Liver Cancer Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of cancer patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the liver cancer patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the liver cancer advocate to the support the cancer patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating available treatment options and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Liver cancer patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of liver cancer patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a cancer advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The cancer patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Liver Cancer?
Liver cancer is mostly seen in adults. There are two main types – the primary and secondary types. The primary is the type that originates from the liver itself. The secondary is the type that comes from another cancer somewhere in the body; like the colon, the pelvis and from the lungs. There are a number of different primary types but the most prevalent is called hepatocellular carcinoma. Males are most affected.
· Generalized weakness.
· Loss of appetite – anorexia.
· Weight loss.
· Mass in the abdomen.
· Fluid in the abdomen – ascites.
· Yellowness of the eyes – jaundice.
· May note an exaggerated redness or purple coloration of tongue and conjunctiva – suggestive of blood conditions called polycythemia or porphyria cutanea tarda.
Causes of Liver Cancer
Like most cancers, the exact cause is not understood. Al that is known is that there is a ‘malfunction’ in the DNA of the concerned cells which lead to abnormal growth. On the other hand, risk factors associated with the cancer are well documented. They are:
· Cirrhosis (fibrotic changes) of the liver.
· Chronic hepatitis B infection.
· Consumption of aflatoxin contaminated foods.
· Toxins like arsenic and thorotrast (vinyl chloride and thorium dioxide). Ironically this is a substance that was formerly used in x-ray investigations.
· Use of androgens and estrogens.
· Males are affected more.
· Race. In the U.S, Asian Americans, those from Pacific Islands, Whites, African-Americans are among the races most affected.
· Type 2 Diabetes.
· Iron metabolism disorder (hemochromatosis)
· Oral contraceptive pills are also viewed with suspicion.
Clinical examination will confirm some of the symptoms mentioned above.
An enlarged tender liver may be noted.
Laboratory investigations include:
· Blood tests may show raised bilirubin.
· Liver function tests.
· Blood test for fetal alpha-proteins will be raised.
· Abdominal scans which may include ultrasonography and CT scan.
· Liver biopsy.
· Liver angiography.
· Bone scans in search of metastases.
· Blood bleeding and clotting time.
· A tap of the ascitic fluid may be bloody and show tumor cells under a microscope.
Treatment of Liver Cancer
Generally speaking, prognosis in liver cancer is not very good. However, a lot can be done to improve a patient’s life and longevity after the diagnosis. Treatment may include:
· Surgery. Some sources suggest that this be done only if the cancer is contained in one lobe and there is no cirrhosis. Meeting these conditions is usually difficult. Either way it can be done to offer palliative relieve.
· Tumor ablation where the tumor cells are killed without removing the tumor.
· Tumor embolization is where the tumor’s blood supply is blocked to kill it.
· Chemotherapy. Common drugs used are Cisplatin floxuridine, Doxorubicin and, mitomycin C.
· Targeted therapies where drugs used selectively kill the tumor cells only.
· Treatment may also involve a change in lifestyle. For example those who smoke or abuse alcohol should stop.
· A qualified nutritionist may also give direction on the best diet regimen to follow.
· Complications like secondary diabetes must also be managed.
Liver Cancer Statistics in the U.S
The American Cancer Society estimates for 2015 are as follows:
Almost 36000 new cases will be diagnosed. About 26000 of this will be men.
Almost 25000 people will die of the cancer and its complications. Again men will form the majority of these deaths at about 17000.
The trend of the incidence increase slowly every year.
The risk of a man getting the cancer is 1:81 while that of a woman is 1:196.
95% of patients are those aged 45 and above. The average age at diagnosis is 65.
This is yet another cancer where lifestyle and environment appear to play a major role in the manifestation of the disease. With a healthy lifestyle even those who are genetically predisposed to get it can escape.