Dr. Fong is the Medical Director of the USC Liver Transplant Program and Associate Professor of Medicine at the USC Keck School of Medicine. He obtained his medical degree from the University of Southern California and completed his residency in Internal Medicine at Los Angeles County-USC Medical Center. He is board certified in Internal Medicine and the subspecialty of Gastroenterology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In Japan, the chemotherapeutic agents are mixed with lipiodol. The idea is
that since the tumor cells preferentially take up lipiodol, they would likewise
take up the chemotherapy. This Japanese technique has not yet been validated in
head-to-head comparisons with conventional TACE.
What are the benefits of TACE?
In one large study involving several institutions in Italy, chemoembolization
did not seem to be beneficial. Patients who did not undergo TACE lived as long
as patients who received TACE, even though the tumors were more likely to shrink
in size in patients who were treated. Does this mean that TACE or intra-arterial
chemotherapy does not work? Maybe, maybe not.
Studies in Japan, however, have shown that TACE can downstage HCC. In other
words, the tumors shrank enough to lower (improve) the stage of the cancer. From
the practical point of view, shrinking the tumor creates the option for surgery
in some of these patients. Otherwise, these patients had tumors that were not
operable (eligible for operation) because of the initial large size of their
tumors. More importantly, these same studies showed an improvement in survival
in patients whose tumors became considerably smaller. In the U.S., trials are
underway to see whether doing TACE before liver transplantation increases
patient survival as compared to liver transplantation without TACE.
It is safe to say that TACE or intra-arterial
chemoinfusion are palliative treatment options for HCC. This means that these procedures
can provide relief or make the disease less severe. However, they are not curative
(do not result in a cure). Fewer than 50% of patients will have some shrinkage
in tumor size. Further, they can be used only in patients with
relatively preserved liver function. The reason for this is that these procedures
can lead to liver failure in individuals with poor liver function.
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
Cancer RSS
Healthy Living Tips
This site complies with the