While liver cancer cases continue to climb in the U.S., so has the medical community’s ability to care for hepatitis B patients affected by liver cancer. Here are some updates and reminders to help you talk to your doctor and get the best care possible. Continue reading "Updates in Hepatitis B-related Liver Cancer Care"
Hoping to learn more about treatment options for liver cancer, but weren’t able to make the webinar with Dr. Gish on April 27th? Continue reading "Treatment Options for Liver Cancer YouTube Webinar With Dr. Robert Gish"
According to media headlines, a recent study apparently found that cancers are mainly caused by “bad luck.” But are the headlines accurate? And if so, do we just cross our fingers and hope for the best? Continue reading "Not Just Bad Luck"
Welcome to the newly launched blog from Liver Cancer Connect, the Hepatitis B Foundation’s dedicated program on liver cancer. The blog will focus on issues that affect families facing liver cancer.
On the recent World Cancer Day 2014, we ushered in the new year with both sobering news and some optimism.
First the sobering news. The American Cancer Society recently reported1 that the number of new cases of liver cancer and the number of deaths due to this disease continue to increase.
The rate of liver/bile duct cancer has risen by 3% to 4% per year and mortality by about 2% over the past 2 decades. In sharp contrast, the death rate for all cancers combined has been steadily declining over the same period and the number of new cases has decreased for most cancers.
Liver cancer is the fifth most common cancer in the world, and the third leading cause of cancer-related deaths. In fact, every 30 seconds, one person in the world dies of liver cancer.
Yet liver cancer is largely preventable!
Eliminating the main risk factors for liver cancer — chronic hepatitis B and C infections and fatty liver disease — can stop the development of liver cancer.
Chronic hepatitis B and C infections, which cause about 85% of liver cancers worldwide, are preventable and treatable. A safe vaccine against hepatitis B (the world’s first anti-cancer vaccine) has been available since 1986. And while a cure is not yet available, hepatitis B infections can be kept under control with effective treatments. There is no vaccine yet for hepatitis C, but it can be cured. And fatty liver disease can be prevented by maintaining a healthy weight and diet.
Equally important in preventing liver cancer are screening and surveillance, which help to find the cancer early. Screening is the first test that a person undergoes to detect either an increased risk for liver cancer or the actual presence of the cancer. Surveillance refers to the regular monitoring for liver cancer on a ~6-month basis.
Early detection increases the number of treatment options available and the chances of successful treatment. A targeted oral therapy called Nexavar (sorafenib) is currently approved for liver cancer in more than 70 countries, and researchers are looking for new ways to fight liver cancer with fewer side effects. Many of these potential new treatments are being studied in clinical trials.
So there is room for optimism. With greater public awareness of the risk factors and how to prevent them, and new therapies being developed, it is possible to reverse the bleak statistics for liver cancer.
With the rallying call, “Liver cancer is preventable!” Liver Cancer Connect is putting the spotlight on the prevention of liver cancer.
Our patient-focused website (www.livercancerconnect.org) explains the main risk factors for liver cancer and the importance of screening, surveillance, and early intervention. Over the next few months we will be expanding the resources on the website and bringing you more news and information on liver cancer. We encourage you to explore the website and send us your comments.
1. Siegel R, Ma J, Zou Z, Jemal A. Cancer Statistics, 2014. CA Cancer J Clin 2014 (epub ahead of print).
Posted in Science World Report, October 17, 2013
A recent study looks at a form of hepatitis B that is only found in men and may explain higher rates for certain types of cancer.
According to a team of researchers from Seoul National University in Korea, they identified a mutation from the hepatitis B virus that seems to appear only in men and may explain why HBV-infected males are roughly five times more likely than HBV-infected women to develop certain types of liver cancer. Continue reading "Hepatitis B Mutation Seen in Only Men, Increased Risk of Liver Cancer"
Coffee consumption reduces risk of hepatocellular carcinoma (HCC), the most common type of liver cancer, by about 40 percent, according to an up-to-date meta-analysis published in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association. Further, some data indicate that three cups of coffee per day reduce liver cancer risk by more than 50 percent.
Posted in Science Daily, October 22, 2013
Could an inexpensive test, used in conjunction with current, traditional HCC testing help reveal one’s liver cancer risk? Research for the V-chip is described in an article published in this week’s Health Canal.
Scientists from the Houston Methodist Research Institute and the University of Texas M.D. Anderson Cancer Center will receive about $2.1 million from the National Cancer Institute to learn whether a small, low-cost device can help assess a person’s risk of developing a common form of liver cancer.
The four-year project is based on technology previously developed by Houston Methodist nanomedicine faculty member Lidong Qin, Ph.D., who is the new project’s principal investigator. Qin’s “V-Chip,” or volumetric bar-chart chip, will be used to detect biomarkers for hepatocellular carcinoma (HCC), the most common cause of liver cancer. The device only requires a drop of blood from a finger prick.
The V-Chip allows the testing of up to 50 different molecules in a blood or urine sample.
“Most of the burden of HCC is borne by people who have low income, with the highest incidence rates reported in regions of the world where infection with hepatitis B virus is endemic,” Qin said. “Developing an accurate and low-cost technology that assesses the risk of cancer could make a big difference to people who ordinarily can’t afford expensive tests.”
M.D. Anderson Department of Epidemiology Chair Xifeng Wu is the project’s co-principal investigator.
Qin and Wu will see whether the V-Chip accurately detects HCC biomarkers. The researchers will also determine which combination of these biomarkers proves most predictive of disease.
Among the biomarkers the researchers will look at are antigens of hepatitis viruses B and C, aflatoxin (a fungal toxin that at high doses is associated with cancer risk), and metabolic indicators of alcohol consumption, obesity, diabetes, and iron overdose.
Tests of the V-chip will not replace traditional testing methods, but rather be carried out in tandem so that patients’ care cannot be adversely affected.
Hepatocellular carcinoma is believed to be the third-highest cause of cancer death worldwide and the ninth leading cause of cancer death in the U.S. It is most commonly caused by a past infection of hepatitis viruses B or C (HBV or HCV) and cirrhosis of the liver caused by alcohol abuse or other toxic damage.
Please visit Health News, Health Canal for more information
A dedicated program of the Hepatitis B Foundation for patients and families
The statistics are sobering. Liver cancer is the seventh most common cancer in the world, but the third leading cause of cancer-related deaths. Worldwide, more than 700,000 people are diagnosed with primary liver cancer each year, accounting for more than 600,000 deaths annually. Equally disturbing is the fact that while the incidence rates of most cancers have declined in recent years, the incidence rate for liver cancer is increasing.
But there is encouraging progress in the fight against liver cancer. Scientific research into new treatments is yielding promising results. And perhaps more significantly, the major causes of liver cancer— such as chronic hepatitis B or hepatitis C infections, and cirrhosis — are largely preventable. A safe and effective vaccine against hepatitis B has been available since 1986. In fact, this vaccine was named the world’s first “anti-cancer” vaccine, because it prevents chronic hepatitis B infection, the world’s leading cause of liver cancer. While no vaccine for hepatitis C currently exists, new drugs can eliminate the virus, thereby halting the progression to liver cancer. And cirrhosis can be avoided by preventing chronic hepatitis B and C infections, limiting alcohol intake, and preventing fatty liver disease associated with obesity.
Knowing that these risk factors are preventable makes it all the more important to identify people at risk for liver cancer, educate them about prevention and treatment options, and direct them to appropriate medical care.
To provide accurate, easy-to-understand information to people diagnosed with liver cancer, the Hepatitis B Foundation has created the first patient-focused website, www.LiverCancerConnect.org. The website aims to help people better understand how liver cancer is diagnosed and how it can be treated or prevented. In addition, wwwLiverCancerConnect.org includes a Drug Watch of potential new liver cancer therapies, an expanding directory of liver cancer specialists, and a clinical trials listing.
The Hepatitis B Foundation is also organizing a series of webinars in 2013 to educate the public about the link between liver cancer and its main risk factors, namely hepatitis B and C infections and cirrhosis caused by fatty liver disease. The webinars, presented by leading international experts in liver diseases, will explain what primary liver cancer is, the importance of liver cancer screening and surveillance, and the treatment options and clinical trials that are currently available. Additional information will be announced on both the Liver Cancer Connect website and HBF’s blog when it is available.
The Foundation invites you to use www.LiverCancerConnect.org to learn about liver cancer and its treatment options, and to locate liver cancer specialists and clinical trials. We welcome your feedback and suggestions at connect@livercancerconnect.org so that we may continue to build on this valuable resource for the global liver cancer community.
Liver Cancer Connect is available on Facebook and Twitter. Join LCC on Facebook at http://www.facebook.com/LiverCancerConnect and follow LCC on twitter with the handle @LiverCancerConn.
Below is a publication from “Healio Hepatology, January 23, 2013 –HBV Genotype C Carries Greater Risk for HCC Than Other Genotypes“, showing the risk of hepatocellular carcinoma among the different hepatitis B genotypes based on a meta-analysis of 43 studies. There are 8 identified HBV genotypes ranging from genotypes A through H. These different genotypes are concentrated in distinct geographic areas of the globe, and may influence the course of disease, as noted below with the greater risk of liver cancer for those with genotype C.
Patients with hepatitis B genotype C are more likely to develop hepatocellular carcinoma than patients with other HBV genotypes, according to recent results.
Researchers performed a meta-analysis of 43 studies (34 cross-sectional, four case-control, four prospective or retrospective cohort studies and one randomized controlled trial) published between 1999 and 2010 assessing the risk for hepatocellular carcinoma (HCC) across the major genotypes of hepatitis B.
Analysis included data on 14,545 patients with HBV, with 517 cases of genotype A, 4,417 of B, 7,750 of C, 1,506 of D, 57 with A and D in combination and 298 with other and/or mixed genotypes. There were 2,841 patients with HCC across all studies.
In 33 studies comparing genotypes B (n=4,417) and C (n=6,060), HCC was significantly more common among participants with genotype C (25% of patients vs. 12%), with an OR of 2.05 (1.52-2.76). Patients with genotypes A (n=517) and D (n=1,506) were at similar risk for HCC across 12 studies (14% for A vs. 11% for D, OR=0.94, 0.67-1.32). Patients with genotype C (n=1,659) were at significantly higher risk than those with genotypes A or D (n=1,403) in 10 studies (30% vs. 7%, OR=2.34, 1.63-3.34). Analysis of HBV subgenotypes Ce (n=1,440) and Cs (n=715) in eight studies indicated a similar risk for HCC between subgenotypes (OR=1.13, 0.76-1.67) (95% CI for all).
“Genotype C HBV is associated with a higher risk of HCC than genotypes A, B and D HBV based on studies largely observational,” the researchers wrote. “This partly explains a higher risk of HCC among patients in Southeast Asia where genotype C HBV is prevalent. Patients infected with genotype C HBV, which is often associated with more active liver disease and higher risk of liver cirrhosis, should be closely monitored for HCC development and considered for antiviral therapy.”
Disclosure: See the study for a full list of relevant disclosures.
From HBF’s expert Guest Blogger, Dr. Thomas London…
At the 2012 Digestive Disease Week meeting in San Diego, an enormous study from Taiwan was reported that encompassed almost all of Taiwan’s 23 million people. (I am indebted to Christine Frangou for her excellent report in Gastroenterology and Endoscopy News and have quoted from it extensively.) The investigators used the Taiwan National Insurance Database to identify all cases of HCC diagnosed from 1997 to 2008. There were 97,430 patients with HCC (most of whom would have had chronic hepatitis B). They were compared with 200,000 controls matched to the HCC cases by age, gender, and date of first physician visit. Using the same database they linked all patients with diabetes and their treatment methods to patients with and without HCC.
From this they were able to show that patients with diabetes had a 2.3-fold increased risk of developing HCC. In those patients who were taking metformin, however, HCC occurred about 20% less often than in those who were not treated with metformin. Furthermore, the longer patients took metformin, the lower their risk of HCC; about 7% lower for each year that they took the drug.
This study is not the final answer. We don’t know why some diabetic patients were treated with metformin and some were not. It is possible that the patients who did not take metformin had some unknown liver abnormality and were deliberately not treated with metformin. Nevertheless, anti-tumor effects of metformin in experimental animals and in cell culture systems continue to be reported. I will keep my eye out for more research on metformin and HCC and report it as it hits the medical press.
Statins are another group of drugs that are in common use. They were first approved by the FDA in 1987 to lower serum cholesterol levels and thereby prevent heart disease. Statins inhibit an enzyme in the liver used to make cholesterol. Several isolated reports suggested that statins might also help prevent HCC. This month investigators at the Mayo Clinic in Rochester, Minnesota reported a meta-analysis (a statistical method to combine results from different studies) of all the reports in the medical literature of new cases (incidence) of HCC and exposure to statin therapy. Ten studies reporting a total of 4,928 HCC cases in 1,459,417 patients were analyzed. Overall, patients who were treated with statins had a 40% lower risk of developing HCC than those who were untreated. The results varied from population to population. Asian populations which were more likely to also have chronic hepatitis B, had a 50% lower risk of developing HCC, while western populations had about a 30% lower risk.
At this time we do not know what the mechanism of a preventative effect of statins on HCC might be. Nor do we know whether statins might have been withheld from patients with high cholesterol levels because they had a liver abnormality. It is likely, however, that more information on these issues will become available in the near future. When that happens I will report it to you.
