In Spain they are diagnosed 6,590 cases of liver cancer per year, assuming 2.3 percent of all tumors and the sixth in order of frequency. It is a tumor unknown, with a high lethality and “Tremendously” preventable. This is how it stands out Bruno Sangro, Director of the Hepatology Unit of the Clínica Universidad de Navarra, Professor of Medicine. and member of the Spanish Association for the Study of the Liver (AEEH) on the occasion of the Liver Cancer Awareness campaign held in October.
Risk factor’s
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Within primary liver tumors, the hepatocarcinoma it is the most frequent (80-90% of cases), followed by cholangiocarcinoma. It is estimated that between 60 and 90 percent of hepatocarcinomas are associated with cirrhosis, whose main cause of non-viral origin is abuse in the alcohol consumption.
“Liver cancer has the peculiarity that, in the vast majority of cases, it appears in patients who have a chronic liver disease. If we compare it with breast cancer, a woman develops this tumor without having a previous problem in the breast. Instead, liver cancer usually has an underlying disease that is usually silent, “explains Sangro.
The most common patient profile is that of a person with diagnosed or undiagnosed cirrhosis that can be caused by hepatitis B virus (HBV) or hepatitis C virus (HCV) or from chronic alcohol abuse. “They are usually male patients over 70 years old,” the expert points out.
The increase in the prevalence of obesity and diabetes In recent years, it has led to an increase in the incidence of non-alcoholic fatty liver disease as well as non-alcoholic steatohepatitis that can lead to cirrhosis and, eventually, the development of hepatocarcinoma.
“It is an immensely preventable tumor because the most frequent causes of cirrhosis, such as hepatitis or alcohol abuse can be avoided”
Bruno Sangro, director of the Hepatology Unit of the Clínica Universidad de Navarra
“Although diabetes and obesity are a risk factor with little influence, this risk increases if a patient with diabetes is diagnosed with cirrhosis. That is, if in the context of metabolic syndrome there is liver disease associated with fat, the risk of liver cancer also increases ”, he emphasizes.
However, the causes of this tumor make it a preventable cancer. “It is an immensely preventable tumor because the most common causes of cirrhosis, such as the hepatitis virus, can be avoided with vaccination campaigns, as well as with the decreased chronic and high alcohol use”, Continues Sangro,“ Finally, it is avoidable to the extent that it can be avoid the epidemic of metabolic syndrome linked to the western lifestyle ”, he completes.
Symptoms and prognosis
Liver cancer can be detected by silent way when the patient goes to be checked for liver disease, but it may also present symptoms that alert his specialist. “The symptoms are those of a liver that begins to malfunction and can cause fatigue, pain in the abdominal area or symptoms caused by a cirrhosis that has been unbalanced ”, he points out.
Liver cancer accounts for 4.5 percent of cancer deathsr. “The prognosis for this tumor is simply bad. AND cure is rarely achieved, if adequate prevention is not done. Why is this happening? Because the liver is an organ that gives few symptoms and the most frequent is that it is not detected in an incidental or sought after way in an asymptomatic patient and wait for the manifestation of symptoms”, Explains the hepatologist, who stresses that this happens when the disease is already very voluminous or has spread to other organs.
The AEEH works to convey to the general public the awareness that this cancer exists and that it is preventable
Awareness work
The lower incidence compared to other tumors requires a greater research effort. “There is not enough awareness because it is not a common tumor. In Spain in particular, luckily, the incidence is not that high and it makes it even more unknown ”, explains Sangra.
The second reason, as described by the expert, is that it is a tumor ‘frowned upon‘, to the same extent that chronic liver diseases are stigmatized. “For example, there is a widespread belief that cirrhosis is caused by bad habits, leading a bad life, drinking a lot … and liver cancer too. Therefore, it is a disease that is hidden. There is a stigmatization of the patient with liver cancer if we compare it with other tumors ”, insists the specialist.
The AEEH has been working for years to reverse this stigmatization situation. “The AEEH also works to move the general public awareness that this cancer exists and that it is preventable. In addition to leading a favorable lifestyle and treat causes of cirrhosis that lead to cancer, it is very important to identify those patients who have chronic liver diseases so that they undergo periodic screening ”, concludes the expert.
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