Posted on Oct 29, 2019
Since 1980, hepatoma incidence in the U.S. has more than tripled. As a result, hepatoma death rates increased 43 percent among men, and 40 percent among women - making it the fifth-most common cause of cancer deaths in men, and the eighth-most common cause of cancer deaths in women.
But a recent study, led by Farhad Islami, the strategic director for cancer surveillance research at the American Cancer Society, found that 70% of liver cancers in the U.S. can be attributed to preventable causes.
So what are the biggest risk factors contributing to the decline in liver health among Americans, and how can we make sure it doesn’t happen to us?
Hepatoma, also called hepatocellular carcinoma (HCC) and hepatocarcinoma, is the most common type of primary liver cancer. (Primary liver cancer is cancer that orignates in the liver. Secondary liver cancer is cancer that spreads to the liver from another organ.)
In Islami’s study, he identifies four avoidable risk factors that are responisble for the rise in hepatoma: obesity, hepatitis C infection, cigarette smoking, and alcoholism.
The obesity epidemic accounts for about 30-40 percent of the overall increase in hepatoma over the last few decades.
In one study published by the American Association for Cancer Research (AACR), researchers found that being overweight was associated with a 21 percent increased risk of liver cancer. Being obese was associated with an 87 percent increased risk of liver cancer, and having type 2 diabetes in addition to being overweight or obese resulted in an even higher risk.
Obesity can lead to nonalcoholic fatty liver disease - a condition where fat builds up inside the liver. Fatty liver disease causes inflammation in the liver, which leads to cirrhosis - the biggest risk factor for hepatoma.
There are also other reasons (not reliant on the development of cirrhosis) that put overweight individuals at higher risk of developing hepatoma. While more research is being done to identify those pathways, overweight individuals should be aware that even if they do not have fibrosis or cirrhosis, they may want to be screened for hepatoma.
About 22 percent of liver cancer deaths have been linked to cigarette smoking. Especially when combined with alcohol use, or in people with hepatitis B or C, smoking significantly increases an individual’s risk of developing hepatoma.
Smoking and inhaling the toxins in tobacco can cause inflammation in the liver, and eventually lead to cirrhosis. Smoking also promotes the production of cytokines, chemicals that cause even more inflammation and damage to liver cells.
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Of all hepatoma cases in the U.S., 70 to 90 percent occur in cirrhotic livers. The main causes of cirrhosis are alcohol abuse and chronic viral hepatitis.
While treatment is available to cure hepatitis C, many people are unaware that they’re infected. Treatment can also be very pricey, making it less accessible. It’s advised that all adults get tested for hepatitis, especially if they ever participated in intravenous drug use at any point in their life.
The amount of alcohol you need to drink to cause cirrhosis varies from person to person. If you are a woman, drinking two to three drinks a day over several years puts you at risk. For a man, three to four drinks a day puts you at risk.
Identifying liver cancer can be difficult because hepatoma liver lesions have a variety of appearances on mendical imaging. This means they can easily be mistaken for other types of liver lesions.
Before a hepatoma diagnosis is confirmed, it is imperative benign liver lesions are carefully ruled out. To ensure accuracy, all radiographic images should be interpreted by a subspecialist radiologist. Familiarity in differentiating liver lesions takes years of experience and can mean the difference between a correct or misdiagnosis.
In patients who lack a history of cirrhosis or other chronic liver disease, but have a suspicious liver mass, a biopsy can help determine malignancy. However, MRI and CT scans are preferred diagnositc tools, since biopsy can be a risky invasive procedure.
Hepatoma does not usually cause any symptoms during the early stages.
As the cancer progresses, it may cause the following symptoms:
Treatment for hepatoma varies depending on the stage of cancer. Early-stage hepatoma cases, where liver function is still normal, may be treated with surgical removal of the tumor. However, as the cancer progresses and liver function is compromised, patients may need a liver transplant.
Radiation therapy, chemotherapy, targeted drug therapy, and immunotherapy are other hepatocellular carcinoma treatment methods.
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