Global Perspective
Liver cancer has been reported to be the fifth most frequent cancer worldwide in accordance with incidence and fourth-most regular reason for
cancer-related deaths. The incidence of liver cancer is reported to be almost from 250,000 to 1,000,000 latest cases per year worldwide.
Elevated occurrence of liver cancer is reported in developing countries while low incidence is seen in developed countries. Hepatitis C virus (HCV) infection is one of the main reasons for liver disease globally. Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at an advanced stage. Some HCV-affected individuals remain asymptomatic for long periods of time and may never develop progressive liver disease. However, few of these patients develop hepatic de-compensation and/or hepatocellular carcinoma. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of health-related quality of life among liver cancer patients. Poor quality of life in liver cirrhosis patients was found associated with the severity of the disease. Chronic liver disease negatively impacts patients’ utilities and health-related quality of life. Non-cirrhotic patients and Child’s A cirrhotic patients had decreased utilities and heath relevant quality of life but Child’s B and C cirrhosis patients had a more significant reduction in utilities in comparison.
Quality of Life and Psychological Distress among Liver Cancer Patients
The rising prevalence of hepatocellular carcinoma in Pakistan has been reported mainly due to Hepatitis C-related chronic liver disease. Hepatitis C virus infection is found to be predominant risk factor for liver cancer in Pakistan. Less than 10% of liver cancer patients with risk factors are screened. Diagnosis of liver cancer is mostly done only when such patients become severely symptomatic at an advanced stage. Out of diagnosed patients, only a few fulfill the criteria for treatment options while the majority are provided only with supportive care. Deprived health-related quality of life in liver cirrhosis patients has been reported in Pakistan. Association among health-related quality of life and hemoglobin, serum albumin, and previous history of encephalopathy and upper gastrointestinal bleed has been reported. A study was designed to assess
quality of life and depression among Liver Cancer patients in Pakistan. The study site for the research included public and private healthcare facilities located in twin cities of Pakistan. The study concluded that liver cancer had a negative impact on risk
factors/past medical history, co-morbidities, and poor socio-economic of life across all domains
along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk
factors/past medical history, co-morbidities and poor socio-economic status negatively affected
functional and symptom scale. Appropriate health educational and psychological interventional
programs targeting patients should be initiated to improve awareness and reduce depression
among liver cancer patients.