Five Year Survival in Hepatocellular Carcinoma with Herbal Agents

Abstract

A 53 years old man with hepatitis C presented 5 years ago, with right upper quadrant pain and a liver lesions (Right lobe:10×10 cm and a smaller left lobe lesion). Alpha-fetoprotein (AFP) level was 900 ng/ml (normal 0 -9 ng/ml), biopsy revealed hepatocellular carcinoma (HCC). He did not receive any therapy and 8 months later his AFP levels went down to 230 ng/ml and CT scan showed complete clearing of left lobe lesion and right lobe lesion had 50% shrinkage. He reports taking a variety of herbal agents since the diagnosis of HCC and the list included, Black Walnut, Barley Green, Ellagic Acid, Cell Forte, Coral Calcium, Chlorophyll water, Milk Thistle, Activin OPC 50 and Gene flora. Liver lesion remained stable and AFP levels dropped to two digits and remained between 25 and 75 ng/ml for around three years. Patient quit taking herbal medications on his physician's advice and due to the cost of herbal medications ($1000/month). His AFP levels started rising and tumor size increased. He was started on chemotherapy, AFP rose to 42000 ng/ml with progression of liver lesions. He refused further chemotherapy and was referred to hospice. He is alive at the time of writing this report, 5 years after the diagnosis of HCC. Discussion: HCC has a median survival of 6 to 20 months. Given the variety of agents he was taking it is difficult to identify any single agent. Several of the herbal medicines he was taking are suspected to have anticancer activity. Studies have shown that Ellagic acid inhibits the growth of cancer cells and promotes apoptosis. Cell forte (IP6inositol + regular inositol) inhibit cell adhesion, migration and invasion in human breast cancer cells. Conclusion: We report a case of advanced HCC that showed significant response to herbal supplements. Further research on the anti-tumor effects of these herbal agents can result in better understanding of HCC and may lead to the development of newer therapeutic agents.