Diet, nutrition, physical activity and liver cancer
Greetings to all on this cool autumn day, in Michigan we are looking at low 50s, with little sunshine.
If you find yourself hanging inside today, maybe even sipping a cup of coffee, consider it a good thing, coffee consumption has been proposed to reduce risk for hepatocellular carcinoma and chronic liver disease.
In honor of Liver Cancer Awareness Month, we focus today on lifestyle choices and liver cancer, using research that has established an association between the two, as well as disease progression in HCV.
Liver cancer types
Liver cancer types
There are several types of liver cancer based on the type of cells that becomes cancerous.
Hepatocellular carcinoma (HCC), also called hepatoma, HCC is the most common type of liver cancer accounting for approximately 75 percent of all liver cancers. HCC starts in the main type of liver cells, called hepatocellular cells. Most cases of HCC are the result of infection with hepatitis B or C, or cirrhosis of the liver caused by alcoholism.
Fibrolamellar HCC is a rare type of HCC that is typically more responsive to treatment than other types of liver cancer.
Cholangiocarcinoma (bile duct cancer) occurs in the small, tube-like bile ducts within the liver that carry bile to the gallbladder. Cholangiocarcinomas account for 10-20 percent of all liver cancers. Intrahepatic bile duct cancer begins in ducts within the liver. Extrahepatic bile duct cancer develops in ducts outside of the liver.
Angiosarcoma, also called hemangiocarcinoma, accounts for about 1 percent of all liver cancers. Angiosarcomas begin in the blood vessels of the liver and grow quickly. They are typically diagnosed at an advanced stage.
Secondary liver cancer, also known as a liver metastasis, develops when primary cancer from another part of the body spreads to the liver. Most liver metastases originate from colon or colorectal cancer. More than half of people diagnosed with colorectal cancer develop secondary liver cancer.
Chronic HCV and HBV are the most common risk factors for HCC, in fact close to 50 to 60% people with HCC in the U.S. have hepatitis C, the risk factor is higher for persons with both HCV and cirrhosis.
Of all persons with severe fibrosis or cirrhosis, 81% were born from 1945-1965
Hepatitis C Is A Serious Disease
One in 30 baby boomers – the generation born from 1945 through 1965 – has been infected with hepatitis C, in addition, data presented at Conference on Retroviruses and Opportunistic Infections (CROI 2015) reported persons with HCV born between 1945 and 1965, again baby boomers - have more advanced liver disease.
An Excerpt; Progression to severe fibrosis or cirrhosis is common among baby boomers with hepatitis C in the US
The aim of the study was to describe the rates of all cancers in the cohort of HCV patients compared to the non-HCV population. Known cancer types associated with hepatitis C include non-Hodgkin's lymphoma, renal and prostate cancers, as well as liver cancer.
For their study, Dr. Nyberg and colleagues assessed all cancer diagnoses that had occurred at KPSC among HCV and non-HCV patients aged 18 and older between 2008 and 2012.
The researchers found that, compared with patients without HCV, patients with HCV are not only at increased risk of liver cancer but of other cancers, including non-Hodgkin lymphoma and prostate and renal cancers.
The team identified 2,213 cancer diagnoses among patients with HCV during the 5-year study period. When liver cancer was excluded, 1,654 cancer diagnoses remained. Among patients without HCV, 84,419 cancer diagnoses were identified, with 83,795 cancer diagnoses remaining after the exclusion of liver cancer.
Based on their findings, the researchers calculated that patients with HCV were 2.5 times more likely than non-HCV patients to be diagnosed with cancer, including liver cancer. When liver cancer was excluded, cancer risk was still almost two times higher for patients with HCV, according to the study.
Background and context
The longer people live with Hepatitis C undiagnosed and untreated, the more likely they are to develop serious, life-threatening liver disease.
Liver disease, liver cancer, and deaths from Hepatitis C are on the rise.
Getting tested can help people learn if they are infected and get them into lifesaving care and treatment.
You should have routine hepatitis C viral testing if any of the following apply:
You have ever used IV drugs
You had a blood transfusion or organ transplant before 1992
You have been on long-term hemodialysis
You have persistently abnormal liver test results
You are or were a health care worker who may have been exposed to hepatitis C through blood exposure, for example a needle stick
You are a child born to a mother who had hepatitis C
Where Can I find a specialist to treat HCV?
Find a Specialist In Your Area
Testing, Diagnosis and Treatment
The burden of hepatitis C virus (HCV) infection is high in the US, with a substantial number of individuals born between 1945 and 1965 having advanced liver fibrosis or cirrhosis and therefore being at high priority for treatment
"About one-half of HCV-infected persons born from 1945-1965 had severe fibrosis or cirrhosis as measured by FIB-4 scoring," the researchers concluded. "Of all persons with severe fibrosis or cirrhosis, 81% were born from 1945-1965."
Article written by Liz Highleyman, available online at aidsmap.
Yesterday, I read a disturbing study from the University of Michigan Health System over at Healio which found that; patients with hepatitis C virus infection treated in 2011 and 2012 had more advanced liver disease vs. patients seen in 1998 and 1999.
In short researchers looked at 1,348 adults with HCV seen at the University of Michigan Health System in 1998/1999 deemed (Era 1) and 2011/2012 in a group called (Era 2), patients in the Era 2 were older, and most patients were treatment experienced. In the Era 2 group more patients were diagnosed with advanced liver disease, such as compensated or decompensated cirrhosis or hepatocellular carcinoma.
The article reported on the dire need of affordable regimens and improvement in early diagnosis for patients currently being treated or (Era 2) group.
“Reduction in HCV disease burden will require development of treatment regimens targeted towards patients in the current Era …, improvement in early diagnosis and referral of infected patients to appropriate centers for treatment, and reduction in costs of newly approved DAAs; otherwise, implementation of screening programs and availability of highly efficacious treatment regimens will have little impact on disease burden.” – by Melinda Stevens
Link to the article; Recent HCV patients show more complications than decades prior.
Cancer risk two times higher for HCV patients after excluding liver cancer
This year a study presented at The International Liver Congress suggested; patients with HCV were 2.5 times more likely than non-HCV patients to be diagnosed with cancer, including liver cancer. When liver cancer was excluded, cancer risk was still almost two times higher for patients with HCVThe researchers found that, compared with patients without HCV, patients with HCV are not only at increased risk of liver cancer but of other cancers, including non-Hodgkin lymphoma and prostate and renal cancers.
The team identified 2,213 cancer diagnoses among patients with HCV during the 5-year study period. When liver cancer was excluded, 1,654 cancer diagnoses remained. Among patients without HCV, 84,419 cancer diagnoses were identified, with 83,795 cancer diagnoses remaining after the exclusion of liver cancer.
Based on their findings, the researchers calculated that patients with HCV were 2.5 times more likely than non-HCV patients to be diagnosed with cancer, including liver cancer. When liver cancer was excluded, cancer risk was still almost two times higher for patients with HCV, according to the study.
Source
Hepatocellular Carcinoma and Lifestyles
This brings us to a review article investigating an association between lifestyles and HCC; Hepatocellular Carcinoma and Lifestyles, published last month in the Journal of Hepatology, the full text is provided by NATAP, download or read the article, here.
Hepatocellular Carcinoma and Lifestyles
This brings us to a review article investigating an association between lifestyles and HCC; Hepatocellular Carcinoma and Lifestyles, published last month in the Journal of Hepatology, the full text is provided by NATAP, download or read the article, here.
" The preventive and therapeutic impact of lifestyle on cancer is remarkable and its exploitation should be further promoted. HCC is a cancer tightly linked to lifestyle.......Epidemiological studies have indicated that physical activity lowers the risk of various carcinomas (esophagus, colon, breast, bladder, lung, kidney, prostate, pancreas, endometrium and ovary)"
Hepatocellular Carcinoma and Lifestyles
The Key Points
The Key Points
• The growing epidemic of metabolic conditions such as obesity and DM and their close
link to NAFLD in turn contribute to the increased risk of HCC development independent
of cirrhosis.
• Both human and animal studies have demonstrated an inverse association between
physical activity and liver cancer.
• Smoking increases the risk of developing HCC.
• Coffee intake is associated with a decreased risk of developing HCC.
• The molecular mechanisms underlying the effects of lifestyles and HCC involve changes
in metabolism, in particular, the activation of AMPK, changes in the immune system and
in inflammation.
LIVER CANCER REPORT 2015
Finally, an overview of the 2015 Liver Cancer Report from World Cancer Research Fund, read the full report, here.
Diet, nutrition, physical activity and liver cancer
World Cancer Research Fund International/American Institute for Cancer Research.
Continuous Update Project Report: Diet, Nutrition, Physical Activity and Liver Cancer.
Background and context
The latest statistics reveal that cancer is now not only a leading cause of death worldwide, but that liver cancer is one of the deadliest forms. Indeed, liver cancer is the second most common cause of death from cancer worldwide, accounting for 746,000 deaths globally in 2012 [1].
One of the reasons for the poor survival rates is that liver cancer symptoms do not manifest in the early stages of the disease, which means that the cancer is generally advanced by the time it is diagnosed. In Europe the average survival rate for people five years after diagnosis is approximately 12 per cent [2].
In addition, the number of new cases is also on the increase. World Health Organization statistics show that 626,162 new cases of liver cancer were diagnosed in 2002, but by 2012 the figure had risen to 782,451. This figure is projected to increase by 70 per cent to 1,341,344 cases by 2035 [1].
Statistics on liver cancer show that the disease is more common in men than women, and that 83 per cent of liver cancer cases occur in less developed countries, with the highest incidence rates in Asia and Africa. On average, the risk of developing liver cancer increases with age and is highest in people over the age of 75, although it can develop at a younger age in people in Asia and Africa - typically around the age of 40. In addition to the findings in this report, other established causes of liver cancer include:
1. Disease: u Cirrhosis of the liver.
2. Medication:
Long term use of oral contraceptives containing high doses of oestrogen and progesterone.
3. Infection:
Chronic viral hepatitis.
4. Smoking:
Smoking increases the risk of liver cancer generally, but there is a further increase in risk among smokers who also have the hepatitis B or hepatitis C virus infection and also among smokers who consume large amounts of alcohol.
In this latest report from our Continuous Update Project - the world’s largest source
of scientific research on cancer prevention and survivorship through diet, weight and
physical activity - we analyse worldwide research on how certain lifestyle factors affect
the risk of developing liver cancer.
This includes new studies as well as studies published
in our 2007 Second Expert Report, 'Food, Nutrition, Physical Activity and the Prevention of
Cancer: a Global Perspective' [3].
How the research was conducted
The global scientific research on diet, weight, physical activity and the risk of liver cancer
was systematically gathered and analysed, and then the results were independently
assessed by a panel of leading international scientists in order to draw conclusions
about which of these factors increase or decrease the risk of developing the disease.
The research included in this report largely focuses on the main type of liver cancer,
hepatocellular carcinoma, which accounts for 90 per cent of all liver cancers [4].
More research has been conducted in this area since our 2007 Second Expert Report
[3]. In total, this new report analyses 34 studies from around the world; this comprises
over eight million (8,153,000) men and women and 24,600 cases of liver cancer.
To ensure consistency, the methodology for the Continuous Update Project (CUP) remains
largely unchanged from that used for our 2007 Second Expert Report [3].
Findings
Strong evidence
There is strong evidence that being overweight or obese is a cause of liver cancer.
Being overweight or obese was assessed by body mass index (BMI).
There is strong evidence that consuming approximately three or more alcoholic drinks a
day is a cause of liver cancer.
There is strong evidence that consuming foods contaminated by aflatoxins (toxins
produced by certain fungi) is a cause of liver cancer. (Aflatoxins are produced by
inappropriate storage of food and are generally an issue related to foods from warmer
regions of the world. Foods that may be affected by aflatoxins include cereals, spices,
peanuts, pistachios, Brazil nuts, chillies, black pepper, dried fruit and figs).
There is strong evidence that drinking coffee is linked to a decreased risk of liver cancer.
Limited evidence
There is limited evidence that higher consumption of fish decreases the risk of
liver cancer.
There is limited evidence that physical activity decreases the risk of liver cancer.
Findings that have changed since our 2007 Second Expert Report
The findings on being overweight or obese, coffee, fish and physical activity in this
report are new; those for alcoholic drinks were strengthened and for aflatoxins remain
unchanged from our 2007 Second Expert Report [3].
Recommendations
To reduce the risk of developing liver cancer:
1. Maintain a healthy weight.
2. If consumed at all, limit alcohol to a maximum of 2 drinks a day for men and 1 drink
a day for women.
This advice forms part of our existing Cancer Prevention Recommendations (available at
wcrf.org). Our Cancer Prevention Recommendations are for preventing cancer in general
and include eating a healthy diet, being physically active and maintaining a healthy weight.
1. Foods that may be contaminated with aflatoxins include cereals (grains), as well as pulses
(legumes), seeds, nuts and some vegetables and fruits.
2. Based on evidence for alcohol intakes above around 45 grams per day (about 3 drinks a day). No conclusion was possible for intakes below 45 grams per day. There is insufficient evidence to conclude that there is any difference in effect between men and women. Alcohol consumption is graded by the International Agency for Research on Cancer (IARC) as carcinogenic to humans (Group 1) [2].
3. Body fatness is marked by body mass index (BMI).
4. Physical activity of all types.
1. Summary of panel judgements
Overall the Panel notes the strength of the evidence that aflatoxins, body fatness and alcoholic drinks are causes of liver cancer, and that coffee protects against liver cancer. The Continuous Update Project (CUP) Panel judges as follows:
Aflatoxins: Higher exposure to aflatoxins and consumption of aflatoxin-contaminated foods are convincing causes of liver cancer.
Alcoholic drinks: Consumption of alcoholic drinks is a convincing cause of liver cancer. This is based on evidence for alcohol intakes above about 45 grams per day (around 3 drinks a day).
Body fatness: Greater body fatness (marked by BMI) is a convincing cause of liver cancer.
Coffee: Higher consumption of coffee probably protects against liver cancer.
Fish: The evidence suggesting that a higher consumption of fish decreases the risk of liver cancer is limited.
Physical activity: The evidence suggesting that higher levels of physical activity decrease the risk of liver cancer is limited
1 - Summary of panel judgements
2. Trends, incidence and survival
3. Pathogenesis
4. Other established causes
5. Interpretation of the evidence
6. Methodology
7. Evidence and judgements
8. Comparison with the Second Expert Report
9. Conclusions
Acknowledgements
Glossary
References
Our Recommendations for Cancer Prevention
2. Based on evidence for alcohol intakes above around 45 grams per day (about 3 drinks a day). No conclusion was possible for intakes below 45 grams per day. There is insufficient evidence to conclude that there is any difference in effect between men and women. Alcohol consumption is graded by the International Agency for Research on Cancer (IARC) as carcinogenic to humans (Group 1) [2].
3. Body fatness is marked by body mass index (BMI).
4. Physical activity of all types.
1. Summary of panel judgements
Overall the Panel notes the strength of the evidence that aflatoxins, body fatness and alcoholic drinks are causes of liver cancer, and that coffee protects against liver cancer. The Continuous Update Project (CUP) Panel judges as follows:
Aflatoxins: Higher exposure to aflatoxins and consumption of aflatoxin-contaminated foods are convincing causes of liver cancer.
Alcoholic drinks: Consumption of alcoholic drinks is a convincing cause of liver cancer. This is based on evidence for alcohol intakes above about 45 grams per day (around 3 drinks a day).
Body fatness: Greater body fatness (marked by BMI) is a convincing cause of liver cancer.
Coffee: Higher consumption of coffee probably protects against liver cancer.
Fish: The evidence suggesting that a higher consumption of fish decreases the risk of liver cancer is limited.
Physical activity: The evidence suggesting that higher levels of physical activity decrease the risk of liver cancer is limited
1 - Summary of panel judgements
2. Trends, incidence and survival
3. Pathogenesis
4. Other established causes
5. Interpretation of the evidence
6. Methodology
7. Evidence and judgements
8. Comparison with the Second Expert Report
9. Conclusions
Acknowledgements
Glossary
References
Our Recommendations for Cancer Prevention
Worth A Click
Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease
World J Gastroenterol 2015 October 7; 21(37): 10621-10635
Rates of non-alcoholic fatty liver disease (NAFLD) are increasing worldwide in tandem with the metabolic syndrome, with the progressive form of disease, non-alcoholic steatohepatitis (NASH) likely to become the most common cause of end stage liver disease in the not too distant future. Lifestyle modification and weight loss remain the main focus of management in NAFLD and NASH, however, there has been growing interest in the benefit of specific foods and dietary components on disease progression, with some foods showing protective properties. This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/ fish oil, coffee, nuts, tea, red wine, avocado and olive oil.
Full Text Available @ World J Gastroenterol
Learn More About Liver Cancer
American Liver Foundation Celebrates Liver Cancer Awareness Month
ALF is in full campaign mode offering information about liver cancer, as well as encouraging people at risk to discuss the facts with their doctor. Visit here to learn more about this deadly disease.
Protect your liver:
Eat healthy, stay active.
Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease
World J Gastroenterol 2015 October 7; 21(37): 10621-10635
Rates of non-alcoholic fatty liver disease (NAFLD) are increasing worldwide in tandem with the metabolic syndrome, with the progressive form of disease, non-alcoholic steatohepatitis (NASH) likely to become the most common cause of end stage liver disease in the not too distant future. Lifestyle modification and weight loss remain the main focus of management in NAFLD and NASH, however, there has been growing interest in the benefit of specific foods and dietary components on disease progression, with some foods showing protective properties. This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/ fish oil, coffee, nuts, tea, red wine, avocado and olive oil.
Full Text Available @ World J Gastroenterol
Learn More About Liver Cancer
American Liver Foundation Celebrates Liver Cancer Awareness Month
ALF is in full campaign mode offering information about liver cancer, as well as encouraging people at risk to discuss the facts with their doctor. Visit here to learn more about this deadly disease.
Protect your liver:
Eat healthy, stay active.
Ask your doctor before taking any prescription, over-the-counter medications, supplements or vitamins. For instance, some drugs, such as certain pain medications, can potentially damage the liver
Avoid alcohol since it can increase the speed of liver damage
Talk to your doctor about getting vaccinated against Hepatitis A and B
Get Tested For HCV
In the past, or even today, some people find out by accident that they have the virus, maybe they had a blood test before a blood donation or were diagnosed during a routine checkup. Sadly, some people are not aware they have HCV.
If you have any of the following risk factors get tested
Born during 1945-1965
Most people with Hepatitis C don’t know they are infected so getting tested is the only way to know.
Baby boomers are five times more likely to have Hepatitis C than other adults.
Talk to your doctor about getting vaccinated against Hepatitis A and B
Get Tested For HCV
In the past, or even today, some people find out by accident that they have the virus, maybe they had a blood test before a blood donation or were diagnosed during a routine checkup. Sadly, some people are not aware they have HCV.
If you have any of the following risk factors get tested
Born during 1945-1965
Most people with Hepatitis C don’t know they are infected so getting tested is the only way to know.
Baby boomers are five times more likely to have Hepatitis C than other adults.
The longer people live with Hepatitis C undiagnosed and untreated, the more likely they are to develop serious, life-threatening liver disease.
Liver disease, liver cancer, and deaths from Hepatitis C are on the rise.
Getting tested can help people learn if they are infected and get them into lifesaving care and treatment.
You have ever used IV drugs
You had a blood transfusion or organ transplant before 1992
You have been on long-term hemodialysis
You have persistently abnormal liver test results
You are or were a health care worker who may have been exposed to hepatitis C through blood exposure, for example a needle stick
You are a child born to a mother who had hepatitis C
Find a Specialist In Your Area
Testing, Diagnosis and Treatment
Get out folks, go for a walk and enjoy this lovely time of the year.
Tina
No comments:
Post a Comment