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Hepatocellular carcinoma is cancer that arises from hepatocytes, the major cell type of the liver. Hepatocellular carcinoma traditionally has been relatively rare in the United States, though with the rise in the number of cases of hepatitis C, the rate of new cases of liver cancer is rising. Worldwide, however, it is either the number one or number two cause of cancer death. It is especially prevalent in parts of Asia and Africa. About 80% of people with hepatocellular carcinomas have cirrhosis. Chronic infection with the hepatitis B virus and hepatitis C virus also increases the risk of developing hepatocellular carcinoma. Aflatoxins, which are produced by a mold that is a contaminant of nuts (most commonly peanuts), grains, and beans, have also been implicated as a major risk factor for causing hepatocellular carcinoma. Although virtually non-existent in the United States, aflatoxins, are common in other parts of the world and often contaminate food.

Most hepatocellular carcinomas are first suspected based on the results of CAT scans or ultrasound scans. Blood alpha-fetoprotein , a blood tumor marker, is a useful lab test for the diagnosis of hepatocellular carcinoma. About 70% of patients with hepatocellular carcinoma have elevated blood alpha-fetoprotein concentrations; however, it is not specific for this condition. We often see normal alphafetoprotein values in the face of massive tumors in the liver. It is often measured as a part of screening in patients with chronic hepatitis B or chronic hepatitis C and cirrhosis. A rising blood alpha-fetoprotein concentration in someone with chronic liver disease suggests the development of hepatocellular carcinoma. Appropriate radiological scans should be done in such instances.

The definitive diagnosis of hepatocellular carcinoma is made by biopsy. Usually, the liver mass is biopsied by a radiologist under with the help of a radiological scan. Sometimes, the mass is biopsied using a laparoscope, a fiber optic instrument that is inserted into the abdomen. Occasionally, open surgical biopsy is necessary.

Hepatocellular carcinoma is curable by surgery only if the tumor is small. Liver transplantation may also be curative for relatively small tumors. Surgery or liver transplantation may not be possible in all cases, usually if the tumor is very large or has spread beyond the liver. If there is invasion of the major blood vessels of the liver with tumor, the hope for cure or transplant are reduced. For large tumors or cancer that has spread beyond the liver, chemotherapy, ligating (tying) or embolization (clotting) of the hepatic artery, alcohol injection into the tumor, or radiation may relieve symptoms and prolong life, but these procedures are not curative.

Liver Specialists of Texas and Dr. Galati have a comprehensive approach to liver cancer, collaborating with colleagues in surgery, radiation oncology, medical oncology, and liver transplantation.

Call 713-794-0700 if you need more information.

Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

Online LIVER Second Opinion

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    From the comfort of your home, without the need to spend additional money on travel, lodging, and food, receive and expert second opinion from the expert physicians at Liver Specialists of Texas

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    There are five steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-65 minutes to complete.

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    Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process. The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

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    To start the process of an Online Liver Second Opinion, please fill out the initial contact form and fax back to our office. A representative from our office will call you for additional details.