Your Clinical Team
There are several specialists involved in the care of patients with primary liver cancer who come together in a multi-disciplinary team (MDT) to discuss your diagnosis and the best treatment options.
This may vary slightly by region but normally includes surgeons, hepatologists, radiologists, pathologists, oncologists and specialist nurses.
In this video Professor Helen Reeves introduces the MDT and how they will be involved in your care.
Find out a bit more about how different specialists will be involved in your care.
Heptologists are physicians or medical doctors, with specialist knowledge of looking after patients with liver problems. Many people who develop liver cancer, have a pre-existing liver condition. So it is important to have a hepatologist involved, to work out if the treatments available are safe. Hepatologists also help to look after people's livers when they are having treatment for their liver cancer. Hepatologists are often involved at the start of a patient's journey from diagnosis, helping to choose the right treatments - with surgeons, radiologists and oncologists - and assessing the success of it.
Clinical Nurse Specialist
A Clinical Nurse Specialist (CNS) is also sometimes known as a ‘key worker’ and will be someone dedicated to a particular area of nursing. A liver cancer CNS will have essential skills, knowledge and experience caring for patients with liver cancer. The CNS is often closely involved in patient care, guiding treatment decisions, but also providing psychological support and symptom control. Your CNS is the person who can advise you on what to do, if you have a problem, as well as help you get in touch with additional people to help you, if that’s needed.
Hepatobiliary surgeons are those who are experienced in operating on a person's liver. Surgeries include laparoscopic or open procedures, removing or sometimes ablating liver tumours. In patients with early stage cancers surgeons also perform liver transplant operations. Our surgeons know about the anatomy of the liver, the blood supply to different lobes, what kind of operations people need, and how much liver needs to be left behind in different patients. With the rest of the team and the patients, surgeons decide if an operation is the right thing for individual people.
An oncologist is a doctor who provides specialised treatments for patients with cancer. A liver oncologist is one who typically focuses on medical treatments that slow down or kill cancer cells. Some oncologists also treat patients with radiotherapies, which needs to be very carefully targeted in liver cancers, so as not to damage liver tissues and liver function. Oncologists are always trying to find better treatments, so they often work in clinical trials units exploring different types of treatments.
Palliative care specialist
Sometimes there is not a specific anti-cancer treatment – either curative or palliative – that our patients can have that will help them. For these people, we focus on their supportive care – looking at a person's symptoms or needs. Whether it's not eating enough, trouble with bowels, sleep, energy levels, pain or anxiety. We know that ‘best supportive care’ focused on individual needs can help people live longer, as well as have a better quality of life. Palliative care specialists include specially trained consultants and nurses, but often many other doctors (eg. G.P.s) and team members (district nurses) who also have expertise. Palliative support can be organised in hospitals, at home and also sometimes in a hospice.
Specialised liver cancer radiologists are medical doctors who those who diagnose the cancers and how advanced they are using medical imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). Interventional radiologists are those who also perform investigations that are guided by imaging (biopsies, liver pressure studies). They also perform some of the treatments, like ablation or transarterial chemo-embolisation (TACE).
If you can, continuing to do some kind of exercise can also be beneficial to you if you have cancer. A physiotherapist is a person qualified to treat people – sometimes with physical methods like massage or heat. Stretching or exercises can also be very helpful in maintaining strength and fitness. Specialist physiotherapy support is not always available when you need it, but ask your doctors or nurses if you think this might help you. On our website, we have also provided some information that you might find helpful.
Continuing to eat and what you eat, is very important – especially if you have cancer. Dieticians understand the process your body goes through when you have liver disease or cancer and can advise people on what they should eat. Not all MDT have a dietician on hand to see and advise patients with liver cancers, so we have provided some advice on our website.
A pathologist is a specialist doctor who studies tissues or cells and interprets changes that occur in disease. A pathologist will study liver biopsy tissues, sometimes with specialised stains and techniques, that help to confirm a diagnosis of cancer – as well as the type of cancer. Pathologists also look carefully at tissues removed at the time of an operation, to ‘stage’ a cancer and tell the team how advanced a cancer is. This can mean in terms of size, but also numbers – sometimes cancers are too small to be seen on scans. At the time of an operation, lymph nodes are often sampled and pathologists will look at these as well, to see if cancer cells have spread there.
This website has been created for you by members of the HUNTER team, a group of researchers and clinicians working to improve the outcomes for patients with liver cancer.
You can find out more about the research being undertaken by HUNTER researchers here.
Living with Liver Cancer has been a collaborative effort which would not have been possible without all of these people.
Professor Helen Reeves
Professor of Liver Cancer & Honorary Consultant Gastroenterologist, Newcastle Hospitals
Professor Derek Manas
Consultant Hepatobiliary and Transplant Surgeon, Newcastle Hospitals
HUNTER Research Technician, Newcastle University
Dr Emily Mavin
HUNTER Project Manager, Newcastle University
Dr Louise MacDougall
Hepatologist, Newcastle Hospitals
Dr Kate Hallsworth
Senior Research Physiotherapist, Newcastle Hospitals
Dr Sam Orange
Lecturer in Exercise Physiology, Newcastle University
Dietician, Newcastle Hospitals
Clinical Nurse Specialist & Macmillan Cancer Nurse Specialist, Newcastle Hospitals
Professor Tim Meyer
Oncologist, Royal Free London
Clinical Nurse Specialist, Kings College Hospital
Macmillan Nurse Specialist, Royal Free London
Patient support group, Newcastle
Mr Ian Parker
Patient representative, Newcastle
Dr Tom Ewen
HUNTER Project Manager, Newcastle University
Cancer Research UK