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Tuesday, 3 December 2013

Cirrhosis - Treatment of the complications of cirrhosis - Liver Cancer

Cirrhosis is defined as a condition of irreversible scarring liver as a result of liver tissue by fibrosis due to final phase of chronic liver diseases of that can lead to poor function of the liver and liver failure. According to the statistics, Number of discharges with chronic liver disease or cirrhosis as the first-listed diagnosis: 101,000 in 2009 and Deaths per 100,000 population: 10.3 in 2010(a). Hepatitis B infection cause of the disease is very prevalent in South-East Asia.
Treatment of the complications of cirrhosis
Liver Cancer(89)
A.2.2.1 In conventional medicine perspective

1. Surgery
a. The aim of the treatment is to cure the cancer with surgery, if possible. Otherwise, treatments are focused to treat and control the symptoms as long as possible. Surgical resection is the best chance for a cure, because of it liver's ability to regenerate when part of it is removed.
b. Risks and side effects
Surgical and anesthesia risks

2. Transplantation
a. Liver is the second most commonly transplanted major organ, after kidney. Statistic from United Network for Organ Sharing (UNOS) showed there are over 17,000 people in the US alone in a waiting list. The procedure of the transplant is to remove the failed liver by replacing it with the healthy donor's liver.
b. Risks and side effects
b.1. Surgical and anesthesia risks
b.2. Rejection
New implant liver is rejected by the immune system
b.3. Nausea
b.4. Pain
b.5. Fever
Due to infection
b.6. Jaundice
As the result of new liver has not function well.
b.7. Weakened immune system
Due to drugs used to suppress the immune system for accepting the implanted liver.
b.8. Side effects of drugs use
b.9. Etc.

3. Hepatic arterial embolisation
a. It is a procedure with an aim to block the blood supply to the tumor in the liver if liver surgery is not possible. It is considered effective if the vessels which supply oxygen and nutrients to the tumor has been cut off, leading to shrinking of the tumor. In hepatic arterial embolization, a narrow tube is inserted into a blood vessel through a small cut in the groin then passed up to the artery blood vessel to block the blood flow to the liver's tumor.
b. Side effects
It is important to note that side effects will disappeared in a few days.
b.1. Nausea and vomiting
b.2. Back pain
b.3. Fever
b.4, Etc.

4. Ablative therapy
a. Ablative therapy has been quite sometime to treat hepatocellular carcinoma by destroying the tumor without removing it, including the uses of heating with radio waves and microwaves, alcohol and freezing (Crytherapy).
b. Risk and side effects
b.1. Belly pain
b.2. Infection
b.3. Bleeding in the chest or abdomen
b.4. Etc.

5. Radiotherapy
By using high-energy x-rays or other types of radiation, radiation therapy kills liver cancer cells and keep them from growing or regrowing. Depending to stage or grade there are two types of radiation therapy.
a. External radiation
By using a machine outside the body to send direct high-energy x-rays or other types of radiation toward the cancer.
b. Internal radiation
By placing a radioactive substance direct into or near the cancer by a medical instrument with the aim to kill nearby cancer cells.
c. Side effects
c.1.. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

6. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of hepatocellular carcinoma, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.


A.2.2.2. in Herbal medicine perspective
1. Fenugreek
Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.

2. Cinnamon
Cinnamon is an evergreen tree, genus Cinnamomum, belonging to family Lauraceae, native to southern China, Bangladesh, India, and Vietnam. In a study in 2005. researcher found that Chemical aspects of coumarin compounds in cinnamon for the prevention of hepatocellular carcinomas.

3. Scutellaria
Scutellaria is also known as skullcaps, a genus of flowering plants, genus Scutellaria, belonging to family Lamiaceae. In a study of Inhibition of Cancer Cell Proliferation and Prostaglandin E2 Synthesis by Scutellaria Baicalensis, researchers found that Scutellaria baicalensis selectively and effectively inhibits cancer cell growth in vitro and in vivo and can be an effective chemotherapeutic agent for HNSCC. Inhibition of PGE2 synthesis via suppression of COX-2 expression may be responsible for its anticancer activity.

4. Japanese carnelian cherry
Japanese cornelian cherry is a genus Cornus, belonging to family Cornaceae, native in China, Japan and Koren. In a study of Chemoprevention against hepatocellular carcinoma ( liver cancer ) of Cornus officinalis in vitro by Am J Chin Med. 2004, researcher found that extracts of Cornus officinalis possessed the anti-oxidant activity through free radicals scavenging activity at a concentration of 50 microg/ml. In summary, our experiment implied that C. officinalis might be a candidate for chemopreventive agent against hepatocellular carcinoma through the antioxidant and anti-neoplastic effects

5. Etc.

A.2.2.3. Traditional Chinese medicine
1. Rou Qui
Rou Qui is also known as Cinnamon Bark. The sweet, acrid and very warm herb has been used in TCM to treat cold limbs, cold limbs, diarrhea, muscle spasm, headache, back pain, sweating and impotent and promote urination as it tonifies fire, enhances yang, disperses cold and promotes circulation in the channels by enhancing the functions of heart, ling and gallbladder channels. In a study in 2005. researcher found that Chemical aspects of coumarin compounds in cinnamon for the prevention of hepatocellular carcinomas.

2. Nu Zhen Zi
Nu zhen Zi is also known as privet fruit. The bitter, sweet and neutral herb has been used in TCM as anti inflammatory, anti cancer and anti oxidization medicine and to regulate immune system, lower blood sugar as it tonifies the liver and kidney, benefits the liver and kidney and clears heat by enhancing the function of liver and kidney channels.

3. Bai Zhi Lian
Ban Zhi Lian is also known as scutellaria. The bitter and cool herb has been used in TCM as diuretic and to treat tumors and cancer as it clears heat, expels toxins, eliminates stagnation, stops bleeding and calms pain by enhancing the functions of lung, liver, spleen, stomach and large intestine channels. In vitro study, essential oil extract of 200mg/ml of the herb possesses the effect of inhibiting the tissues of rectum cancer or colon cancer.
In lab tests of animals and breast-cancer cells, BZL101 caused apoptosis or cell death, researchers found.

4. Long Kui
Long Kui is also known as wonderberry. The bitter, cold, slightly sweet and toxic herb has been used in TCM as diuretic and antipyretic and to treat acute kidney inflammation, chronic bronchitis, throat cancer, larynx Cancer, uterus cancer as it clears heat, eliminates toxin, improve urination by enhancing the function of liver, kidney and stomach channels. A study was done at the College of Environmental and Chemical Engineering at the Yanshan University in Hebei, China, researcher found that the tumor growth inhibition of long kui polysaccarides might correlate with the reduction of TNF-alpha level of blood serum, which resulted in a massive necrosis (accidental death of cells) in tumor tissues and the up-regulation of Bax and down-regulation of Bcl-2 and mutant p53 gene expression, which triggered apoptosis in tumor cells.

5. Bai Hua She She Cao
Bai Hua She She Cao is also known as spreading hedyotis, The bitter, sweet and cold herb has been used in TCM as anti-bacteria, anti-inflammation, anti-tumor, anti-virus agent and to treat snakebite and enhances immune system as it clears heat, drains dampness, expels toxins and resolves abscesses by enhancing the functions of liver, stomach, large intestine channels.
The Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine, National University of Singapore researcher results showed that the ethanol extract from Bai Hua She She Cao effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

7. Etc.
 
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Sources
(a) http://www.cdc.gov/nchs/fastats/liverdis.htm

(89) (http://medicaladvisorjournals.blogspot.ca/2011/06/cancer-from-b-to-t-most-common-types-of_20.html