Comprehensive Liver Cancer Clinic
One of the services provided through the Liver Transplantation Program at Northwestern Memorial Hospital is the weekly Comprehensive Liver Cancer Clinic. The purpose of this clinic is to provide liver cancer patients with the opportunity to be evaluated in a clinic focused exclusively on their illness, thus allowing for individual care plans tailored specifically to a liver cancer diagnosis.
The prevalence of primary liver cancer, or hepatocellular carcinoma (HCC), is increasing dramatically in the United States, due mostly to the hepatitis C epidemic. Another challenge is that liver cancer patients span a wide spectrum of tumor stages and degree of liver insufficiency, making therapeutic decisions difficult. Because of such complexities and the fact that the majority of liver cancers occur in the setting of chronic liver disease, liver cancer management requires the kind of comprehensive team approach our Comprehensive Liver Cancer Clinic employs.
The clinic is complemented by a multidisciplinary liver cancer tumor board, which includes surgeons, hepatologists, medical oncologists, and diagnostic and interventional radiologists, as well as members of the the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, a National Cancer Institute-designated Comprehensive Cancer Center.
Every Monday afternoon patients are seen in the clinic, where they have the opportunity to interact with members of the team. The team then evaluates the extent of any chronic liver disease and any liver cancer, and devises a management/treatment plan. In order to better stage the disease, we may ask patients to undergo further testing, which can include detailed imaging of the liver by MRI and CT scan, metastatic surveys of the bones and chest and possibly a direct measurement of the portal pressure gradient. A biopsy also may be recommended.
Every Friday this board meets specifically to discuss the care plans of clinic patients and to review the cases of referred patients who will subsequently be seen in the clinic. Based on the review of imaging and laboratory results, the team and the patient will come to a joint decision about appropriate treatment. On Friday afternoons clinic nurses call patients and referring physicians to inform them of management decisions.