Hepatoma is a common and deadly cancer among Asians. I lost a close friend, a Fil-Am physician, a couple of years ago, and a few others before that, all to hepatoma. They all lived for only about 6 months from the time of diagnosis.
Also known as hepatocellular carcinoma, hepatoma is the most common (70 percent to 85 percent) primary cancer of the liver. The rarer ones are cholangiocarninoma, hepatoblastoma and angiosarcoma. The word primary means the cancer originated in the liver, in contrast to secondary or metastatic liver cancer, which originated from another organ, like cancer of the lung, breast, pancreas, colon, or stomach spreading to the liver. Most cancer found in the liver are metastatic from other organs.
In the United States, the incidence is between 1 to 5 cases per 100,000 population per year. About 70 percent of cases of hepatoma worldwide are due to chronic hepatitis B infection, compared to only 20 percent in the United States, where 60 percent to 80 percent are alcoholic cirrhosis-related. Among those not caused by hepatitis B virus, 50 percent to 70 percent were due to chronic hepatitis C infection. Mean age of hepatoma patients is 55-62 years, and with a male to female sex ratio of 3-4 :1
What causes hepatoma?
Those with chronic hepatitis B or C infection are prone to develop liver cancer. Other causal agents include alcoholism and chronic liver cirrhosis.
Will hepatitis lead to hepatoma?
While those who have hepatitis B or C have increased risk of developing hepatoma, not all persons with a history of hepatitis B or C infection will automatically develop hepatocellular carcinoma. For these persons, a healthy lifestyle could help boost the immune system and conceivably lessen the risk.
What are the other risk factors?
Chronic use of oral contraceptives, unsterile intravenous drug abuse, primary biliary cirrhosis, hemochromatosis, some metabolic disorders (Niemann-Pick), chlonorchiasis, gallstones, and choledochal cyst, chronic exposure to vinyl chloride polymers.
What are the symptoms?
Some cases have no symptoms at all till the hepatoma has progressed, and different individuals may experience symptoms in variable ways. Some of the most common symptoms and signs are abdominal pain, weight loss, fever, nausea, vomiting, swollen abdomen, fatigue, jaundice (yellow discoloration of the skin and eyes), large mass in the right upper quadrant of the abdomen. A former neighbor of ours in the Philippines, who is barely in his fifties, was found to have a grapefruit-size hepatoms on ultrasound last month, and his only complaint was mild abdominal pain. Patients in this stage of the liver cancer are incurable and usually have 4-6 months to live.
How can one prevent hepatoma?
Vaccination against hepatitis B virus to prevent getting hepatitis B infection is an effective way to significantly reduce the risk of developing hepatoma. Hepatitis B is transmitted sexually, and through blood transfusion, like hepatitis C. So preventive measures in this regard is fundamental. On top of this, abstinence from, or moderation in intake of, alcoholic beverages will help.
Does vaccination help?
Yes, since universal immunization against hepatitis B was implemented among children, statistics show that the incidence of hepatoma has been reduced to 1/4 to 1/3, compared to the period before the use of the vaccine. Global immunization against hepatitis B among all infants will surely help in minimizing, if not eradicating hep-b caused hepatoma.
We all look to the day when deadly diseases like hepatoma and all other cancers could be prevented with the use of vaccines, or effectively treated with oral medications, like in the case of tuberculosis, which used to spread and ravage all the organs of the body like cancer, until French scientists Calmette and Guerin discovered the BCG vaccine against TB in 1906, and later, streptomycin was isolated on October 19, 1943 by Albert Schatz, a graduate student, and first randomized trial of the drug used against TB in 1947.
Indeed, prevention of diseases, through healthy lifestyle, and vaccines if available, is the best strategy for well-bring and maximal; longevity.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
