Unique Palliative Care Challenges in a Young Adult With a Rare Malignancy

Area of Science:

• Oncology
• Palliative Medicine
• Gastroenterology

Background:

• Palliative care is increasingly integrated into standard medical practice for serious illnesses.
• Palliative care physicians provide specialized interventions to manage complex symptoms.
• Early palliative evaluation is crucial for patients with advanced or refractory conditions.

Observation:

• A 17-year-old male diagnosed with mixed hepatocellular carcinoma and hepatoblastoma faced disease progression.
• The patient developed malignant gastric outlet obstruction and refractory hypoglycemia.
• Referral for palliative care was initiated at age 20 due to disease progression and complex symptoms.

Findings:

• A strong patient-provider relationship facilitated identification of patient values.
• An individualized palliative and hospice care plan was developed.
• Interventions included endoscopic ultrasound-guided gastrojejunostomy and continuous at-home dextrose infusions.

Implications:

• This case highlights advancements in palliative medicine, incorporating procedural and home-based interventions.
• Palliative care can effectively align patient values with end-of-life goals.
• Successful symptom management and individualized care planning are key in complex oncological cases.