There are about 13 thousand new cases diagnosed in Italy, almost 90% in those suffering from liver cirrhosis. Patients must be taken care of in specialized structures
Liver cancer the fifth big killer, after lung, colorectal, breast and pancreas. There are about 13 thousand new cases diagnosed in Italy in 2020, 9,100 of which were caused by viruseshepatitis B and C and the remainder from other liver diseases. Unfortunately the neoplasm does not give clear and specific symptoms, so only 10% of cases are identified early on when surgery can be decisive: for this reason the cure rates are still low e only a fifth of patients live five years after diagnosis. It is therefore not surprising that many patients have a strong need for assistance in the course of their daily lives and suffer an important impact in social and economic terms that involves the entire family unit. what emerges from a survey conducted by EpaC Onlus Association, conducted to identify the needs and difficulties of patients with hepatocellular cancer.
The survey
90% of cases represented by hepatocarcinoma and at greater risk of getting sick are people predisposed to having persistent liver damage due to a number of causes (including: hepatitis B and C virus infections, alcohol abuse, genetic and autoimmune diseases, diabetes, obesity) which often worsen over the years leading to cirrhosis of the liver, a severe disease that can lead to cancer over time. Overall, 75% of the interviewees for the survey, carried out with the unconditional contribution of Roche, stated that they needed the assistance of their loved ones (41% a family member and 31% more than a family member), 3% used of a paid helper and only 25% declare that they did not have any kind of support. More than one in two patients has experienced there is a strong need to have clear, precise and easily available information on the centers to contact, that is, capable of responding quickly and comprehensively to needs. Always for about half of the interviewees it is essential to be able to access priority paths for access to excellent facilities and be informed in order to access experimental therapies, as well as being able to have clear information on the concrete possibilities of treatment and above all on the real life expectancy. No less important, 52.4% expressed the will to be able to have the possibility of having access in a simple and clear way to information relating to the availability of experimental therapies and participation in clinical trials.
Experienced centers and multidisciplinary teams
The survey also revealed data on the need to have diagnostic therapeutic assistance paths (PDTA) on a regional basis and on the need to be able to take advantage of centers of excellence that are equipped with multidisciplinary teams able to manage the patient at 360 degrees. To obtain a complete diagnosis, 63% declared that they had to go to one or more facilities in addition to the one in which they were in care: 53% by their own choice, 30% on the recommendation of the same specialist and 17% because structure was not equipped. Today we are faced with a double challenge represented by the need to foster an ever greater knowledge of the risks associated with advanced liver disease and by the very essential need to promote synergistic collaboration of all the interlocutors involved in the treatment of the disease – he comments Ivan Gardini, president of the EpaC Onlus Association -: in fact, patients with hepatocellular cancer often present other concomitant pathologies and also for this reason it is necessary that they be followed by a multidisciplinary team that brings together the different skills. This synergy can be a great help for improve management not only for patients but also for caregivers, favoring the construction of local and regional networks in order to trace rapid routes to highly specialized hospitals.
The therapies
As for therapies, only patients at the initial stage can be subjected to surgical removal of tumor cells and, in very selected cases, a liver transplantation, which represents an optimal treatment because it also addresses and resolves the serious problem of liver cirrhosis. Other strategies available, depending on the size of the tumor and various other criteria, are local ablative (ie destruction) treatments, for example with radiofrequency, and the chemoembolization by arterial route. There are also some effective drugs and today new perspectives are opening up to offer a possibility of additional treatment capable of prolonging the survival even of the sick at an advanced stage.
December 28, 2021 (change December 28, 2021 | 09:31)
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