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Coexisting Conditions: Cancer and Liver Disease

Coexisting Conditions: Cancer and Liver Disease. Objectives. The learner will be able to: State the potential effects of having the coexisting conditions of cancer and liver disease. Discuss nursing implications of caring for a patient with both cancer and liver disease.

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Coexisting Conditions: Cancer and Liver Disease

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  1. Coexisting Conditions:Cancer and Liver Disease

  2. Objectives The learner will be able to: • State the potential effects of having the coexisting conditions of cancer and liver disease. • Discuss nursing implications of caring for a patient with both cancer and liver disease.

  3. Liver Disease Overview • Any condition that causes liver inflammation or tissue damage and affects liver function • Can affect the body’s ability to: • Convert essential food nutrients. • Store vitamins and minerals. • Regulate blood clotting. • Produce proteins and enzymes. • Maintain hormone balances. • Metabolize toxins. • Classified by the cause and effect on the liver

  4. Causes and Complications Potential causes: • Tumor • Infection • Injury • Drug effects • Toxin exposure • Autoimmune process • Genetic mutation Potential complications: • Inflammation • Scarring • Obstructions • Clotting abnormalities • Liver failure

  5. Types of Liver Dysfunction • Liver cancer or metastasis • Acute liver failure • Autoimmune-associated • Cirrhosis • Genetic • Hepatitis and other infections • Biliary obstruction

  6. Potential Impact • Chemotherapeutic agents are primarily metabolized or excreted in the kidneys or the liver. • Hepatotoxicity (liver damage) is a side effect of most chemotherapy agents. • Usually manifested by elevated liver enzymes (LFTs): bilirubin, GGT, ALT/SGPT, and AST/SGOT • Extent of hepatotoxicity depends on various factors. • Preexisting or metastatic cancer-related liver disease can have an effect on the administration of chemotherapy. • Most cancer clinical trials exclude patients with impaired hepatic function, potentially further limiting treatment options.

  7. Nursing Care Implications • Gather thorough health history data, including detailed information about conditions and medications. • If moderate to heavy alcohol use is reported, obtain further details to ascertain extent of use. • Assess baseline and ongoing laboratory results, specifically LFTs. • Address any dose reductions based on LFTs and other dose-limiting symptoms. • Assess and manage baseline and ongoing symptoms related to all conditions. • Assist with collaboration efforts between physicians treating both liver disease and cancer.

  8. References American Liver Foundation. (2012). Liver disease information center. Retrieved from http://www.liverfoundation.org/abouttheliver/info/ Eklund, J.W., Trifilio, S., & Mulcahy, M.F. (2005). Chemotherapy dosing in the setting of liver dysfunction. Oncology (Williston Park), 19, 10571063. Retrieved from http://www.cancernetwork.com/display/article/10165/106688 Lab Tests Online. (2012). Liver disease. Retrieved from http://labtestsonline.org/understanding/conditions/liver-disease National Institutes of Health, MedlinePlus. (2012). Liver disease. Retrieved from http://www.nlm.nih.gov/medlineplus/liverdiseases.html Ramadori, G., & Cameron, S. (2010). Effects of systemic chemotherapy on the liver. Annals of Hepatology, 9, 133143. Retrieved from http://www.annalsofhepatology.com/PDF/vol9n2/Hp102-03.pdf Superfin, D., Iannucci, A.A., & Davies, A.M. (2007). Commentary: Oncologic drugs in patients with organ dysfunction: A summary. Oncologist, 12, 10701083. Retrieved fromhttp://theoncologist.alphamedpress.org/content/12/9/1070.full

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