Spread the News: Liver Cancer is Preventable

The origin of many cancers still baffles the medical community, with hope for the future residing predominantly in treatment effectiveness. A growing body of evidence shows that incidence rates for liver cancer in particular have increased 3-fold since the mid-1970s.

However, the good news is that certain liver cancers are preventable.

Most people are unaware that their liver is their silent internal life support system. It is responsible for processing hundreds of life sustaining body functions 24/7 that include refining and detoxifying everything they eat, breathe, and absorb through their skin. This pervasive ignorance regarding the importance of the liver and how it can be severely compromised, has resulted in the prevalence of obesity, fatty liver, hepatitis, diabetes and drug and alcohol abuse . . . diseases that can ultimately lead to cirrhosis and liver cancer, but that are potentially preventable.

Many individuals do not associate obesity or diabetes with the liver. While the liver is a non - complaining organ, it performs hundreds of complex chemical conversions that include processing foods ingested so that essential vitamins, proteins and other nutrients are made available for building strong bones and muscles, creating energy, hormones, immune and clotting factors, etc. It is critical to inform patients that excess consumption of sugar and fatty foods causes the excess fat to be stored in liver cells, where it accumulates to form fatty liver disease, potentially leading to cirrhosis and eventually liver cancer.

Current recommendations regarding what to eat and what not to eat have had little effect on reducing the incidence of obesity. Why? Information about liver health has been absent in schools for decades, and individuals are unknowingly participating in liver damaging behaviors.

Hepatitis viruses are also major contributors to liver damage and development of liver cancer. According to the Annual Report to the Nation released in 2016 by Centers for Disease Control and Prevention and the National Cancer Institute 50% of liver cancer is related to hepatitis C infections (Report on Status of Cancer, 1975-2012/Ryerson et al).

A national risk awareness campaign has been launched by CDC to encourage Baby Boomers, those born between 1945 and 1965, to be tested for hepatitis C, according to Dr. John Ward, Director of the Division of Viral Hepatitis at NCHHSTP, CDC.

However, simply identifying risk behaviors without addressing the patient knowledge gap has been a major deterrent to identifying potentially infected individuals.

"Despite advances in the treatment of hepatitis C and B . . . there is still a desperate need to increase the understanding of liver wellness and disease prevention in the American public. By the time I meet many patients, their liver disease has silently advanced to irreversible damage", reports David Pound, MD, President of Indianapolis Gastroenterology Research Foundation

Hepatitis B, and resulting liver cancer can be prevented through vaccination, and is highly recommended. However, the vaccine is underutilized in populations over the age of 19. Unfortunately, there is no vaccination available for hepatitis C, and prevention depends on individuals avoiding liver damaging behaviors.

Patients need to be made aware that tattoos, body piercings, and/or unprotected sex allow hepatitis viruses direct access to their liver and can result in liver damage, or potentially even liver cancer. Even invasive diagnostic and/or treatment procedures performed in the past may have inadvertently exposed them to these blood-borne diseases. Informing them of this mode of transmission, may reduce the stigma associated with contracting hepatitis and encourage them to self-identify their risk of infection. Simple blood tests can identify these infections, an essential first step in selecting appropriate treatment for controlling the progression of hepatitis B, and curing hepatitis C. Since hepatitis diagnostic tests are not included in routine screening programs, it is essential that physicians are vigilant in assessing their patient’s potential for infection.

Tragedies related to drug and alcohol abuse highlight the fact that individuals are unaware of the devastating impact their misuse of drugs can have on the liver. Over-the-counter, prescription, and illicit drugs have to be processed through the liver. When the liver is overwhelmed by too many drugs too often, it cannot detoxify them effectively, resulting in the death of liver cells and their ability to conduct life sustaining body functions. Continued assault from excess drugs and alcohol, combined with other unhealthy food and lifestyle behaviors can accelerate liver damage, and increase the risk for eventual development of liver cancer.

Concerned about the suffering, loss of lives, and economic burden of caring for chronic liver related illnesses that could have been prevented, thousands of liver specialists, nurses, and other healthcare providers urgently recommend that liver health information/education be provided in schools, government and military agencies. Ignorance is the liver's worst enemy.

Filling the knowledge gap of primary prevention through liver health education is critical in motivating individuals to act on what they’ve learned. The non-complaining liver is an unknown entity to most individuals and a major contributor to hepatitis, obesity, diabetes, and drug and alcohol abuse. A combination of policy initiatives, physician vigilance, and patient involvement is essential in controlling these pervasive diseases and preventing liver cancer.