Palliative Care: Why Are You Referring Me To Die?

Mrs A, is currently undergoing palliative chemotherapy for metastatic breast cancer (lung, liver, bone). She was complaining about lower back pain and also left lower ribs pain, caused by cancer spreading to her bones. I wanted to refer her to palliative care but she declined. She mentioned that palliative referral means that she is about…… Continue reading Palliative Care: Why Are You Referring Me To Die?

Living Longer: Advanced Stage Liver Cancer (BCLC C)

Introduction Unfortunately, more than 2/3 of liver cancer patients are diagnosed at advanced stage liver cancer (BCLC C). Advanced stage liver cancer (BCLC C) consist(s) of: invasion into major liver blood vessels or/ and spread beyond the liver (lung, lymph nodes). Patients in BCLC C group will benefit from systemic treatment (also suitable for BCLC…… Continue reading Living Longer: Advanced Stage Liver Cancer (BCLC C)

Living Longer: Early Stage Liver Cancer (BCLC A)

Introduction For early stage liver cancer (BCLC A), average survival is around 36 months without treatment. BCLC A Early stage liver cancer (BCLC A) is when: Single liver tumor > 2cm or 3 liver tumors < 3cm each Good liver function (Child Pugh A) Good performance status Treatment options are: Liver tumor resection (if tumor…… Continue reading Living Longer: Early Stage Liver Cancer (BCLC A)

Living Longer: Very Early Stage Liver Cancer (BCLC 0)

Introduction Most of the time, very early stage (BCLC 0) liver cancer is discovered incidentally during routine medical check-up. With better surveillance programme in Japan, 30% of liver cancer there are diagnosed at this stage (as compared with 5-10% in the West). BCLC 0 Very early stage liver cancer (BCLC 0) is when: Single and…… Continue reading Living Longer: Very Early Stage Liver Cancer (BCLC 0)

Understanding Liver Cancer (Hepatocellular Carcinoma – HCC)

Introduction In Malaysia, liver cancer ranked eighth most common cancer amongst Malaysian population, with males to female ratio around 2:1. Mostly, around 80%, present at late stages (III, IV). Risk factors Main risk of developing liver cancer is liver cirrhosis, which is liver impairment caused by scarring/ fibrosis of liver. One third of patients with…… Continue reading Understanding Liver Cancer (Hepatocellular Carcinoma – HCC)