Primary liver cancer is one of the 10 common cancers worldwide with a male to female ratio of (4:1). The most important risk factors for the development of hepatocellular carcinoma (HCC) are chronic hepatitis B/C virus infection, chronic alcoholism, and consumption of aflatoxin (a fungal toxin that contaminates stored grains). Geographical areas with higher incidence of hepatocellular carcinoma have been found to also have higher incidence of chronic hepatitis B virus infection.
Pain in the right hypochondrium, weight loss, anorexia, fever, lethargy, abdominal swelling, and bone pain are the common features of liver cancer. Rapid development of these features in a chronic hepatitis B patient is suggestive of HCC. The best treatment is liver transplantation when the disease is localized to the liver and has not spread to the surrounding structures. However most patient presents with advanced disease and compatible donors are also limited. Thus prevention is the way forward.
In a study conducted in Taiwan, about 21000 patients with chronic (HBV) infections participated and were followed up for 15years. The incidence of hepatocellular carcinoma was found to reduce by half in patients treated with Chinese herbal medicine (CHM) as compared to those not treated with CHM (5.28% vs. 10.18%).
A similar study was conducted on 127 237 liver cancer patients from 2009 to 2011. The use of traditional Chinese medicine as an adjunct treatment was demonstrated to prolong survival of patients. Patients taking herbs were significantly associated with a decreased risk of death. This is made possible by its ability to stimulate host immune response for cytotoxic activity against the malignant cells and thus, inhibit tumour growth, metastasis and reduce the side effects of chemotherapy.
Thus, to reduce the incidence of liver cancer in patients with hepatitis B virus infection, and prolong the survival of those with liver cancer, CHM has been advocated to be incorporated in the treatment protocols of hepatitis B virus infection and liver cancer.
1) Liao YH1,2, Lin CC3,4,5, Lai HC4,6, Chiang JH7,8,9, Lin JG1, Li TC Adjunctive Traditional Chinese Medicine Therapy Improves Survival Of Liver Cancer Patients. Liver Int. 2015 Dec;35(12):2595-602. doi: 10.1111/liv.12847. Epub 2015 Apr 29 Link
2) Tsai TY, Livneh H, Hung TH, Lin IH, Lu MC, Yeh CC. Associations Between Prescribed Chinese Herbal Medicine And Risk Of Hepatocellular Carcinoma In Patients With Chronic Hepatitis B: A Nationwide Population-Based Cohort Study. BMJ Open. 2017 Jan 25;7(1):e014571. doi: 10.1136/bmjopen-2016-014571. Link