Clinical nurse specialist role in setting up a joint hepatocellular carcinoma clinic at a specialist liver unit

Abstract

The incidence of hepatocellular carcinoma (HCC) is increasing. Notably, the majority of these patients have two potentially life-threatening conditions (cirrhosis and HCC), and management requires close working between several specialties. Treatment of HCC is also an active area of research, and the last decade has seen an increase in the number of complex treatment strategies that can be applied in this disease. When the author started working at the Royal Free Hospital, London, in 2010 as the hepato-pancreato-biliary oncology clinical nurse specialist, it soon became apparent that the HCC service was growing rapidly. However, the service appeared fragmented; HCC patients were being managed solely by hepatologists, oncologists or surgeons, and they had different treatment pathways. Given the dual pathology of HCC patients, and with the increasing number of treatment options available, the team decided on a more central way of managing them, which was to set up a joint HCC clinic. This article describes the evolution of the clinic, including the role played by the dedicated HCC clinical nurse specialist.