October 15, 2018 | Category: Uncategorized

Hepatitis C virus, often a silent enemy, can increase risks of developing liver cancer in both men and women

Half the population of Carson City. The entire capacity of the Mackay Stadium at the University of Nevada, Reno. About 100 times the seating in an average movie theater.

That’s how many men and women die of liver cancer each year — approximately 26,000.

In fact, even as cancer deaths across the country have fallen, liver cancer continues to kill more and more each year. According to a recent study by the Centers for Disease Control and Prevention (CDC), death rates for the disease jumped 43 percent among adults between 2000 and 2016.

“The increase in death rate related to liver cancer is twofold,” said Timothy Halterman, MD, a gastroenterologist with Gastroenterology Consultants. “There has been an obvious increase in the number of liver cancer cases likely due to hepatitis C infection, as well as other risk factors including fatty liver disease related to obesity and alcohol use.  Also, the prevention and treatment of other common cancers, such as colon and breast cancer have improved compared to advances made in diagnosis and treatment of liver cancer.”

During this 16 year period, liver cancer rose from the ninth leading causing of death to the sixth, with more men dying of the disease than women.

Researchers say the spike could partly be due to Hepatitis C, a virus that causes inflammation of the liver and, if left untreated, can eventually lead to cirrhosis.

“The main problem with hepatitis C currently is it is under-diagnosed,” Dr. Halterman said. “Approximately 4 to 5 million Americans — or 1 percent of the population — are living with chronic hepatitis C, but only about half of them know they have it.  In order to prevent more liver cancers, we need to do a better job finding those with hepatitis C and treating it before it has a chance to cause irreversible liver damage and liver cancer.”

A lack of symptoms associated with the virus is one barrier to diagnosis. Like a handful of viruses, including mono and shingles, Hep C can lay dormant in your body for years, or even decades, before causing any trouble.

The CDC estimates up to 80 percent of people with chronic hepatitis C won’t experience any symptoms until the damage is done. That means it’s often too late — even though the virus can be successfully treated with antiviral medication.

How did we get here

The largest group at risk for liver cancer includes those born between 1945 and 1965. Some scientists point to the virus’ spread during the 60s, 70s and 80s — before medical professionals understood how it was transmitted.

Up until 1992, blood transfusions and organ transplants weren’t screened for HCV, according to the CDC.

So, maybe you’re asking: what does this mean for me?

If you were born between 1945 and 1965, the CDC recommends that you be screened by your doctor for hepatitis C.

If you underwent a blood or organ transfusion before 1990 and haven’t been tested for the virus, you should also speak to your physician.

And, don’t think you’re off the hook if you were born after 1965. People can also be exposed to the virus in other ways, such as unprotected sex or sharing needles used to inject drugs.

In fact, the leading cause of new cases of hepatitis C in younger people is due to the rise of the opioid epidemic, Dr. Halterman said.

Not everyone who gets Hepatitis C will develop liver cancer, but complications from the virus can be serious, regardless.

Anything that increases your chance of developing cirrhosis will increase your risk of liver cancer. People who have hepatitis C should not drink alcohol, and should consult their doctor before taking certain prescription and non-prescription drugs.

Ultrasounds tend to be the main screening tool to check for liver tumors. However, people who don’t have cirrhosis most likely won’t need to be monitored closely for HCV-related liver cancer.

In those with cirrhosis of the liver due to any cause, they should be screened with an ultrasound of the liver as well as blood test called AFP (liver tumor marker) every 6 months.

Because liver cancer doesn’t usually display any outward signs or symptoms, these screenings are important as the earlier the disease is found, the better chance of treatment and survival.

When signs are present, they can include:

  • Weight loss (without trying)
  • Loss of appetite
  • Feeling very full after a small meal
  • Nausea or vomiting
  • An enlarged liver, felt as a mass under the ribs on the right side
  • An enlarged spleen, felt as a mass under the ribs on the left side
  • Pain in the abdomen or near the right shoulder blade
  • Swelling or fluid build-up in the abdomen
  • Itching
  • Yellowing of the skin and eyes (jaundice)

Other risk factors for liver cancer include chronic infection with hepatitis B virus, inherited liver disease, long-term obesity and excessive alcohol consumption.

If you have a question or concern about your health, please schedule an appointment with Dr. Halterman or one of our other physicians or mid-levels.

Born in Columbus, Ohio, Timothy Halterman, MD, did not stray far from home while completing his medical education and residency at Ohio State University. His interest in gastroenterology led him to the west coast, where he completed his fellowship training. Dr. Halterman moved to Reno in September 2011 to begin practice with Gastroenterology Consultants. When he’s not in the office, Dr. Halterman enjoys being outdoors.