I once treated a patient who was very distressed, always fearing that her liver cysts would develop into liver cancer!So, can liver cysts actually become cancerous? How do they form?Liver cysts primarily present clinically as swelling in the right upper abdomen or right flank, often accompanied by abdominal distension, poor appetite, fatigue, and eventually shortness of breath. The cysts can grow large enough to reach the navel, significantly affecting the patient’s eating and activity. Without any examinations, patients often suspect liver cirrhosis or even liver cancer, but with accurate testing, a diagnosis can usually be confirmed, and they typically do not become cancerous.
This patient had been experiencing increasing discomfort in her right flank for six months, with pain and symptoms such as reduced appetite and poor sleep quality, which greatly affected her normal life. During my examination, while the patient was lying flat, I could palpate a mass in her right flank. The hospital’s examination report indicated multiple liver cysts, with an irregularly enlarged liver shape and cystic masses protruding from the liver, measuring approximately 4.2cm×3.5cm, with regular boundaries and anechoic and cloudy low echo.In Traditional Chinese Medicine (TCM), liver cysts fall under the category of “accumulation” and are often due to prolonged liver Qi stagnation and dampness, leading to Qi stagnation and blood stasis.Our liver is primarily responsible for the smooth flow of Qi; when Qi is obstructed, it affects the liver’s ability to regulate. Over time, if Qi does not flow, Qi stagnation occurs; simultaneously, the movement of blood and body fluids, which is related to Qi, is also affected, leading to phlegm-damp obstruction and blood stasis. Therefore, in treatment, methods to soothe the liver, regulate Qi, and invigorate blood circulation can be employed.I prescribed a classic foundational formula for the patient, modifying it as needed.
This foundational formula is called Da Qi San (Major Qi Powder). This formula primarily addresses symptoms of Qi stagnation and blood stasis.In the formula, I used Qing Pi (Green Tangerine Peel) and Xiang Fu (Cyperus) to soothe the liver and gallbladder Qi; Chen Pi (Aged Tangerine Peel) and Huo Xiang (Agastache) to regulate the spleen and stomach Qi; and Jie Geng (Platycodon) to open the chest and diaphragm Qi. The combination of these 5 herbs primarily works to move Qi and disperse accumulations;then, I added San Leng (Sparganium) and E Zhu (Curcuma) to invigorate blood and eliminate stasis; Rou Gui (Cinnamon) and Yi Zhi Ren (Alpinia) to warm and tonify the spleen and stomach Yang, enhancing the stasis-resolving effects of San Leng and E Zhu. Finally, I adjusted the formula with other Chinese herbs based on the patient’s condition to achieve the goals of regulating the liver, invigorating blood, and clearing dampness. After one course of treatment, the patient’s symptoms of right flank fullness, pain, and sleep disturbances significantly improved.Additionally, I remind everyone that no matter how good the herbs or how precise the combinations, they still need to be adjusted based on the patient’s actual condition after TCM differentiation.Alright, that’s all for today’s topic. If you have related questions, feel free to leave a comment!
