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Liver Cancer in TCM

General Description

Liver cancer or hepatocarcinoma is either primary or metastatic in origin .Those originating in hepatic cells or intrahepatic duct are recognized as primary hepatocarcinoma ;while those originating in other regions and moving to the liver are known as metastatic hepatocarcinoma.Generally speaking,liver cancer refers to primary hepatocarcinoma.It is chiefly manifested as pain in the right espigastrium,emaciation,anorexia,lassitude and progressive hepatomegaly.It is one of the most common malignant tumors .According to epidemiological data,its morbidity and mortality in China come in third ,next to those of stomach and lung cancer .In TCM ,liver cancer is included in the categories of “zhengji”(abdominal mass) and “huangdan”(jaundice).It is the resultof a blending disorder of qo,blood,dampness,heat,blood stasis and toxic substance,which is caused by deficiency with accumulation of dampness ,phlegm stagnation and blood stasis,invasion and retension of exogenous pathogenic factors as welll as impairment by emotional upsets with mental depression.The diseased location is the liver,with the spleen,gallbladder and stomach involved.Deficiency of visceral qi and blood is the principal aspect ;a blending disorder of qi,blood mdampness,heat,blood stasis and toxic substance is the secondary aspect .


Essencials for Diagnosis

Liver cancer is clinically manifested as painin the liver or espigastrium,abdominal distension,lassitude,poor appetite,emaciation,or diarrhea and fever .Progressive hepatomegaly is present,with tenderness,hard texture and nodular protrusion on its surface .

A history of chronic viral hepatitis and hepatocirrhosis.

A rise in r-GT and positive AFP in serological examination .

Ultrasonnography B,CT scanning and MRI suggest a space occupying lesion in the liver .


Syndrome Differentiation and Treatment

This disease is characterized by principal deficiency and secondary excess.Principal deficiency is manifasted as lassitude,rapidly progressive emaciation,and even sallow complexion and indolence of speaking ;hard lump in the right espigastrium with tenderness,or accompanied by jaundice ,ascites,edema,distension and fullness and oppression of the abdomen are the manifestations of secondary excess.For severe cases,it is advisable to fucus the treatment on the secondary aspect,chiefly to eliminate pathogenic factors with the methods of activatng blood to remove stasis ,eliminating mass,purging retained fluid and dissipating stagnant qi.But generally,purging therapy and tonifying therapy should be used at the same time to strengthen healthy qi and eliminate pathogenic factors,and corresponding methods are invigorating the spleen,replenishing qi,nourishing yin and blood,soothing the liver,activating blood to remove stasis ,regulating qi and dissipating stagnant qi,purging retained fluid and alleviating edema .


Liver Qi Stagnation

Chief manifestations : Distendingpain in the right hypochondrium,chest oppression,frequent sighing,impaired appetite ,occasional diarrhea,mass in the right lower hypochondrium,thin and greasy tongue coating,andwiry pulse.
Therapeutic Methods : To soothe the liver,invigorate the spleen,activate blood and remove stasis .


Qi Stagnation and Blood Stasis

Chief manifestations : Huge mass in the hypochondrium,hypochondric pain radiating to the back ,which is aggravated at night,tenderness,abdominal distension and fullness,impaired appetite ,loose stools sometimes and dry stools at other times,lassitude,dark purple tongue with petechia and ecchymosis,deep and thready or wiry and unsmooth pulse .
Therapeutic Methods : To promote circulation of qi ,activate blood ,remove stasis and eliminate mass .


Damp-heat Accumulation

Chief manifestations : Restlessness ,irritability,yellowish skin and sclera,dryness and bitterness in the mouth,abdominal distension and fullness,impaired appetite,stanning pain in the hypochondrium ,deep yellow urine,dry stools,dark purple tongue with yellow coating,wiry and smooth or smooth and rapid pulse .
Therapeunic Methods : To clear away heat ,nor malize the function of gallbladder and purge fire to remove toxic substance .


Liver-yin Deficiency

Chief manifestations : Hypochondriac pain,dysphoria with feverish sensation in the chest ,palms and soles ,vertigo,impaired appetite,distended abdomen with varicose veins ,or hematemesis,hemafecia and subcutaneous hemorrhage in severe cases ,red tongue with little coating ,and thready and rapid pulse .
Therapeutic Methods : To nurish blood ,soothe the liver and cool blood to remove toxic substance .

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