Hepatocellular Carcinoma: What Are the Palliative Care Options?

Palliative care must be proposed early to hepatocellular carcinoma patients due to the alteration brought about by the disease in the quality of life. Sleep difficulty is improved by proper sleep hygiene and eventually hydroxyzine low dose. Depression may require serotonin recapture inhibitors. For malnutrition and sarcopenia, a good assessment of nutritional status will help; frequent meals, a late evening snack, eventually oral nutritional supplements, and sometimes enteral nutrition are of major importance; branched-chain amino acids can be a good support. Pain management is frequently underused; paracetamol can be safely used (2-3 g/d); Non Steroidal Antiinflammatory Drugs (NSAIDs) must be avoided; opiates are the second line treatment of choice but are started at low and infrequent doses with slow increment. In all cases, an honest communication with the patients and appropriate care of the family are key.