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Living with cancer· Appointment prep

Appointment sheet: Early hepatocellular carcinoma (BCLC 0 and A)

One page to bring and write on: your details, the questions for Early hepatocellular carcinoma (BCLC 0 and A) plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Early hepatocellular carcinoma (BCLC 0 and A)

Prepared with OnCo (onco.cc/prep/hcc-early/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

16 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example BCLC stage, Child-Pugh and ALBI liver function, Portal hypertensionbefore resection, Alpha-fetoprotein, LI-RADS imaging category on contrast CT or MRI, Microvascular invasion and satellite nodules on the resected specimen), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Single tumour, preserved liver function
  1. 5.For my situation (single tumour, preserved liver function), which of the standard options do you recommend and why?
Within Milan criteria with cirrhosis or portal hypertension
  1. 6.For my situation (within milan criteria with cirrhosis or portal hypertension), which of the standard options do you recommend and why?
Not suitable for surgery or ablation
  1. 7.For my situation (not suitable for surgery or ablation), which of the standard options do you recommend and why?
After curative treatment
  1. 8.For my situation (after curative treatment), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Atezolizumab, Bevacizumab, and what side effects should I expect?
  3. 10.How do the results of IMbrave050 apply to someone like me?
Detection
  1. 11.For my situation (detection), which of the standard options do you recommend and why?
Any stage
  1. 12.Are there clinical trials I could join, for example of IMbrave050, Liver transplantation for cancer (Milan criteria and beyond), Immunotherapy downstaging to transplant with a safe washout, Blood-based HCC surveillance to replace six-monthly ultrasound?
  2. 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 15.I read that “Recurrence in the remaining cirrhotic liver after resection or ablation”. How does that affect my plan?
  5. 16.I read that “No adjuvant therapy has held up in a phase 3 trial”. How does that affect my plan?

The words I may hear

  • Bridging therapy: Treatment given to keep a fast-growing cancer in check during the weeks between deciding on CAR-T (or transplant) and actually receiving it, while the cells are being manufactured or a donor found.
  • BCLC staging: The liver-cancer staging system that combines tumour size, liver function and fitness to recommend treatment: ablation or surgery, transplant, TACE, or drugs.
  • Hepatitis B and C as cancer causes: Two viruses cause most liver cancer worldwide.
  • Microwave ablation (MWA): Like radiofrequency ablation but using microwaves, which heat faster and larger volumes and are less affected by nearby blood vessels.
  • Radiofrequency ablation (RFA): Killing a tumour by heating it with an electrical current through a needle placed under image guidance, without removing it.
  • Alpha-fetoprotein (AFP): Alpha-fetoprotein is a protein made by the fetal liver that a substantial share of hepatocellular carcinomas switch back on.
  • Hepatectomy (liver resection): Cutting out the part of the liver containing tumour.

Tests and results to bring

Biomarker results to ask for: BCLC stage, Child-Pugh and ALBI liver function, Portal hypertension (platelets, varices, hepatic venous pressure gradient) before resection, Alpha-fetoprotein (prognosis and transplant selection), LI-RADS imaging category on contrast CT or MRI, Microvascular invasion and satellite nodules on the resected specimen.

Scans and tests linked to this cancer: HCC surveillance in cirrhosis (ultrasound + AFP), MRI, Ultrasound, MRD / molecular residual disease testing.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call