Steps to protect your liver

Maintaining a healthy lifestyle and getting the Hepatitis B vaccine is the most effective way of preventing liver cancer, writes KASMIAH MUSTAPHA. IT may not have received as much attention as other forms of cancer, but in reality, liver cancer is the most common cancer in the world. It is also the third leading cause of cancer-related deaths worldwide.

Making it even more deadly are the two types of liver cancer — primary and secondary. Primary liver cancer is defined as cancer that begins in liver cells — called hepatocytes. This type of cancer is called hepatocellular carcinoma (HCC), which accounts for 90 per cent of liver cancer cases.

Secondary liver cancer is the result of the mutation of the cells from another type of cancer which spreads to the liver.

HCC is caused by several factors which include chronic infection of hepatitis B and/or hepatitic C virus, cirrhosis which is scar tissues of the liver, alcohol abuse, long-term exposure to alfatoxins which is produced by many species of fungus that can be found in tree nuts, peanuts and other oilseed, smoking, long-term use of anabolic steroids and obesity.

Often HCC has no symptoms until the cancer is at an advanced stage making early treatment almost impossible.

Symptoms usually include fatigue, pain on the right side of the upper abdomen or around the right shoulder blade, nausea, loss of appetite, feeling full after a small meal, unexplained weight loss and jaundice.

Consultant clinical oncologist Dr Chong Kwang Jeat says the prognosis for HCC is never good with the survival rate of less than a year. This is largely due to the fact that the symptoms are presented at an advanced stage and there are very few treatment options for the patients.

“Liver cancer is under-reported due to lack of awareness and there is certainly a high medical need for an early and reliable diagnosis as well as for an effective life-prolonging treatment,” he added.

In Malaysia, liver cancer is the 10th most common cancer among men and the 15th most common cancer among women.

In 2003, there were 530 cases of HCC reported in Malaysia. Ninety per cent of HCC is cause by hepatitis B, followed by hepatitis C and alcohol.

However, while it may be impossible to prevent secondary liver cancer, there are possibilities of reducing the risks from HCC by taking steps to protect your liver.

Those in the high risks group — namely those with chronic hepatitis B, C and drink alcohol — should go for screening often as early detection have the potential to cure the disease.

“The most effective way of preventing liver cancer is to get vaccination from hepatitis B. The vaccination will provide protection from the infectious disease and at the same time protect your liver from HCC.”

According to the World Health Organisation, hepatitis B vaccine has an outstanding record of safety and effectiveness. Since 1982, over one billion doses of hepatitis B vaccine have been used worldwide. Studies have shown that the vaccine is 95 per cent effective in preventing children and adults from developing chronic infection if they have not yet been infected.

Dr Chong says treatment for liver cancer will depend on the stage of the disease. If it is caught in the early stage, surgery to remove the cancerous growth will be done. However only about 15 per cent of patients can be operated on.

“Treatments include surgery, radiation therapy, chemotherapy, percutaneous ethanol injection and targeted therapy.”

Meanwhile, Professor Dr Peter Galle, Department of Internal Medicine director at the University of Mainz in Germany, says surgery and chemotherapy are used to treat liver cancer that is diagnosed in the early stage, when the tumour is confined to a small area of the liver.

“Unfortunately liver cancer is a devastating disease that is diagnosed too late, too often. This is because there are no symptoms in the early stages of the disease.”

Bayer Schering Pharma had recently launched sorafenib as the oral targeted therapy for the treatment of liver cancer. Sorafenib was approved and launched in Malaysia for the treatment of kidney cancer last year. Based on clinical trials, it is found that sorafenib improves patient’s survival rate by 44 per cent.
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source: NST Online, http://www.nst.com

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