Liver Cancer - Managing Possible Liver Failure

HCC patients may develop liver failure. The common symptoms of liver failure include the development of ascites (swelling of the belly), lower extremity swelling, jaundice (the skin and eyes turn yellow) and hepatic encephalopathy (sluggish, forgetful, confusion, etc). Patients who develop these symptoms should alert their physician for diagnosis and treatment of liver failure.
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Transcript:
Patients with primary liver cancer, hepatocellular carcinoma, are running two races. Race against the cancer progression, and race against possible upcoming liver failure which is the result of cirrhosis and progression of cancer. So, I want to tell you some symptoms that suggest liver failure, and if those symptoms start to show up, contact your physician, who will manage the symptoms of the liver failure.

The liver is a factory, it makes protein, and when the liver is not working very well, the albumin, which is the main protein liver makes, the level gets decreased. The patient may develop ascites, their belly become distended with fluids, and the legs become swollen, and the management is usually we try to give the patient diuretics, fluid pills, to get rid of the swelling and get rid of fluids. We also arrange patients for peri-centesis draining of the fluids from the belly.

Other symptoms of liver failure is the patient turn yellow because the bilirubin goes up and that can make the patient's skin itch. When that occurs please alert your physician and your physician may want to do some imaging to find out why the bilirubin is elevated.

The other main important symptom is something called hepatic encephalopathy. Our liver is a factory to get rid of toxins. When we eat, the food in the gut gets worked on by the bacteria that makes this toxin called ammonium. The ammonium usually travels to the liver and gets captured by the liver. The liver uses it for other purposes. When the liver is not working very well, the ammonium travels to the brain, makes people sluggish, makes people forgetful, and sometimes they can be confused. We do have a treatment for that. So if patients start have those symptoms we usually treat them with Lactulose which is a sweet syrup that binds to the ammonium to try to get rid of the ammonium, or we give patients a type of antibiotics called rifaximin and that will control the bacteria in the gut to decrease the production of the ammonium.

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  Liver Cancer