As the country observes the month-long Liver Cancer and Viral Hepatitis Awareness and Prevention Month, more Filipinos continues to be diagnosed with liver diseases, yet it remains a “silent epidemic.” Unhealthy lifestyle, largely influenced by Western diet and habits, is said to be among the factors leading to the rising numbers, according to experts. The outlook for liver cancer is poor, but the disease is preventable because the major risk factors for the disease have already been identified.
Liver cancer is the fifth most commonly occurring cancer in men and the ninth most commonly occurring cancer in women. There were over 840,000 new cases in 2018. The Philippines ranks 23rd of the Top 25 countries with the highest rates of liver cancer in 2018 according to the Continuous Update Project Panel of World Cancer Research Fund and American Institute for Cancer. In the Philippines and other underdeveloped countries, however, the incidence of liver cancer is rather high. According to a DOH advisory, it shows that liver cancer is the third most common form of cancer among Filipinos—in men, it is the second most common, while in women, it is the ninth most common.
Liver cancer is relatively common in the Philippines primarily because many Filipinos suffer from cirrhosis of the liver, a major risk factor for liver cancer. Cirrhosis of the liver precedes 80%of all liver cancers; thus, any condition that predisposes to cirrhosis indirectly causes liver cancer. The usual cause of liver cirrhosis among Filipinos is chronic Hepatitis B, a major public health problem in the country. Chronic Hepatitis B afflicts between 10 and 12% of all Filipinos. Other less significant causes of cirrhosis are Hepatitis C infection and alcoholism.
In 2014, statistics show that liver cancer claimed the lives of 20 Filipinos a day and the number is projected to double by 2030. That same year, the Department of Health partnered with the Philippine Charity Sweepstakes Office (PCSO) to provide monetary assistance amounting to 1.5 million pesos to indigent patients who need to undergo liver transplantation at the National Kidney and Transplant Institute (NKTI). A liver transplantation procedure usually costs up to 4 million pesos, but this is reduced by almost half at the NKTI, a government hospital.
Liver cancer has a poor prognosis or outlook because it is often diagnosed very late in its course. It usually presents no symptoms until the tumor is already at least 10 cm in size, at which time the disease has typically already spread and is in the advanced stage. Most liver cancer patients die within a year of diagnosis, and the five-year survival rate for the disease (if no treatment is undertaken) is less than five percent. Even with treatment, the five-year survival rate for liver cancer is still a low 35%.
The World Cancer Research Fund and American Institute for Cancer Research judged there is strong evidence that greater body fatness, and consuming alcoholic drinks and foods contaminated by aflatoxins increase the risk of liver cancer. According to them, there is strong evidence that drinking coffee decreases the risk of liver cancer. There is some evidence that being physically active and consuming fish might decrease the risk of liver cancer.
The recent onslaught of COVID-19 poses a risk for those who suffer from Liver cancer as they are immune-compromised. Measures that can significantly reduce one’s risk for cancer of the liver include vaccination for Hepatitis B, avoidance of alcohol, and proper storage of foodstuff. Healthy lifestyle and proper nutrition is desired. After all, prevention is better than cure. # Leo Christian V. Lauzon
