Non-alcoholic fatty liver disease

Exercise Could Hold Key to Successful Cancer and Mental Health Treatment.

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Mounting evidence continues to show that exercise may be a key component in successful cancer prevention and treatment. Studies have also found that it can help keep cancer from recurring, so it’s really a triple-win.

Yet not surprisingly few oncologists ever tell their patients to engage in exercise beyond their simple daily, normal activities, and many cancer patients are reluctant to exercise, or even discuss it with their oncologist. Hopefully, you will not be one of them.

Most recently, research announced at the 2013 International Liver Congress1found that mice who exercised on a motorized treadmill for an hour each day, five days a week for 32 weeks, experienced fewer incidents of liver cancer than sedentary mice.

Exercise may also be absolutely crucial in the treatment of depression, according to recent research.2 I’ve often stated this, and the science continues to support this advice.

Meanwhile, mounting evidence condemns the “evidence-based” drug paradigm, as reviews keep finding that large amounts of published drug research is either seriously flawed or outright fraudulent — motivated of course by the financial interests of the funding party.

Might Exercise Be a Key to Cancer Cure?

Hepatocellular carcinoma (HCC) is a cancer that originates in your liver cells, and is one of the most common types of cancers. According to the featured article inMedical News Today,3 HCC accounts for just over five percent of all cancers worldwide, and causes an estimated 695,000 deaths annually.

According to the reported research,4 the first of its kind for this type of tumor, regular exercise may be the key to significantly reducing your chances for developing liver cancer.

The study involved two groups of mice: One group was fed a high fat diet, and then divided into two sub-groups — one that exercised and one that did not. The second group was fed a controlled diet, and also divided into sub-groups of exercise and non-exercise. According to the featured article:

“After 32 weeks of regular exercise, 71 percent of mice on the controlled diet developed tumors larger than 10mm versus 100 percent in the sedentary group. The mean number and volume of HCC tumors per liver was also reduced in the exercise group compared to the sedentary group.”

In the high-fat diet group, exercise decreased the development of non-alcoholic fatty liver disease. Professor Jean-Francois Dufour told Medical News Today:

“We know that modern, unhealthy lifestyles predispose people to non-alcoholic fatty liver disease which may lead to liver cancer; however it’s been previously unknown whether regular exercise reduces the risk of developing HCC. This research is significant because it opens the door for further studies to prove that regular exercise can reduce the chance of people developing HCC.

The results could eventually lead to some very tangible benefits for people staring down the barrel of liver cancer and I look forward to seeing human studies in this important area in the future. The prognosis for liver cancer patients is often bleak as only a proportion of patients are suitable for potentially curative treatments so any kind of positive news in this arena is warmly welcomed.”

Exercise Needs to be Part of the New Standard of Care for Cancer

But the benefits of exercise are not limited to prevention alone. It can also help you recuperate faster and help prevent recurrence of cancer. A report issued by the British organization Macmillan Cancer Support5 just last year argues that exercise really should be part of standard cancer care. It recommends that all patients getting cancer treatment should be told to engage in moderate-intensity exercise for two and a half hours every week, stating that the advice to rest and take it easy after treatment is an outdated view.

Story at-a-glance

  • Modern, unhealthy lifestyles predispose you to non-alcoholic fatty liver disease which may lead to liver cancer. Recent research suggests that regular exercise reduces the risk of developing liver cancer
  • Previous research has shown that breast and colon cancer patients who exercise regularly have half the recurrence rate than non-exercisers, and the cumulative evidence strongly indicates that exercise really should be part of standard cancer care
  • Many recent studies have shown that exercise provides a level of protection against stress-related disorders and depression, and recent research demonstrates that these protective benefits are induced even if the exercise is forced as a mandatory part of a program, such as doctor’s orders, school curriculum or military service
  • Mounting evidence shows that our healthcare and clinical guidelines are based in large part on fraudulent studies that report untruthful results in order to accommodate the interests of corporations. In one review, scientists could NOT replicate 47 of the 53 published studies—all of which were considered important and valuable for the future of cancer treatments
  • Source: mercola.com

 

 

Intricate Interplay.

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In our latest Clinical Problem-Solving article, a 55-year-old man presented with sinus congestion, headaches, chills, mild nausea, fatigue, and a “foggy” sensation that had lasted approximately 1 week. He reported darker urine than usual and had noticed that his eyes were turning yellow.

Although generally regarded as a chronic liver disease, autoimmune hepatitis is manifested as an acute illness in about 25% of patients.

Clinical Pearls

• What is the differential diagnosis for severe aminotransferase elevations?

In contrast to the broad differential diagnosis for elevations in serum aminotransferase levels that are less than 5 times the upper limit of the normal range, the causes of severe aminotransferase elevations (>20 times the upper limit of the normal range) are more limited and include Wilson’s disease, acute biliary obstruction, and viral, toxic, ischemic, and autoimmune hepatitis.

• What are the two types of autoimmune hepatitis?

Two types of autoimmune hepatitis have been proposed; type 1 is defined by positive results on testing for antinuclear antibodies and smooth-muscle antibodies, and type 2 by positive results on testing for antibodies against liver-kidney microsome type 1 and liver cytosol type 1. Type 2 autoimmune hepatitis has been described mainly in children in Europe and is rare in the United States. Among patients with type 1 disease, the reported prevalence of antinuclear antibodies alone is 13%, smooth-muscle antibodies alone 33%, and both 54%. Autoantibodies develop later in the disease in some patients who are seronegative on initial evaluation. Autoantibody-negative autoimmune hepatitis is important to recognize because patients with this condition typically have a favorable response to glucocorticoid therapy.

Morning Report Questions

Q: What is the standard treatment for severe cases of autoimmune hepatitis?

A: Treatment with either prednisone alone (at a dose of 60 mg daily) or a combination of prednisone (at a dose of 30 mg daily) and azathioprine (at a dose of 50 mg, or 1 to 2 mg per kilogram of body weight, daily) is recommended in cases of severe autoimmune hepatitis, on the basis of data from randomized clinical trials; combination therapy is generally preferred because the lower dose of glucocorticoid reduces side effects. Prednisolone in equivalent doses can be substituted for prednisone. Glucocorticoids are tapered over a 4-week period to a level required to maintain a biochemical remission, and this maintenance regimen is then continued until disease resolution (defined as biochemical remission for a minimum of 24 months), unless there is treatment failure or drug toxicity.

Q: What are the characteristics of nonalcoholic fatty liver disease?

A: Nonalcoholic fatty liver disease is one of the most common causes of asymptomatic aminotransferase elevations and chronic liver disease in Western countries. It encompasses a spectrum of disorders, from simple steatosis to fibrosing steatohepatitis that can progress to cirrhosis and its complications, including hepatocellular carcinoma. Aminotransferase levels can wax and wane, often into the normal range. Associated features include insulin resistance, central adiposity, dyslipidemia, and hypertension. The diagnosis of nonalcoholic fatty liver disease requires that there is no history of substantial alcohol consumption, although the definition of substantial alcohol consumption and the effect of obesity on thresholds for the development of alcoholic fatty liver disease remain unclear. Statins can be safely used in patients with nonalcoholic fatty liver disease and, in the majority of patients with this condition, are associated with improvement in liver enzyme abnormalities.

Source: NEJM