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ESMO Patient Guides COVID19 1000x250

Outpatient visits

High priority

Your outpatient appointment may be a high priority if:

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    Your liver is not working properly (decompensated liver) and you are experiencing symptoms such as fatigue, jaundice, abdominal pain, nausea or fever
  • You are on the waiting list for a liver transplant
  • Your doctor thinks that you might have HCC
  • You have recently been diagnosed with HCC and are waiting to start treatment
  • You are experiencing moderate to severe side effects from your HCC treatment

Medium priority

Your outpatient appointment may be a medium priority if:

  • You have been newly diagnosed with HCC but the tumour(s) is/are very small (<1 cm)
  • You are responding well to your current treatment for HCC with no significant side effects. In these cases, any planned follow-up visits may be conducted via telephone
  • You are experiencing some mild side effects to your treatment for HCC
  • You have an appointment to obtain a second opinion on your HCC diagnosis/treatment

Low priority

Your outpatient appointment may be a low priority if:

  • It is a follow-up visit because you have had HCC but have been in remission for a long time (more than five years). In these cases, any scheduled blood tests and/or imaging appointments may be relocated to your local healthcare centre, with subsequent results discussed between you and your doctor by telephone
  • You have end-stage liver function. In these cases, appropriate supportive care can be arranged close to home by telephone

Diagnosis and imaging

High priority

Your appointment may be a high priority if:

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    You need additional imaging tests to confirm a diagnosis of HCC where previous examinations/tests suggest that a diagnosis of HCC is possible
  • You have an imaging appointment to see how your HCC is responding to treatment
  • You have an imaging appointment to see if your HCC has spread to your bones
  • You have an imaging appointment because your liver is not working properly (decompensated liver)

Medium priority

Your appointment may be a medium priority if:

  • You have an imaging appointment to assess small (<1 cm) lesions in your liver that your doctor thinks might be HCC

Low priority

Your appointment may be a low priority if:

  • You are due to have an imaging assessment as part of routine screening. In these cases, your appointment may be delayed depending on how likely it is that you will develop HCC. For example, people with known risk factors for HCC, such as those with advanced cirrhosis, chronic hepatitis B virus (HBV), Non-alcoholic steatohepatitis (NASH) or diabetes, may be prioritised over people without any known risk factors
  • You have a follow-up imaging appointment because you have had HCC but have been in remission for a long time (more than five years). In these cases, any scheduled blood tests and/or imaging appointments may be relocated to your local healthcare centre, with subsequent results discussed between you and your doctor by telephone

Surgery

High priority

Your appointment may be a high priority if:

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    You have acute or chronic liver failure or end-stage liver disease and are due to have a liver transplant
  • You are due to have surgery to remove a large HCC tumour in your liver

Medium priority

Your appointment may be a medium priority if:

  • You are due to have a liver transplant but you don’t currently have any symptoms of liver disease
  • You are due to have surgery to remove a small HCC tumour in your liver

Radiotherapy

High priority

Your appointment may be a high priority if:

  • Your HCC has been staged as Barcelona Clinic Liver Cancer (BCLC) stage A and you are due to receive treatment with transarterial chemoembolisation (TACE) or selective internal radiotherapy (SIRT) whilst you wait for a liver transplant
  • You are due to receive treatment with TACE or SIRT as a palliative treatment for HCC

Medium priority

Your appointment may be a medium priority if:

  • Your HCC has been staged as BCLC stage 0 and you are due to receive treatment with TACE or SIRT whilst you wait for a liver transplant
  • You are due to receive thermal tumour ablation therapy in order to destroy a small HCC tumour

Low priority

Your appointment may be a low priority if:

  • You are due to receive a form of radiotherapy-based treatment that is unlikely to provide significant benefit and where the risk of COVID-19 infection outweighs any potential benefit of treatment

 

Systemic treatment

High priority

Your appointment may be a high priority if:

  • You are scheduled to receive first- or second-line treatment for your HCC. However, some of your outpatient visits and follow-up appointments may be relocated to your local healthcare centre or conducted via telephone

Medium priority

Your appointment may be a medium priority if:

  • You are scheduled to receive an investigational treatment for your HCC that is unlikely to provide significant benefit

Low priority

Your appointment may be a low priority if:

  • You have an appointment for weekly blood tests to monitor your progress whilst receiving systemic treatment for HCC. These tests may be delayed providing you do not have any symptoms
  • You are due to undergo imaging tests to monitor your progress whilst receiving systemic treatment for your HCC

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