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Hepatocellular carcinoma

Hepatocellular carcinoma (HCC, also called hepatoma or liver cancer) is a primary malignancy (cancer) of the liver. Most cases of HCC are secondary to either hepatitis infection (usually hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis). In countries where hepatitis is not endemic, most cancers in the liver are not primary HCC but metastasis (spread) of cancer from elsewhere in the body, e.g. the colon. Treatment options of HCC and prognosis are dependent on many factors but especially on tumor size and staging. more...

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In Sub-Saharan Africa and most other Third World countries the commonly accepted prognosis is a median survival of 3 months from diagnosis. This is partially due to late presentation with large tumours, but also the lack of medical expertise and facilities.

Epidemiology

The epidemiology of HCC exhibits two main patterns, one in North America and Western Europe and another in Non-Western Countries (regions such as sub-Saharan Africa, central Asia, Southeast Asia, and the Amazon basin).

Non-Western Countries

In some parts of the world, such as Sub-Saharan Africa and Southeast Asia (and especially Taiwan and China) HCC is the most common cancer, generally affecting men more than women, and with an age of onset between late teens and 30's. This variability is in part due to the different patterns of Hepatitis B transmission in different populations - infection at or around birth (as in Taiwan) predispose to earlier cancers than if people are infected later. The time between hepatitis B infection and development into HCC can be years even decades, but from diagnosis of HCC to death the average survival period is only 5.9 months, according to one Chinese study during the 1970-80s, or 3 months (median survival time) in Sub-Saharan Africa according to Manson's textbook of tropical diseases. HCC is one of the deadliest cancers in China. Food infected with Aspergillus flavus (especially peanuts and corns stored during prolonged wet seasons) which produces aflatoxin, poses another risk factor for HCC.

North America and Western Europe

Most malignant tumors of the liver discovered in Western patients are metastases (spread) from tumors elsewhere. In the West, HCC is generally seen as rare cancer, normally of those with pre-existing liver disease. It is often detected by ultrasound screening, and so can be discovered health-care facilities much earlier than in developing regions such as Sub-Saharan Africa.

Diagnosis, screening and monitoring

Hepatocellular carcinoma (HCC) most commonly appears in a patient with chronic viral hepatitis (hepatitis B or hepatitis C, 20%) or with cirrhosis (about 80%). These patients commonly undergo surveillance with ultrasound due to the cost-effectiveness.

In patients with a higher suspicion of HCC (such as rising alpha-fetoprotein levels), the best method of diagnosis involves a CT scan of the abdomen using intravenous contrast agent and three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the radiologist to detect small or subtle tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease that most HCC patients have can make the findings more difficult to appreciate.

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AHCC® study published in Journal of Hepatology: AHCC intake can improve prognosis for postoperative hepatocellular carcinoma patients - active hexose
From Townsend Letter for Doctors and Patients, 12/1/02

A nine-year study conducted on 269 post-operative liver-cancer patients using AHCC[R] (Active Hexose Correlated Compound) was recently published in the Journal of Hepatology (2002;37:78-86), The Official Journal of the European Association for the Study of Liver. The study demonstrated a significant and positive influence on immune function, concluding that AHCC can improve the prognosis for postoperative hepatocellular carcinoma (HCC) patients.

In vitro experiments have shown that AHCC enhances natural killer cell activity, and may be considered a potent biological response modifier in the treatment of cancer patients. A prospective cohort study was performed from February 1, 1992 to December 31, 2001. A total of 269 consecutive patients with histologically confirmed HCC were studied. The study examined ten different parameters related to liver function after surgery.

Of the 269 patients, 113 received AHCC orally after undergoing curative surgery. Researchers at the University of Osaka, Japan, concluded that, compared with the control group, the AHCC group had a significantly longer period with no disease recurrence, a higher survival rate, and an increased overall survival rate.

AHCC is derived from a highly specialized manufacturing process developed in the mid-1980s that relies on the hybridization of several species of mushrooms cultivated in Japan. According to industry analysts in Japan, over 700 hospitals and medical clinics recommend AHCC to patients in that country as part of an immune enhancement maintenance regimen, creating a $150 million (USD) industry.

AHCC has been the subject of numerous clinical studies conducted at prestigious Japanese institutions such as Hokkaido University, Kyomin University and Teikyo University. Currently 40,000 individuals worldwide use the nutritional supplement monthly.

The abstract of the study can be viewed at http://www.elsevier.com.

Correspondence:

Integrated Marketing Group

P.O. Box 311

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Website: www.ahccresearch.com

COPYRIGHT 2002 The Townsend Letter Group
COPYRIGHT 2003 Gale Group

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