Liver cancer, also known as hepatocellular carcinoma, can be primary or secondary. Primary liver cancer arises from liver cells, which become abnormal in both their behavior and their appearance.

Secondary liver cancer arises from another place in the body. This metastatic spread most commonly comes from cancer of the colon, breast, stomach, pancreas, bladder, kidney, ovary, uterus, or lung.

A third type of liver cancer, known as metastatic liver cancer, is a very rare condition when primary liver cancer spreads to other locations in the body.

Primary liver cancer often occurs in patients who have a known history of chronic liver disease, resulting in cirrhosis. Risk factors include:

• Hepatitis B
• Hepatitis C
• Alcoholic abuse
• Non-alcoholic fatty liver disease (steatohepatitis)
• Obesity
• Elevated iron content in the blood (hemochromatosis)
• Male gender
• Age 55 or older
• Asian or Hispanic ethnicity
• Liver cancer in a first-degree relative (parent or sibling)

Liver cancer doesn’t always result in symptoms, but as the tumor grows larger it can press on other structures and cause symptoms. Examples include:

• Jaundice (yellowing of the skin and eyes)
• Decreased appetite
• Nausea/vomiting
• Ascites (fluid accumulation in the belly)
• Swollen feet/legs
• Weight loss

The process of diagnosing liver cancer typically begins with imaging such as an ultrasound, CT scan, or MRI. A sample of tissue, known as a biopsy, is taken if the tumor is in an easily accessible location. If a biopsy is not possible, liver cancer can be diagnosed based on a combination of imaging and lab testing. The lab test typically drawn to evaluate for liver cancer is alpha-fetoprotein (AFP), which is usually elevated in about 75% of patients with liver cancer.

After diagnosis, liver cancer is staged based on the extend of spread.

Conventional medicine treatments for liver cancer will depend on the location of the tumor(s) and how widespread the cancer is. Liver tumors can sometimes be surgically removed if they are of smaller size and in an easily accessible location. Radiation, embolization, and chemotherapy are also used in conventional medicine.

In integrative oncology, we not only rely on the aforementioned treatments, but also emphasize multiple intravenous therapies, nutrition, supplementation, and mind-body medicine. The goal is to approach each cancer case in as detailed a manner as possible. Thus, we do not only focus on the specifics of the cancer itself, but on the specifics of the patient. We also take many factors into consideration, including the patient’s past medical history, lifestyle, support system, and treatment goals. Once we account for all of these variables, we are left with a case that is as unique as a fingerprint. We feel that such a patient-centered approach is essential in the treatment of cancer.

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The most caring physician

Dr. Stegall is the most caring physician.

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