Misunderstanding Liver Disease
Dr. Jody Olson didn't come from a family of college graduates. He was the first. When he began college, he thought he wanted to become a lawyer. A popular TV drama about attorneys and his natural love for debate may have influenced him. A wise college advisor told him to study science, just in case he decided to change his career plans. That advice opened unexpected doors.
To help pay for school, Dr. Olson became a paramedic. This hands-on medical work sparked a stronger interest in medicine. His paramedic advisor was also the pre-med advisor who guided him toward medical school. At first, he planned to become an obstetrician-gynecologist. But at the very last moment, he switched to internal medicine. That choice gave him a broader foundation and led him to specialize in liver disease.
The Changing Causes of Liver Cancer
Liver cancer, especially hepatocellular carcinoma (HCC), has many causes. Globally, viral hepatitis remains one of the main drivers. But the landscape has shifted in countries like the United States.
New treatments for hepatitis C have lowered the number of liver cancer cases caused by that virus. Treatments for hepatitis B have also improved. There isn't a cure, but there are manageable treatments. These treatments have lowered the risk of liver cancer caused by hepatitis.
Another threat is spreading fast: fatty liver disease. It often strikes along with type 2 diabetes, high blood pressure, heart disease, and obesity. It's not as simple as telling someone to lose weight or exercise.
Fatty liver disease has multiple causes, including genetics and lifestyle. It requires long-term, multi-step management. There's no single pill or quick fix to reverse it.
Who Qualifies for Liver Transplants?
After a liver cancer diagnosis, doctors first check for treatments that can cure it, like surgery to remove the tumor or a liver transplant.
A transplant becomes an option only when the cancer remains in the liver. Doctors use specific rules to help predict if the cancer might spread outside the liver. These rules are the Milan Criteria. Under the Milan criteria, a patient can have:
Up to three tumors, none larger than three centimeters, or
One tumor up to five centimeters.
If the cancer stays within these limits, the patient has a better chance of getting a transplant. They also reduce the possibility of the cancer coming back. If the cancer is more advanced, the risk of spread is too high for a transplant to be effective.
The Misconceptions About Liver Disease
One significant barrier to early diagnosis is public misunderstanding. Many people still believe all liver disease comes from alcohol or drug abuse. In reality, liver disease can have many causes, such as:
Viral infections (hepatitis)
Metabolic problems
Rare autoimmune conditions, and more
This stigma can make patients hesitant to discuss their condition. It can also hide the full scale of the problem.
60–70% of people with cirrhosis didn't know they had liver disease before diagnosis. That's according to a University of Chicago study. Often, liver disease shows no symptoms until it's advanced. In some cases, the first sign is liver cancer.
The Silent Nature of Hepatitis
Liver inflammation and damage can be silent for years. Viral hepatitis B or C may cause no apparent symptoms, even in long-term infections. These illnesses go unnoticed without regular blood tests or scans, and by then, the damage is severe.
That's why liver health groups around the world are working to:
Raise awareness
Encourage testing
Find the disease earlier
Yet, in many parts of the world, viral hepatitis remains underdiagnosed.
Why Dr. Olson Loves His Specialty
Dr. Olson calls the liver "the most interesting organ in the body." Liver medicine offers a rewarding career for doctors who enjoy:
Solving complex problems
Working in teams across many specialties
Building long-term patient relationships.
Helping a patient through a liver transplant is a big highlight. So is supporting someone with a long-term, untreatable condition to have the best quality of life possible.
Liver medicine is still a relatively small field, which means specialists often know each other well. Dr. Olson says it's also a friendly, supportive community. A community that shares the goal of fighting one of the world's most overlooked health problems.
Key Takeaways for the Public
Liver disease is not just about alcohol: Many forms have no relation to alcohol or drugs.
The disease is often silent: You can have liver disease for years without symptoms.
Screening matters: Blood tests and imaging can detect problems before severe damage.
Lifestyle plays a role: A healthy diet, regular exercise, and managing chronic conditions can reduce risk.
Awareness is low: Education is key to breaking stigma and encouraging early diagnosis.
Dr. Jody Olson had a unique career path. He went from aspiring attorney to paramedic to liver specialist. His journey shows how unexpected turns can lead to meaningful work. His mission now is clear: fight the stigma, raise awareness, and help patients face liver disease with knowledge and hope.
