Metastatic Liver Cancer Prognosis - How to see when the end is near?

Published: 04th April 2008
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If you or a loved one have been diagnosed with cancer, you want answers. Many can give you the information you need to either prepare for the end or to prepare for the fight of your life. However, many times this does not mean a good outcome. Many times you will hear of someone who has been diagnosed with cancer which has "metastasized". Metastasis of any type of cancer means the cancer has originated in one part of the body and has spread to other parts. This can happen when a cancer was not caught in the early stages and has colonized other parts of the body in addition to the primary site. Most times when talking about a cancer which has metastasized, you will hear people say "It's metastasized to the liver". Due to the unique position of the liver in the the body's system, the liver is one of the most vulnerable organs of the body. The liver continuously filters the body's blood, allowing it to become vulnerable to any substance ingested by that person whether it be food or chemicals. It also converts food and drugs into chemicals to be absorbed in the small intestines. The liver acts as a filter for the circulating volume of blood of the body which sets it up for any contact with cancerous cells which may be in the blood stream from another site. Most cases of liver cancer are actually metastatic disease meaning the cancer originated in another part of the body and the cancerous cells either were filtered out by the liver or the liver was in close proximity to the original site. Liver cancer itself can be divided into two types, primary and secondary. 

Primary liver cancer is a cancer which starts in the liver. Primary liver cancer can be of two types, hepatocellular which is a cancer of the liver proper and cholangiocarcinoma which is actually a cancer originating in the common bile duct or gall bladder. Early detection of liver cancer is difficult because symptoms do not generally occur until the cancer is in an advanced state. Liver cancer is generally caused by some type of damage to the liver. There are many types of damage but over half of the diagnoses of liver cancer occur because of cirrhosis which means there has been scarring of the liver. The most common cause of cirrhosis is due to abuse of alcohol. Cirrhosis can also be caused by hepatitis B and C, smoking, obesity and fatty liver, herbicides, hematomacrosis which is a hereditary condition which is associated with too much iron in the blood,and poisoning either by chemical or plant origin. Primary liver cancer strikes twice as many men as women in the US. Liver cancer in the US, only accounts for around 2% of the types present in the US. This statistic rises to around 50% in undeveloped countries mainly because the incidence of hepatitis is much higher there. 

Secondary cancer, which is cancer which originates somewhere else in the body, is generally difficult to treat and is not generally discovered, again, until too late to treat. Secondary cancer can be found after the discovery of the primary site or the secondary cancer site may be all that is found until after the patient has died. When someone you love has cancer, all you want to hear about is the cure or the treatment which will consume your very life. Hearing the facts on the survival rates and the likelihood of a cure are sometimes all you want to hear. However, at times a cure is not to be found. Survival may not be assured by anyone, even someone who is very knowledgeable about the subject. Facing death may be the next stage for the patient and for the family. 

The act of dying is one of the "don't talk about" subjects in most of today's cultures. Where once loved ones were cared for and frequently died, at home, they now are either in a hospital or a hospice when the time comes for them to exit this world. More and more people are allowing their loved ones to be cared for by strangers during the dying process and not by the family who loves them. Gone are the days of keeping vigil by the bedside of a loved one. Now people are content to let the physicians tell them when the time of death shall be only to miss the last moments of the patient's passing. Doctors will even tell you the estimate they give is not a "set in stone" time of death for a loved one. The best they can do is to estimate the end is nearing by the signs and symptoms. Even the very people who work with terminal patients can tell you, there are no definitive signs for foretelling death. Someone who is expected to have months to live may die within the day. Conversely, someone who is expected to live for a very short time may last for months. There are several criteria however, that healthcare professionals watch for which are indicative of approaching death. 

They are: 

The patient says they are dying: Amazingly people are sometimes able to sense their own demise.

Changes in the breathing rate or pattern: Respiration will develop a strange pattern such as shallow breathing progressing into deep breathing, stopping for a breath and then starting the pattern over again. They may also develop a pattern of deep breathing which will then pause and then start again. 

If they are on a cardiac monitor: You may see a pattern of skipped or abnormal beats with the heart, sometimes racing and then slowing down. You may also see a drop in blood pressure with the top part of the blood pressure, the systolic blood pressure, dropping. Care should be taken not to point to this marker as the prediction of death but rather may be a symptom of something else going on with the patient's health. Normally systolic blood pressure does not drop to more than 80. Also when the healthcare professionals cannot obtain a lower number (diastolic blood pressure), this may be indicative of approaching death. 

The patient may have blue mottling or a bluish cast to their arms or legs. They may also appear pale or have a bluish or grayish cast around their mouths. 

The patient may have difficulty getting comfortable and try to rearrange themselves in a more comfortable position in bed.

They may be unable to move and their mouths may start to remain open. 

They may have a fixed stare and not make eye contact with anyone. 

They may experience loss of control of their bladder or bowels in someone who previously was not incontinent. 

They may also develop a fluid buildup in their lungs and/or their arms and legs. You may notice the buildup of fluid in the lungs with their breathing. This is considered to be the "death rattle" people talk about in people who are dying. 

our loved one may have one or all of these symptoms plus they may have other symptoms which will happen before death. 

It is very important to remember, your loved one is able to hear up until they moment of passing. Let them know you are there and that you love them. This may be the last things they hear before passing over. They may not be able to respond to you but just your presence at the bedside may calm them and reassure them when they are nearing death. An easy passing is all we can hope for at the end of this life and you may be the one to be there for your loved one.

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Emma Morris on September 9, 2011 said:
When a loved one is diagnosed witha life threatening illness such as cancer it is never easy. To learn that there is nothing you can do and that you only have a short length of time with them is very tough.Being able to understand what this cancer is can allow you to accept the inevitable and this article is very helpful in providing this acceptance. This experience can have a great strain on you life and may leave you needing support from an outside source to help you to get back on your feet and feel strong both emotionally and physically once again. This article helps you to know where these is support for you and also answers to any quations you may have.

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