Doctors determine the stage of liver cancer by figuring out how much it has spread throughout the body upon diagnosis. Figuring out the stage of the cancer helps determine the best treatment options and what the patient’s future outlook is. The diagnosis and staging is based on tests like ultrasounds, CT or MRI scans and other physical exams and blood tests. There are different ways to stage the cancer, but once it reaches the terminal stage, it’s similar and not difficult to determine the outlook.
What Is Terminal Liver Cancer?
A patient has end-stage liver cancer when the cancer has spread from where it started in the liver to other key organs throughout the body. Typically, it spreads to the peritoneum, or the lining of the stomach, the lungs and bones. It may also spread to lymph nodes, which are located all over the body. Based on TNM system by The American Joint Committee on Cancer, this may refer to M1.
What Are the Physical Signs of Terminal Liver Cancer?
Fever
During a patient’s final days, the body temperature spikes as it is a part of the body’s natural way of shutting down. The fever can approach 104 degrees and causes the patient to sweat. You can feel warm when touching them. The normal treatments for a fever such as acetaminophen or ibuprofen won’t help, and instead, a pain reliever may be given to help the patient be more comfortable.
Breathing
A sign that death is imminent is a distinct change in the patient’s breathing. Instead of smooth, soundless breathing, you will likely hear a rattling or gurgling noise as they try to breath. This is not a sign of choking, but rather from the gradual weakening of muscles in the chest. Oxygen or other medications may be needed to make breathing easier.
Terminal Restlessness
When a patient is near the end of their battle with terminal liver cancer, they may be constantly restless. They will likely not be aware of it, but will move around constantly or look and sound like they’re in pain or discomfort. Pain medications can help, and the simple act of reminding the patient that you’re there with them can also help.
Vision
Changes in eyesight are another sign that the patient is in the end stages of liver cancer. They may have trouble recognizing loved ones or seeing people and things that are right in front of them.
Vital Signs
Knowing how to count respirations and take a pulse is important in taking care of someone who is on hospice care. Loss of a pulse or heart beat means the patient has passed away. Their pupils will likely dilate. Contact a hospice nurse or physician right away so they can officially document the patient’s time of death.
How to Provide Emotional Support to a Person Who Is Living with Terminal Liver Cancer
A patient dying of end stage liver cancer likely has a lot on their mind, including what their loved ones will fare after they’re gone. They also want to be able to retain some level of independence as they gradually get sicker. That's why some simple ways are listed here to address these worries.
Spend time with them, even if it’s just sitting next to their bed and having a simple conversation.
Listen to their worries about dying and don’t dismiss them or tell them it’s going to be okay. These fears are legitimate and should be heard.
Don’t keep things from the patient. Even if it’s a bad doctor’s report or other difficult news, they deserve to know everything that’s happening to them.
Help the patient with wills, advance directives and do not resuscitate orders, and reassure them that you will respect their wishes.
Facilitate whatever spiritual needs the patient has, whether it’s praying with them or arranging for visits from church leaders.
Ask if there’s anything you can do to help the patient, and also be willing to respect their need for privacy and alone time.
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