma (HCC). The purpose of this article is to describe HCC and the multidisciplinary approach at the Philadelphia Veterans Affairs Medical Center (PVAMC). MATERIALS AND METHODS: HCC is one of the most common solid tumors in the world, but it is rare in North America. It is associated with environmental carcinogens identified in animal studies, hepatitis B and C, cirrhosis of any etiology, and various metabolic diseases. No reliable therapy has been established for HCC. Surgical resection is the best treatment, but it is possible only in the patient with adequate hepatic reserve and limited-stage cancer. From January 1995 to May 1998, 22 patients at PVAMC received a diagnosis of primary HCC. One patient was a candidate for surgery, two patients received radiation therapy, and one patient underwent chemoembolization. Eighteen patients presented with an advanced-stage disease and comorbidities. RESULTS: Therapy goals in these 18 patients were limited to supportive care and enhancement of quality of life. A multidisciplinary team provided care to this challenging patient population. The multidisciplinary team treating HCC at PVAMC consisted of physicians, nurses, pharmacists, social workers, and a chaplain. Most care occurred in the outpatient setting. Supportive therapy included the controlling of ascites and abdominal discomfort, hepatic encephalopathy, and pruritus. Opioids relieved abdominal pain. Psychiatric support and counseling helped patients and families cope with the poor prognosis. CONCLUSIONS: A multidisciplinary team approach helped provide care for this challenging population. Through anecdotal reports, patients and family expressed satisfaction with their care. Research is needed to systematically test interventions designed to enhance quality of life in patients with HCC.

Original languageEnglish (US)
Pages (from-to)302-308
Number of pages7
JournalCancer Practice
Volume7
Issue number6
DOIs
StatePublished - 1999

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Hepatocellular Carcinoma
Veterans
Animal Hepatitis
Patient Care
Quality of Life
Clergy
Environmental Carcinogens
Neoplasms
Hepatic Encephalopathy
Metabolic Diseases
Therapeutics
Pruritus
Hepatitis C
North America
Hepatitis B
Pharmacists
Ascites
Abdominal Pain
Opioid Analgesics
Population

Keywords

  • Hepatocellular carcinoma
  • Multidisciplinary care
  • Neoplasm, liver
  • Supportive care

ASJC Scopus subject areas

  • Oncology
  • Nursing(all)

Cite this

Multidisciplinary care of hepatocellular carcinoma. / Van Cleave, Janet; Devine, Pamela; Odom-Ball, Pam.

In: Cancer Practice, Vol. 7, No. 6, 1999, p. 302-308.

Research output: Contribution to journalArticle

Van Cleave, Janet ; Devine, Pamela ; Odom-Ball, Pam. / Multidisciplinary care of hepatocellular carcinoma. In: Cancer Practice. 1999 ; Vol. 7, No. 6. pp. 302-308.
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