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Adenomas of the Liver

Liver disease is serious and requires treatment and regular monitoring by a liver specialist.

A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner. Over nearly 40 years of practicing medicine I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.

I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.

If you have any questions you may contact my naturopaths on 623 3343232 or email us at contact@liverdoctor.com

Adenomas of the Liver

Liver cell adenoma is a common and benign (non-cancerous) tumor of the liver. A liver adenoma is an encapsulated liver tumor (has a capsule around it) and it does not contain bile ducts.

adenomaCauses of Adenoma

Since the 1980s liver cell adenoma and liver cell adenomatosis have emerged as new entities in medical practice due to the widespread use of oral contraceptives, hormone replacement therapy and the increased imaging of the liver via scans.

The increased prevalence of patients with liver cell adenoma is due to the widespread use of estrogen-based oral contraceptives, and due to the increased use of imaging of the abdomen for a variety of unrelated reasons. This means that many adenoma tumors are identified as incidental findings in patients with no liver symptoms. The clinical importance and natural history of these incidental adenoma tumors is not fully understood, and there is a need for optimal management strategies in such patients.

The causal relationship between oral contraceptives and other oral estrogens and liver cell adenoma is proportional to the dose and duration of the hormone medication. The incidence is highest in women over 30 years of age after using oral contraceptives for more than 2 years. It is estimated that the risk of growing an adenoma increases by a factor of 5 after 5 years, and by 25 after 9 years of oral contraceptive usage.

Outcome of liver adenomas

Liver adenoma has the possibility of severe outcomes such as bleeding and transformation into liver cancer. On review of published studies there is evidence that 10% of liver cell adenomas progress to liver cancer. Pregnancy often stimulates rapid growth in liver adenomas with risk of potentially fatal spontaneous rupture.

Diagnosis of liver adenoma

Despite significant progress in imaging techniques of the liver such as MRI scans, a definite diagnosis of adenoma is by excision biopsy.

Treatment of liver adenoma

If the patient is on oral contraceptives or estrogen containing hormone replacement therapy it is vital to cease using them. This often results in the adenoma shrinking, but there is still a risk of transformation into liver cancer. Oral contraceptive-induced liver cell adenomas are reversible if oral contraceptives are discontinued within a certain time period. With prolonged oral contraceptive usage pre-cancerous changes (dysplastic foci) develop within the liver cell adenoma that may progress to liver cancer. The causative role of oral estrogen containing contraceptives in producing liver cell adenoma is beyond doubt, and many studies have shown regression and even complete disappearance of adenomas after cessation of the oral contraceptive pill.

Because adenoma has a risk of bleeding and malignant transformation, surgical excision is usually done for solitary liver adenomas.

Liver Cell Adenomatosis

Liver cell adenoma caused by estrogen/progestogen ingestion is usually solitary (one tumor only), but some people may develop several adenomas spread throughout the liver. This latter condition is known as liver cell adenomatosis and does not have the strong association with estrogen or anabolic steroid use.

If the tumors are causing severe symptoms and are accessible to surgery, they should be surgically removed. Other treatments such as embolization (blocking the blood supply) to bleeding tumors and radiofrequency destruction may be useful in some patients.

Follow up

Regular and long term medical supervision is vital because even complete disappearance of the adenoma does not prevent the later development of liver cancer, which has been observed five years after cessation of oral contraceptive usage and regression of the adenoma.

There are no reports of new adenoma formation or development of liver cancer after surgical removal of solitary liver cell adenoma. This provides a strong argument in favor of surgical removal as the primary treatment for solitary liver cell adenoma.

In liver cell adenomatosis where there is extensive distribution of the lesions, management decisions are more problematic, as targeted adenoma excision as for solitary liver cell adenoma, is not an easy treatment.
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If there are many large tumor nodules ranging from 1 to 4 inches (2–10 cm) in diameter then enlargement and deformation of the liver may occur. This is called a “massive type” may be rapidly progressive and presents a real treatment challenge. The ‘multifocal type’ contains many adenomas up to 2 inches (4-5 cms) in diameter but the liver shape is not deformed or enlarged. These patients are unlikely to have many symptoms and appear to have a less aggressive clinical course.

Patients should be entered into a follow up program that includes yearly CAT or MRI scanning, and frequent serum alpha-fetoprotein (AFP) measurement. AFP is a protein that is a marker for liver cancer and rising levels must be taken seriously. These tests are done to detect progression of disease (increased lesion size) and/or transformation into liver cancer.

All female patients should be advised to stop hormone medication (e.g. oral contraceptives and hormone replacement therapy), and also ensure that they prevent further pregnancies.

Those who have the massive form of liver cell adenomatosis may have multiple large lesions within a single lobe of the liver, and are best managed by partial removal of the liver. Patients with multifocal liver cell adenomatosis should be monitored with regular liver imaging. Progression of disease with larger adenomas, concern of malignant transformation, and increasing symptoms are indications for resection in multifocal liver cell adenomatosis. Resection is the preferable option unless technically impossible.

Liver transplantation should be considered only as a last resort. Indications where liver transplantation is considered may include rise in serum alpha-fetoprotein, concern about transformation to cancer on scans, and patients with marked enlargement of the liver and repeated bleeding of the adenomas.

Nutritional Help for Adenomas

In patients with liver adenomas, either solitary or multiple, it is important to have a healthy diet and to avoid eating sugar and refined carbohydrates. If you are overweight a low carbohydrate diet that is free of all grains and sugar is important and may shrink tumors.

It is vital to support healthy liver function with supplements of the following –

For more information visit Selenium Research

A quick liver detox program for benign liver tumors

The liver is the only organ that can breakdown (metabolize) fat soluble toxins and turn them into water soluble forms. Once they are water soluble they can be eliminated via the watery fluids of the body such as the bile, sweat, saliva and urine. If you liver does not break them down they will stay in your liver and the fatty parts of your body and this can contribute to liver tumor formation and liver inflammation.

Dr Sandra Cabot’s 2 week liver detoxification program

Here are the principles of the program –

  • Drink 10 glasses of water daily – drink it throughout the day
  • Start the day with a glass of water containing the juice of a freshly squeezed lemon or lime

Eat only the following during your 2 week detox –

  • Fruits and vegetables – the fruits and vegetables can be raw and cooked.  You may have any vegetable you want including starchy vegetables such as sweet potato, carrot, parsnips and turnips etc.  If you make a vegetable soup, use may use vegetable stock, Herbamare or miso to flavour it. To cook the vegetables, you may use the following methods – steam them, roast them or stir fry them with olive oil. You can spread or paste the vegetables with a thin layer of olive oil or coconut oil before you roast them in the oven. Do not use a microwave oven to cook your vegetables or fruits, as this is irradiating your food and will damage the cell structures in the vegetables and fruits. You can stew the fruits in their own juice and water with a tiny amount of honey or stevia. Cinnamon sticks add a nice flavour to stewed fruits. If you can afford it, purchase organic fruits and vegetables.
  • Salad dressing ingredients – you may use cold pressed olive oil or macadamia oil, coconut oil, apple cider vinegar, mustard, fresh lemon or lime and fresh or dried herbs. Mix ingredients in a jar and shake or whisk with a fork or blend in a blender
  • Raw nuts and seeds – you can choose any seeds (pumpkin seeds, hemp seeds, chia seeds, ground flaxseeds) and any raw nuts
  • Tahini and hummus are allowed and make a nice dip with avocado and lemon
  • Milks – only coconut or almond milk is allowed
  • Drink 8 ounces to 10 ounces (250 to 300mls) of raw juice daily – best ingredients to juice are parsley, basil, mint, carrot, cabbage, beet, green apple, lemon, orange and ginger. You can also add a cruciferous vegetable to the juice such as kale, broccoli, Brussels sprouts or cauliflower.
  • Take a powerful liver tonic containing the herb Milk Thistle, B vitamins, selenium and the amino acid Taurine to support the detoxification process in your liver. Take NAC (N Acetyl Cysteine) to increase production of glutathione in the liver.

You may want to do this detox diet several times during a year to keep your total body toxin level at acceptable levels.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.

2 comments

  1. I have liver adenoma and dcis stiu in my left breast. Will this detox help me ?

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THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FDA AND ARE NOT INTENDED TO DIAGNOSE, TREAT OR CURE ANY DISEASES.