Liver Cancer Causes, Symptoms, and Care

Dr. Moon did not grow up dreaming of becoming a doctor. His dad was an anesthesiologist, and his mom was a nurse. At dinner, they often talked about the hospital. Hearing about long hours and stressful cases made him want a different career.

In college, he majored in marketing and planned to go into journalism. While studying psychology, he took a class called Physiology of Psychology. It explored how the brain and body play a role in mental illness, and he was fascinated by the material.

He began volunteering at a hospital and interacting with patients. Those experiences changed his mind. Medicine no longer seemed like something to avoid, but a calling. From that point forward, he committed to becoming a doctor.

Finding His Passion in Gastroenterology and Hepatology

r. Moon became interested in studying liver health in medical school. He enjoyed the problem-solving aspect of diagnosing and treating digestive and liver conditions.

In one hospital rotation, he worked on a GI unit. He enjoyed using procedures like upper endoscopies to quickly find and fix problems. He became more interested in liver health at the University of Washington in Seattle. There, he worked with a research mentor at the Seattle VA hospital.

His mentor introduced him to large-scale database research on liver diseases. The research included cirrhosis and primary liver cancer. The work sparked his interest in liver health and liver cancer, and it became the main focus of his career.

Understanding Cirrhosis

Dr. Moon explains cirrhosis as the result of long-term liver damage. Common causes include:

  • Fatty liver disease

  • Alcohol-associated liver disease

  • Hepatitis B

  • Hepatitis C

A few other common causes exist, but these four are the most frequent. Over time, long-lasting liver problems cause repeated cycles of damage and healing. While the liver heals itself well, it still develops scar tissue. In cirrhosis, the liver becomes heavily scarred, reducing its ability to function.

Two main problems occur:

  1. Reduced liver cell function. Liver cells perform many vital jobs in the body, from filtering toxins to aiding digestion. Damage limits these abilities.

  2. Blocked blood flow. Scar tissue slows blood flow through the liver's central vein (the portal vein), leading to portal hypertension.

Complications of portal hypertension include:

  • Fluid buildup in the belly (ascites)

  • Confusion from toxin buildup (hepatic encephalopathy)

  • Enlarged veins in the esophagus that can rupture and bleed

  • Swelling in the legs

  • Fatigue, itching, cramps, and sometimes abdominal pain

These symptoms can affect quality of life and require ongoing care. 

A Varied and Meaningful Career

Dr. Moon values the variety in his schedule. Mondays are for clinic visits, and Wednesdays include liver transplant selection meetings. Thursdays are for endoscopy procedures. He dedicates Fridays to the multidisciplinary HCC clinic. The clinic comprises oncologists, interventional radiologists, radiation oncologists, and surgeons.

His favorite days are when he meets with patients and their families. He explains the illness, treatment choices, and what may happen next. These talks let him answer questions and comfort them during a difficult time.

Liver Transplant: A Critical Question for HCC Patients

After diagnosing HCC, Dr. Moon first considers if a liver transplant is an option. His multidisciplinary team assesses each patient's case.

Some patients meet the Milan criteria. The Milan criteria are a guideline for liver transplant eligibility. Others can get treatment that shrinks the cancer enough to make them eligible for more options (AKA "downstaging").

Yet, only a minority of liver cancer patients ever receive a transplant. If the cancer has spread outside the liver, a transplant is not an option. Other barriers include:

  • Major health problems not linked to the liver

  • Ongoing drinking

  • Little family or friend support

  • Lack of insurance

The Role of Research

For Dr. Moon, research is a way to answer important patient care questions. Collaborating with leaders in hepatology allows him to explore new ideas and approaches.

Many research questions come straight from patients or medical trainees. If medical research doesn't have clear answers, Dr. Moon sees it as a chance for more investigation. His work aims to improve both immediate patient care and long-term medical knowledge.

Balancing patient care with research for future treatments makes his work especially meaningful.

Unanswered Questions in Liver Cancer

Dr. Moon believes there's still more to learn about liver cancer risk factors. In addition to known causes, he wants to study possible environmental risks.

He also sees a need to improve early detection. Better surveillance tools allow for more diagnosed patients at a curable stage.

Treatment research is another important focus. Scientists are working to improve liver cancer care. Dr. Moon studies how patient choices can guide it. He also works to prevent or manage common problems that may happen after treatment.

A Commitment to Patients and Progress

Dr. Andrew Moon went from studying marketing to becoming a liver doctor. His progression shows his curiosity and openness to new interests. His work combines direct patient care, complex medical procedures, and impactful research.

During clinic visits, he gives clear information and advice to patients and their families. His research focuses on helping people with liver disease and cancer live healthier, longer lives.

Whether he's in the exam room, doing a procedure, or leading a research discussion, Dr. Moon works to guide patients with kindness and clarity.

Dr. Andrew Moon

Dr. Andrew Moon is a hepatologist at the University of North Carolina and is part of the UNC Multidisciplinary HCC Clinic. Dr. Moon has research interests including the prevention of liver cancer with improved surveillance, the comparative effectiveness of locoregional therapies, the role of patient preferences in HCC treatment decisions, and patient-reported outcomes.

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