Palliative Care

Top tips:

  1. HCC usually occurs in patients with cirrhosis

Learn more about your patient

  • determining their goals beliefs
  • advance care planning

Learn more about your patient

  • determining their goals beliefs
  • advance care planning

Learn more about your patient

  • determining their goals beliefs
  • advance care planning

Learn more about your patient

  • determining their goals beliefs
  • advance care planning

Palliative care

  • Palliative care principles should be followed in all patients with HCC – this basic/primary palliative care can be carried out by Hepatology and includes advance care planning and goals of care discussions ± screening for potentially treatable symptoms.
  • Specialist palliative care involvement (this may be a board certified specialist or the primary care physician if they are comfortable with palliative care) should be considered with complex palliative care including refractory symptom burden or hospice referral that is not straight-forward.

Order sets for HCC:

For adults with cirrhosis diagnosed with HCC.
HCC order sets

Calculators:

Use these calculators to help with HCC:

ALBI calculator

Child Pugh

MELD-Na

Total Tumour Volume Calculation

References:

This section was adapted from content using the following evidence based resources in combination with expert consensus. The presented information is not intended to replace the independent medical or professional judgment of physicians or other health care providers in the context of individual clinical circumstances to determine a patient’s care.

Authors: Dr. Kelly Burak, Dr. Aldo Montano Loza, Dr. Puneeta Tandon

References:

  1. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018 Jul;69(1):182-236 (PMID 29628281)
  2. Heimbach JK et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 2018 Jan;67(1):358-380 (PMID 28130846)
  3. Sherman M, Burak K et al. Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma. Curr Oncol 2011; 18(5):228-240. PMID 21980250
  4. Burak KW, Kneteman NM. An Evidence-Based Multidisciplinary Approach to the Management of Hepatocellular Carcinoma (HCC): The Alberta HCC Algorithm. Can J Gastroenterol 2010; 24(11): 643-650. PMID 21157578.
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