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October 1, 2015

October is Liver Cancer Awareness Month. It may be a sleeper of a event when compared to other health campaigns, but for us who live with viral hepatitis, it’s an uncomfortable but critical reminder of the importance of monitoring our liver health to prevent cancer.

Viral hepatitis, especially B and C, are viral infections that can cause liver cancer  (also called hepatocellular carcinoma or HCC.) Researchers are still studying why some people are more prone to liver cancer, but we who live with chronic hepatitis B or C have a 25 to 40 percent lifetime risk of developing liver cancer. The infection, which hijacks our liver cells to manufacture more virus, causes inflammation, scarring and even cancer as the liver cells grow out of control.

The longer we are infected with viral hepatitis, the higher our risk of developing liver cancer. While liver cancer often occurs in people with cirrhosis (severe liver scarring), some of us develop cancer without cirrhosis.

Liver cancer is also a threat to us who are overweight and have hepatitis B or C. If you have viral hepatitis and are overweight with fatty liver disease, your risk of liver cancer more than doubles. Today, 20 percent of Americans have fatty liver disease (also called non-alcoholic fatty liver disease or NAFLD).

These are all reasons why we must be willing to save our own life and get checked for liver cancer regularly. Getting screened gives you information about your body. If cancer is present, wouldn’t you rather know about it sooner, when it’s still treatable?

Medical guidelines currently recommend regular screening in hepatitis B-infected men starting at age 40 and in women at age 50. But there are also people who should get cancer screening sooner, including:

  • Anyone with cirrhosis and/or a family history of liver cancer
  • People of Asian and Pacific Islander descent. Liver cancer is the third-leading cause of cancer deaths among Asian-Americans and the eighth-leading cause of cancer deaths among Caucasian Americans.
  • Younger Asian-Americans with chronic hepatitis B who smoke or have a family history of liver cancer
  • Men born in Africa appear to be at higher risk of liver cancer at a younger age, so screening is recommended starting at age 20
  • And, people co-infected with HIV and/or hepatitis B or C, and/or with fatty liver disease

What kind of cancer screening should we get?

Tests for liver cancer should be performed using ultrasound imaging every six months, according to the American Association for the Study of Liver Diseases (AASLD). This device uses sound waves to examine the liver for tumors or abnormal growth or shapes. The alfa-fetoprotein (AFP) blood test is not sensitive or specific enough to be used alone for screening, but it can be used in combination with ultrasound screening.

Early-stage liver cancer often causes no symptoms, which is why regular screening is so important for early detection. So what are the symptoms of advanced liver cancer?

  • Pain in the upper abdomen (belly) on the right side
  • A lump or a feeling of heaviness in the upper abdomen or a swollen abdomen
  • Loss of appetite, feelings of fullness and weight loss
  • Weakness or feeling very tired
  • Nausea and vomiting
  • Yellow skin and eyes (jaundice)
  • Pale stools and dark urine
  • Fever

These symptoms could result from other health problems, so it’s very important to see a knowledgeable health care provider early so problems can be diagnosed as soon as possible.

In the past 20 years, the prevention and treatment of liver cancer have improved tremendously. Today, liver cancer can often be prevented, detected at an early stage, and effectively treated if caught early enough. So get monitored, it just might save your life.