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Dark urine
Liver failure
Fatigued
Lost weight recently
Easily tired
Bloating
Swelling in the area under my right ribs
Not seeing your symptoms? No worries!
Liver cancer most commonly refers to hepatocellular carcinoma, the primary type of liver cancer. It often develops after long-term liver damage caused by chronic hepatitis B or C infections, heavy alcohol use, or nonalcoholic fatty liver disease. These conditions can lead to ongoing inflammation and cirrhosis, increasing the risk of cancer over time. Early detection is key, as symptoms may not appear until the disease has advanced.
Your doctor may ask these questions to check for this disease:
Once a specialist confirms the diagnosis, the next step is to determine the extent (stage) of the disease. Treatment depends on the disease's extent and other factors, like age and overall health. Options include chemotherapy, radiation therapy, surgery, immunotherapy, targeted drug therapy and localized therapies.
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Jul 28, 2025
Following the Medical Content Editorial Policy
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This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
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Q.
Milk Thistle After 65: Supporting Liver Function Safely
A.
Milk thistle can offer modest liver support after 65 through antioxidant and anti inflammatory effects, but it is not a cure and should not replace medical care; there are several factors to consider, and you can see below for the evidence, realistic benefits, and why lifestyle steps still matter more. Safety hinges on your medications and conditions, since it can interact with blood thinners, diabetes, cholesterol, heart, and some cancer drugs, and typical studied doses are 140 to 210 mg silymarin taken 2 to 3 times daily. See below for who should avoid it, how to choose a quality product, possible side effects, when to talk to your doctor, and a symptom check that may guide next steps.
References:
* Gholami, M., Alimohammadi, A., Alizadeh, M., Tavakoli-Tameh, A., & Shahriari, M. (2022). Silymarin as a potential protector against age-related organ dysfunction: a review. *Ageing Research Reviews*, *74*, 101540.
* Tang, D. S. Y., Chan, F. K. L., Lo, W. M., & Wong, V. W. S. (2023). Safety of Herbal Medicines in Patients with Chronic Liver Disease: A Systematic Review. *Journal of Clinical and Translational Hepatology*, *11*(1), 163-176.
* Keshari, R. S., Mishra, G., Chhabra, G., Singh, N., Kumari, M., Khan, H., ... & Khurana, S. (2022). Pharmacokinetics and Pharmacodynamics of Silymarin in Humans: A Review. *Molecules*, *27*(15), 5035.
* Wei, Y., Xie, H. Y., & Fan, Y. Y. (2019). Clinical efficacy and safety of silymarin in the treatment of liver diseases: a systematic review and meta-analysis. *Experimental and Therapeutic Medicine*, *17*(6), 4651-4659.
* Izzo, A. A., & Ernst, E. (2021). Herbal supplements and drug interactions: A comprehensive review. *British Journal of Clinical Pharmacology*, *87*(9), 3422-3444.
Q.
Milk Thistle for Women: Detox and Liver Health Guide
A.
Milk thistle may support women’s liver health and gentle detox through silymarin’s antioxidant and anti inflammatory effects, potentially helping liver cell protection and estrogen processing, but it does not flush toxins overnight or treat liver disease. There are several factors to consider. See below for who should avoid or use caution, potential side effects and drug interactions, how to choose a standardized 70 to 80 percent silymarin product with typical doses of 140 to 210 mg taken 2 to 3 times daily, and red flag symptoms that require prompt medical care.
References:
* Loguercio C, Festi D. Silybin and the liver. Liver Int. 2011 May;31(5):751-60. doi: 10.1111/j.1478-3231.2010.02402.x. PMID: 21320397.
* Abenavoli L, Capasso R, Milic N, Capasso F. Silymarin in non-alcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol. 2018 Jan;12(1):31-37. doi: 10.1080/17476309.2018.1397223. PMID: 29094776.
* Surai PF. Silymarin as a Natural Antioxidant: An Overview of the Current Evidence and Perspectives. Antioxidants (Basel). 2015 Jun 22;4(2):204-47. doi: 10.3390/antiox4020204. PMID: 26783637.
* Federici C, Cacciapuoti F, Loffreda S, Liguori A, Cacciapuoti F. A critical appraisal of the use of silymarin in liver diseases. Nutr Metab Cardiovasc Dis. 2020 Feb 28;30(3):362-371. doi: 10.1016/j.numecd.2019.10.027. PMID: 31838084.
* Marugha U, Takeda H, Sone H, Sugiura S, Yajima N, Kasaoka S, Kashiwagi K, Igarashi K. Estrogenic and antiestrogenic properties of silymarin constituents. J Med Food. 2002 Winter;5(4):185-92. doi: 10.1089/10966210260515124. PMID: 12639118.
Q.
Is Your "Wine Mom" Culture Hiding This? 5 Silent Signs of Early Liver Stress in Young Women
A.
Five often-missed signs of early liver stress in young women in wine mom culture include persistent fatigue, digestive changes, subtle skin changes like mild jaundice, heightened sensitivity to alcohol or common medications, and mood or concentration shifts, and because women metabolize alcohol differently, these can appear even with moderate use. There are several factors to consider, including which symptoms merit testing and simple steps that truly support liver recovery. See below for complete details and guidance on when to seek care and how to plan your next steps.
References:
* Rehm J, Shield KD, Gmel G, et al. Alcoholic liver disease in women: a rapidly evolving epidemic. Eur J Gastroenterol Hepatol. 2020 Aug;32(8):931-935. doi: 10.1097/MEG.0000000000001712. PMID: 32626245.
* Kim S, Heo J, Lim YS. Alcohol-related liver disease: Current insights. World J Gastroenterol. 2022 Jan 21;28(3):283-294. doi: 10.3748/wjg.v28.i3.283. PMID: 35084931; PMCID: PMC8783451.
* Sookoian S, Pirola CJ. Nonalcoholic Fatty Liver Disease and Related Metabolic Disorders in Young Adults. Hepatology. 2023 Mar;77(3):885-896. doi: 10.1002/hep.32733. Epub 2022 Nov 24. PMID: 36720199.
* Lu Z, Shang J. Clinical Manifestations and Treatment of Alcoholic Liver Disease. Curr Med Sci. 2022 Jun;42(3):576-583. doi: 10.1007/s11596-022-2615-z. Epub 2022 May 26. PMID: 35620249.
* Sun Q, Zhang Y, Fu X, et al. Prevalence of Fatty Liver in Young Adults: A Systematic Review and Meta-Analysis. Metabolites. 2023 Jul 17;13(7):843. doi: 10.3390/metabo13070843. PMID: 37495574; PMCID: PMC10383792.
Q.
Does Rick Simpson Oil (RSO) work for Cancer?
A.
Current evidence does not show that Rick Simpson Oil cures or reliably treats cancer in humans; while cannabinoids in RSO have anti-cancer activity in lab and animal studies, there are no robust clinical trials and most reported benefits are symptom relief. There are several important risks and caveats—including variable dosing and purity, psychoactive effects, liver strain, and serious drug interactions—so it should never replace proven treatments; discuss any use with your oncologist. See the complete details below to understand potential benefits, risks, quality-control steps, and how these factors could affect your next steps.
References:
Massi P, Solinas M, Cinquina V, & Parolaro D. (2013). Cannabidiol as a potential anticancer drug. Br J Clin Pharmacol, 22549284.
Caffarel MM, Sarrió D, Palanca S, et al. (2015). Cannabinoids reduce ErbB2-driven breast cancer progression via AKT/mTOR signalling. Oncogene, 24825245.
Kim SU, Park JY, Kim DY, et al. (2014). Liver stiffness measurement predicts decompensation in patients with compensated cirrhosis: a prospective study. J Hepatol, 24713405.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Sukowati CHC. Heterogeneity of Hepatic Cancer Stem Cells. Adv Exp Med Biol. 2019;1139:59-81. doi: 10.1007/978-3-030-14366-4_4. PMID: 31134495.
https://link.springer.com/chapter/10.1007/978-3-030-14366-4_4Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/liver-cancer/diagnosis-treatment/drc-20353664