Memorial Sloan Kettering experts discuss risk factors and treatments for liver cancer.
What are the main causes of primary liver cancer? Scarring of the liver (cirrhosis) caused by too much alcohol use or infection with hepatitis B or C infection are largely to blame.
Up to 80 percent of primary liver cancers around the world are caused by infection with the hepatitis B or hepatitis C virus. Infection with this virus can affect you for many years and result in cirrhosis (scarring) in your liver. People get infected through physical contact with the blood or bodily fluids of a person who has the virus in their body.
You can get infected with the hepatitis B or C virus through:
- unprotected sex
- sharing unsterilized needles
- a blood transfusion, if received before 1992 (after that year, donated blood has been screened for the virus)
Because primary liver cancer caused by viral hepatitis tends to develop slowly over the course of two to three decades, there are steps you can take to get screened for the infection and prevent it from becoming advanced.
Ways to Prevent Liver Cancer
You can lower your risk for developing liver cancer by following healthy lifestyle measures, such as regular exercise, controlling your weight, and eating a healthy diet with limited amounts of alcohol.
It’s also important to avoid infection with the hepatitis B and C viruses.
Protect against Hepatitis B and C Infection
If it isn’t treated, hepatitis B infection can lead to cirrhosis (scarring), liver failure, and cancer. Vaccines for hepatitis B are available for children and adults. If you are at risk for hepatitis B or C infection, consider undergoing a screening test.
If you have chronic hepatitis B, you might be a candidate for antiviral therapy, which can slow down the progression of liver disease and decrease (although not eliminate) the risk of liver cancer. While there is no vaccine for hepatitis C, the right treatment can eliminate the virus in most people.
If you have chronic hepatitis, you should visit your doctors for regular surveillance with imaging tests, such as ultrasound, CT, or MRI.
Other Risk Factors for Liver Cancer
In addition to infection with chronic hepatitis B and C, the following conditions increase the risk of developing liver cancer.
- Nonalcoholic fatty liver disease (NAFLD): This disease is also called nonalcoholic steatohepatitis. It causes a type of fat called triglycerides to gather in the liver, which can lead to damage. NAFLD can cause cirrhosis (scarring of the liver) and liver failure. It commonly occurs in people who are overweight or obese, or who have type 2 diabetes or a metabolic syndrome characterized by high blood sugar, extra body fat around the waist, and abnormal cholesterol levels. With obesity on the rise in the United States, NAFLD is increasingly a risk factor for liver cancer.
- Cirrhosis of the liver made worse by alcohol use: Drinking alcohol greatly increases the risk of cancer in people infected with the hepatitis B or C virus, so it’s important to avoid drinking if you have viral hepatitis.
- Hemochromatosis: This is one of the most common genetic disorders in the United States. It increases the risk of liver cancer because it causes the body to absorb too much iron from food. Hemochromatosis is most commonly found in people of Irish descent.
- Exposure to arsenic: This naturally occurring substance is sometimes found in drinking water. It is also a part of vinyl chloride, a chemical used in making certain plastics that can increase your risk for liver cancer.
- Too much intake of male hormones or anabolic steroids: These hormones, which build muscle, are considered a risk factor.
- Ingestion of aflatoxin: Aflatoxin is generated by certain types of mold in improperly stored grains and nuts. It is extremely rare in the United States.
Screening for Primary Liver Cancer
Cirrhosis of the liver and certain types of chronic liver disease, such as chronic hepatitis B, leave you more likely to have liver inflammation and scarring — and to develop liver cancer.
We can help you set up a plan for a surveillance program to undergo regular screening with imaging tests, such as ultrasound, every six months. This will allow us to identify the disease at an early stage so that you can start to get care at a point when the cancer is still very treatable.