About Liver Cancer

Nurses General Nursing

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I will try to make this short.

I recently found out my ex husband, divorced to 10 years, has liver cancer. We have a 14 year old daughter. We divorced due to problems that eventually damage your liver, abuse of alcohol and prescription pain meds. He has cirrhosis, hepatitis B, diabetes and now cancer. (all of this came about after we divorced)

Most all of my experience with liver cancer has been as a hospice nurse, so of course they were all terminal. The only information I can get from him is basic and that they are going to do surgery. He doesn't know what surgery, he doesn't seem to know if chemo or radiation is planned. He still abuses medication and his liver enzymes are always whacky, he is not a very reliable source for information and because I am an ex I am not privy to it from the doctor.

My daughter is really fed up with him but I haven't told her anything about the cancer yet. I really don't know what to say. I need to talk to her this coming weekend because the surgery is next week. Even though she is irritated with all that he has done she is going to be devstated. This is her father and despite it all she loves him. I start to think about this talk and I could almost hyperventilate.

Maybe there is something I don't know, but honestly, isn't this usually terminal? How do you tell a 14 year old her dad is terminal?

without knowing the specifics, it is likely that it is terminal...

esp where i don't think he'd be a candidate for a transplant.

you tell your dtr that dad is very sick...

and that it doesn't look good for him.

and that all you can do is pray (if you're the praying type) that he remains free of pain.

and the doctors and nurses will also make sure he doesn't suffer.

prepare her that he may get confused, his belly may get big, etc...

but for now, everyone is going to take it one day at a time.

support her in how she chooses to handle this.

many loving hugs to you and your dtr.

leslie

Thanks for responging:

He has been sick for a LONG time. He already looks like he just came from a concentration camp and has for a while now.

She is quite interested in medicine and wants to be a doctor. She is very savvy when it comes to medical things. She knows alot more than the average teen when it comes to medicine, I guess, because I am nurse and she reads alot and watches alot of medical tv shows. She will want answers.

Specializes in behavioral health.

My ex has liver cancer too. We have been divorced since 1987. He was more into drugs than drinking. Not only was he a lousy husband, but a terrible father to our children. He wasn't involved very much with them. He wanted to see them when it was convenient for him. And, he wanted to do things with them that "he " wanted to do. He has hx of Hep. C (after we split up) and cirrhosis. My children are now grown ages 24 and 26. He has kept in touch with my son, who he always favored. However, not with my daughter. He wants nothing to do with her since she had bi-racial baby. Neither, of my children were very affected by the news of his liver cancer. And, my daughter is already feeling guilty for not being able to feel "a loss" when her father dies. My son will feel bad, but more for his grandmother's loss. They have remained close with their paternal grandmother all of these years.

My ex has had surgery and gone through all of the tests for a transplant. He is on the transplant list. Several months ago, he was hospitalized for pancreatitis. Also, has had his gall bladder removed. The surgeon says that he saw no sign of cancer when he had the gall bladder removed. So, his was more localized.

My ex no longer drinks, but I am sure that he abuses his pain meds. As that was his DOC. Unfortunately, now he has reason for taking them.

My son live in the west, and we live in the northeast. This was news that I did not want to tell him over the phone. We told him when he was home for visit a few months ago. He took the news very well. It is his dad and he does love him. But, he is not close with him and there is still much resentment towards him.

As far as my ex's prognosis, I am very optimistic, IF he receives his transplant Also, if his body does not reject it. In fact, he has a friend that had a transplant 20 years, ago. Also, my deceased brother had a friend who had three transplants. It is a miracle that he is still alive. He had been in a coma for over a year. Today, this man lives like he is dying. e.g. He is taking all kind of trips and living life to its fullest.

I can empathize with you. When you tell your daughter, explain it in the most optimistic way that you can. I am really sorry. I believe that I know what you are going through.

She is quite interested in medicine and wants to be a doctor. She is very savvy when it comes to medical things. She knows alot more than the average teen when it comes to medicine, I guess, because I am nurse and she reads alot and watches alot of medical tv shows. She will want answers.

ok, here's an excellent link you can have her read.

http://www.nci.nih.gov/cancerinfo/pdq/treatment/adult-primary-liver/patient/

i'm sure she'll appreciate receiving this information, and sounds like she wouldn't want the situation to be sugar-coated...

just the facts, as you know them.

but since she has this interest in learning, equip her with any/all pertinent data r/t her father's dx.

i've dealt with many teens in hospice...

and can confidently tell you that most (i want to say all) want to know the facts.

with peace,

leslie

A few yrs ago I had to tell my then 9 and 10 year that Dad was unexpectantly on life support and was not going to live. These were guidelines I used:

Keep it simple. It's easy to babble on and focus on what you feel comfortable with--the medical field. But it is not her focus.

Let her know no matter what has been thought or said about him in the past that she did not play a role in his disease/death. His life choices may have played a role in his death but nothing she may have done.

Explain what Hospice is and their role in his care.

Be honest--don't sugar coat the facts. Let them know exactly what is going on, and as death approaches, let her know what may happen.

Review the 5 stages after death according to Kubler-Ross, and let her know what she may be feeling before, during and afterward.

Make sure she knows mom will be there. But think about having a Trust drawn up and let her know what will happen should anything happen to you.

I will try to make this short.

I recently found out my ex husband, divorced to 10 years, has liver cancer. We have a 14 year old daughter. We divorced due to problems that eventually damage your liver, abuse of alcohol and prescription pain meds. He has cirrhosis, hepatitis B, diabetes and now cancer. (all of this came about after we divorced)

Most all of my experience with liver cancer has been as a hospice nurse, so of course they were all terminal. The only information I can get from him is basic and that they are going to do surgery. He doesn't know what surgery, he doesn't seem to know if chemo or radiation is planned. He still abuses medication and his liver enzymes are always whacky, he is not a very reliable source for information and because I am an ex I am not privy to it from the doctor.

My daughter is really fed up with him but I haven't told her anything about the cancer yet. I really don't know what to say. I need to talk to her this coming weekend because the surgery is next week. Even though she is irritated with all that he has done she is going to be devstated. This is her father and despite it all she loves him. I start to think about this talk and I could almost hyperventilate.

Maybe there is something I don't know, but honestly, isn't this usually terminal? How do you tell a 14 year old her dad is terminal?

This is probably hepatocellular carcinoma (HCC). The prognosis depends on the extent, tumor size and metastatis. The only real cure for HCC is liver transplant. The tumor(s) have to be under a certain size for most centers to consider transplant. Use of alcohol and prescription drug abuse are all problems. Palliation can be effective in some patients and give them good quality of life. Besides resection (surgery) many programs are using radio frequency ablation or Ytrium beads with good effect. Just because someone has liver cancer doesn't mean its terminal. However, the combination of liver cancer, cirrhosis and certain lifestyle choices are usually fatal in the near or long term.

David Carpenter, PA-C

Update:

I talked with my daughter about this on Friday and she did better than I thought. Thanks for the advice.

The surgery is Thursday we'll see how it goes from there. From what I read I wouldn't think he would have been a candidate for a resection but it looks like they are doing one.

Shelley

Update:

I talked with my daughter about this on Friday and she did better than I thought. Thanks for the advice.

The surgery is Thursday we'll see how it goes from there. From what I read I wouldn't think he would have been a candidate for a resection but it looks like they are doing one.

Shelley

shelley, what a relief.

keep us updated, please?

leslie

The relief was short lived.

I received a call from my ex father in law this evening the surgeon called them in and the surgery is cancelled, the tests that were did show mets to the spine. The doctors are going to meet and decide how to proceed from here????

Shelley

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

It doesn't sound good. Be honest because she's going to look it up on the internet anyway. Tell her what you know and that you're going to be there for her anyway that she needs you.

i agree...not good.

and definitely, remain honest with your dtr...

taking it 1 piece of news at a time.

warmest wishes.

leslie

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