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A middle-aged man, a teetotaler, was diagnosed with non-alcoholic fatty liver and diabetes three years ago. Instead of taking medication for diabetes, he decided to resort to alternative therapies.
The result of his decision, tragically, is a stage four liver cancer diagnosis.
Highlighting the incident, Dr Cyriac Abby Philips aka TheLiverdoc posted on X regarding the critical importance of adhering to medical treatment and the potential risks of relying solely on alternative therapies.
He posted, “He was a teetotaler. He was not willing for anti-diabetes tablets or insulin because of misinformation on ‘modern medicines’ being synthetic chemicals and chose the ‘naturopathy’ way. He wont make it beyond a year. His son is devastated,” TheLiverdoc posted.
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Non-alcoholic diabetic with fatty liver
Three years ago, the patient was diagnosed with fatty liver alongside diabetes. Despite the diagnosis, he rejected conventional medical treatment for his diabetes, opting instead for naturopathy.
This decision was influenced by a distrust of “modern medicines” which he perceived as harmful synthetic chemicals. Over the years, his condition worsened, with continuous poor blood sugar control, evidenced by occasional testing.
The situation took a dire turn in November when the patient began losing weight, eating less, and suffering from unexplained body pains and sleeplessness.
He and his son sought evaluation and treatment for his fatty liver condition, not realising the severity of his underlying health issues.
Upon admission, a CT scan revealed a normal but slightly fatty liver, contradicting the initial belief of severe liver damage. Alarmingly, the scan also showed multiple nodules, not only in the liver but spread throughout the body, including the spine and hip bones.
One liver nodule was indicative of hepatocellular carcinoma, a form of liver cancer, confirmed by an exceedingly high alpha-feto-protein (AFP) level of 3300, where normal is below 10.
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No cirrhosis but liver cancer diagnosed
This shocking diagnosis highlights a critical health message. Dr Philips explains that liver cancer can develop even in the absence of cirrhosis, particularly due to conditions like hepatitis B virus infection and non-alcoholic fatty liver disease (NAFLD), exacerbated by diabetes.
liver disease in diabetics (supplied)The aggressive form of NAFLD, known as non-alcoholic steatohepatitis (NASH), can particularly lead to liver cancer in patients with a normal liver function test.
He says, “There are two conditions of the liver that can lead to cancer even in the absence of cirrhosis. Usually, liver cancer develops in cirrhotic livers,”
He warns that hepatitis B virus infection and non-alcoholic fatty liver (especially due to diabetes) and its aggressive form NASH (non-alcoholic steatohepatitis) can result in liver cancer in the background of a normal liver even after a normal liver function test.
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Prevent Hepatitis B related liver cancer with vaccines
Dr Philips emphasises the importance of hepatitis B vaccination as a preventive measure against virus-related liver cancer.
He says regular monitoring and vaccination can significantly reduce risks. Additionally, for diabetic patients, adhering to prescribed medications is crucial. Diabetes can be as damaging to the liver as alcohol and is associated with various cancers, including liver cancer.
The healthcare professional also urges individuals with a family history of diabetes or related complications to get regular check-ups. Symptoms like unexplained weight loss, excessive thirst, hunger, or fatigue should prompt immediate diabetes testing.
He explains, “Check your hepatitis B status. HBsAg (CMIA method) and anti-HBsIf both are negative then you need a full three-dose vaccine – at 0, 1 and 6 months. If HBsAg is positive, you are infected and need further evaluation. If anti-HBs is positive, it means you are protected. If anti HBs is between 10 and 100 -> you need a booster dose only. If anti HBs >100 – > nothing to do, full protective antibodies are there.”
Diabetes and fatty liver
Dr V Mohan, renowned diabetologist and chairman of Dr Mohan’s Diabetes Specialities and Madras Diabetes Research Foundation, recently launched an exclusive liver clinic at his diabetes centre.
He said the clinic was started since 32 percent of Indians are believed to have fatty liver disease and added that 70 to 90 percent of people with obesity and diabetes are the ones who suffer from it.
He explained that nearly one in five cases can progress to severe liver diseases such as cirrhosis or even liver cancer. Obesity and diabetes take a toll on many parts of the body, including the liver, due to its crucial role in metabolism.
“When the body’s fat storage reaches its saturation level, any additional fat leads to the release of fatty acids into the liver. In those with diabetes, insulin resistance is a key problem. Their muscle, fat, and liver cells do not react appropriately to insulin, resulting in elevated levels of both insulin and blood sugar in the bloodstream,” he clarifies.
Meanwhile, Dr Philips asks people to know about lifestyle diseases that could lead to cancer and keep them at bay.
“You have to take care of yourself, for you to be useful for others around you. Remember this.”
