Liver disease is serious and requires treatment and regular monitoring by a liver specialist. A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner.

Over nearly 40 years of practicing medicine I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.

I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However, my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.

If you have any questions you may contact my naturopath, Christine, on 623 334 3232 or email us at support@liverdoctor.com

Liver tumors (cancer)

A liver tumor is an abnormal growth or mass found in the liver. Such tumors can be secondary or primary tumors.

Secondary liver tumors

The most common liver tumor is a secondary (metastatic) tumor. This means that the tumor has spread to the liver (metastasized) from its original source of origin in another part of the body. The most common sources of origin are cancers of the intestines, breast or bronchial tubes (lungs). The tumor will take root in the liver and continue to grow, often causing multiple tumors and eventually causing liver enlargement and perhaps yellow jaundice.

Primary tumors

Primary liver tumors begin their existence in the liver. Tumors that originate in the liver may be benign or malignant. Diagnosis is made with imaging techniques such as ultrasound scan, CAT scan or MRI of the liver.

Primary liver cancer

Primary liver cancer refers to cancer cells originating in the liver and is known as Hepatic Cell Carcinoma (HCC). Primary cancer of the liver is one of the most common cancers worldwide and often occurs in persons below the age of 50 years.

Recent progress in treatment protocols has improved the prognosis of patients with HCC; however, the long-term outlook remains disappointing because of the frequent recurrence rate and the spread of the cancer cells via the liver veins (portal venous invasion). This occurs in 16%–65% of patients and results in extensive spread of cancer cells through the entire liver.

The high mortality rate of HCC is the result of high recurrence in the liver via the liver veins (portal venous invasion). These disappointing statistics can be improved by using a holistic approach incorporating the use of nutritional supplements and raw juicing.

The symptoms of HCC usually progress rapidly and consist of weight loss, loss of appetite, fever, abdominal pain and swelling. The liver feels enlarged, hard and irregular. Primary liver cancer does not have a good outlook, and this is why it is important to avoid the factors that cause it. Early diagnosis and correction of these factors can prevent primary liver cancer.

In patients with chronic infection with the hepatitis C virus (HCV) or the hepatitis B virus (HBV) there is an increased risk of liver cancer.

Screening for liver cancer should be done every 6 months in hepatitis patients with the following factors –

• African or Asian descent and aged over 20
• Aged over 40
• Cirrhosis of the liver
• A family history of liver cancer

The screening tests that should be done include –

• A blood test to measure the level of alpha-fetoprotein (AFP), which is a marker for liver cancer
• An ultrasound scan of the liver

What factors increase the risk of primary liver cancer?

• Older age – In North America, Europe and Australia, liver cancer most commonly affects older adults. In Asia and Africa, liver cancer diagnosis tends to occur at a younger age (between 20 and 50) because of the high incidence of chronic viral hepatitis since childhood.
• Cirrhosis – over many years, chronic inflammation causes scar tissue to form in your liver and this increases your chances of developing liver cancer.
• Some genetic liver diseases – inherited liver diseases that can increase the risk of liver cancer include hemochromatosis (iron overload) and Wilson’s disease (copper overload).
• Diabetes – diabetics have a greater risk of liver cancer than people who don’t have diabetes.
• Fatty liver disease – accumulation of fat in the liver from poor diet increases the risk of liver cancer.
• Exposure to aflatoxins – Eating foods contaminated with fungi that produce aflatoxins increases the risk of liver cancer. Crops such as corn and peanuts can become contaminated with aflatoxins.
• Chronic infection with the HBV or the HCV.
• High alcohol intake – Drinking more than a moderate amount of alcohol over many years increases your risk of liver cancer.
• Obesity – If you are very overweight you have a higher risk of liver cancer.
• Your sex – men are more likely to develop liver cancer than women.

Liver cancer prevention and treatment

A healthy diet and lifestyle can greatly reduce your risk of liver cancer, even if you have a chronic viral infection of the liver. Overload with iron or copper can be treated which prevents liver cancer. Early diagnosis of liver disease enables treatment that can prevent liver cancer. Avoid smoking and excess alcohol intake and follow the dietary recommendations in this book.

If you are fighting liver cancer the following supplements will help your own immune system to fight the cancer and slow down its growth. They will also reduce the chances that the liver cancer will spread.

The most important nutrients to prevent cancer include –

• Selenium and zinc
• Vitamin D3
• Iodine
• Omega 3 essential fatty acids
• Phyto-nutrients and pigments found in a wide variety of herbs, fruits and vegetables
• Vitamin K

I urge you to check you have an adequate amount of these things in your diet and to supplement with vitamin D, selenium, zinc and iodine.

Selenium

An observation study of the liver cancer preventive effect of selenium supplementation was done in China. The 8-year follow-up data showed reduced primary liver cancer incidence of 35.1% in selenized table salt supplemented people versus the non-supplemented population. On withdrawal of selenium from the treated group, primary liver cancer incidence rates began to increase. However, the inhibitory response to the HBV was sustained during the 3-year cessation of treatment.

It takes quite a few months for the selenium to build up to protective levels in the important areas of your body, such as the liver and the immune system and thus a long term commitment to taking these supplements is needed.

References available on request

Vitamin K2 reduces growth and invasion of human liver cancer cells

Vitamin K2 may be a promising therapeutic treatment for the management of HCC.
A study examined the effects and mechanisms of the retardation of liver cancer cell growth induced by MK-4, which is a form of vitamin K2. The results were very positive; the rates of  venous invasion by liver cancer cells in the vitamin K–treated group were 2% at 1 year and 13% at 2 years; the rates were 21% at 1 year and 55% at 2 years in the control group.

Oral administration of vitamin K2 was shown to reduce the ability of liver cancer cells to invade and spread via the veins in the liver (portal venous system).

In this study, it was shown that vitamin K2 inhibits the invasiveness and growth of liver cancer (HCC) cells. This could be because high doses of vitamin K2 might alter the effects of key signalling molecules which stimulate cancer cells to grow. The benefit of vitamin K2 was apparent only at high doses, which is consistent with the finding that high doses of vitamin K2 were needed to inhibit liver cancer cell (HCC) activities. This study was reported in the journal Hepatology and produced results which suggest that high-dose vitamin K2 treatment can function as an inhibitor of primary liver cancer (HCC) cell growth.

Most of the present studies were performed using relatively high doses of vitamin K2. In Japan, vitamin K2 is usually administered to osteoporotic patients at a dose of 45 mg daily. Several reports have showed that orally administered vitamin K2 is concentrated in the liver, and the concentration in liver tissues is at least 10 times greater than in plasma. Thus, cancer cells situated in the liver might be exposed to higher concentrations of vitamin K2 because of more prolonged exposure. The data from this study indicates that vitamin K2 supplementation actually reduces the growth and invasion of liver cancer cells.

Vitamin K2 has no known adult human toxicity, which makes orally administered vitamin K2 a very promising treatment for preventing cancer and for keeping tumors inactive (dormant). More clinical trials are in progress to evaluate vitamin K2 in patients with primary liver cancer. Future trials may determine the efficacy of vitamin K2 for other types of cancer.

Reference: Motoyuki  Otsuka, et al, Vitamin K2 inhibits the growth and invasiveness of hepatocellular carcinoma cells via protein kinase A activation, Hepatology Volume 40, Issue 1 ; 243–251, July 2004

Liver cancer – Looking to the future

Primary liver cancer also known as hepatocellular carcinoma (HCC) has a very high rate of recurring in the liver which gives it a poor prognosis. To improve the outcome for patients with HCC, the development of a preventive compound that can reduce or delay the incidence of recurrence is a critical issue that demands urgent research.

To this end a compound called Acyclic retinoid (ACR) was studied as a preventative. ACR is a synthetic retinoid, which successfully improves HCC patient survival rates by preventing the recurrence and formation of new liver tumors.

ACR exerts its preventive effects on HCC development by inhibiting RXRα phosphorylation. The concept of “clonal deletion and inhibition” therapy is defined as the removal and inhibition of latent malignant clones from the liver before they expand into clinically detectable tumors. ACR prevents the development of liver cancer by utilizing this concept. In the future, combination chemoprevention using ACR as a key drug with synergistic effects may be an effective new strategy for the prevention of HCC.

ACR is also expected to prevent the development of liver cancer in obese people with fatty liver, who are at an increased risk of liver cancer.

Screening programs using new tests have enabled the early detection of liver cancer in patients with chronic liver disease and has increased the number of candidates for local treatments such as hepatic resection and percutaneous ablation therapy. It is disappointing that very few patients undergoing such local treatments can be cured and the overall results of these treatments are still unsatisfactory, mostly because of post-treatment recurrence.

Acyclic retinoid, also known as polyprenoic acid inhibits experimental liver cancer genesis (hepatocarcinogenesis) and induces death (apoptosis) of human liver cancer derived cell lines. Oral administration of polyprenoic acid for 12 months significantly reduced the incidence of a second primary liver cancer as compared with placebo. Furthermore, the survival rate was also significantly improved by polyprenoic acid; the 6 year survival was 74% in the polyprenoic acid group and 46% in the placebo group. Side effects of polyprenoic acid were mild and none of the usual toxicities of retinoids, such as dry skin, dry and cracked lips or conjunctivitis, were observed in this trial.

Among preventative treatments, the oral administration of polyprenoic acid (ACR) may be the most promising approach because of its simplicity, ready availability, non-invasiveness and the lack of the necessity for radiation protection.

However, it is early days and questions remain concerning the use of ACR in the prevention of liver cancer (HCC). These include –

• What is the optimal dose and duration of polyprenoic acid therapy?
• Who are the appropriate patients to be treated with this agent?
• Does adjuvant therapy with polyprenoic acid really reduce the incidence of second primary cancer and improve survival?
• Would polyprenoic acid therapy also successfully prevent the occurrence of primary HCC in patients with chronic liver disease?

To answer these questions a number of well controlled trials, such as dose finding trials and double-blind randomized controlled clinical trials are essential. Developments in the molecular biology of the origin of liver cancer (hepatocarcinogenesis) will enable the identification of a suitable patient population for this therapy.

Ref J. Clin. Oncol. (2001) 31 (8): 357-358.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.