Out of the 42,030 new cases expected by year’s end, liver cancer will claim 31,780 American lives. Worldwide, the disease is predicted to strike 800,000, and kill 700,000. More than 82 percent of liver cancer patients die within five years of diagnosis, according to the National Institutes of Health. With numbers like that, it should come as no surprise that liver cancer, also called hepatic cancer, is the second cancer killer globally. As liver cancer is actually on the uptick (cases have increased by two percent since 2007), and with October being Liver Cancer Awareness Month, it is worth noting several advances in the field, as well as identifying what hurdles remain. Diagnosis & Prevention Perhaps unsurprisingly, a 2018 French study suggests that liver cancer caused by alcohol consumption may have a worse prognosis than other forms. While hepatitis B and C remain the main causes of liver cancer, alcohol is involved in 25 – 30 percent of diagnoses in the United States. Of the 894 study patients, 582 had a history of chronic alcohol abuse; median overall survival was 9.7 versus 5.7 months in the non-alcohol-related and alcohol-related groups respectively. Investigators surmise that survival rates fall because of alcohol-related liver damage. On a side note, scientists believe hepatitis vaccinations could prevent about half of liver cancer cases worldwide. Another study linked an enzyme related to stress reduction to liver cancer. Nqo1, produced by the body to counter free radicals, is also used by liver cancer to regulate two major cell proliferation pathways that are key to enabling the metabolic reprogramming that enables cancer cells' super-efficient use of glucose as fuel and ultimately their rapid replication. Doctors found that by knocking out Nqo1, the metabolic adaptation needed to enable liver cancer cell proliferation was rendered inert. Therapies & Treatments Researchers at the University of Texas Southwestern found via mouse models that a protein in the body’s innate immune system that responds to gut microbes can suppress hepatocellular carcinoma (HCC), the most common type of liver cancer. HCC is associated with chronic inflammation, and investigators discovered the cytosolic pathogen sensor NLRP12 acts as a “negative regulator” of inflammation. Researchers looked at the signals sent by tumor cells in mice with and without the Nlrp12 gene. They found that the JNK (c-Jun N-terminal kinase) pathway — previously shown to be associated with liver cancer — is highly active in liver tumors that lack NLRP12; research into how NLRP12 regulates the JNK pathway is underway. Another potential treatment is starving liver cancer to death: Scientists at the University of Delaware and the University of Illinois at Chicago silenced a key cellular enzyme, hexokinase-2,  an enzyme that helps cancer cells metabolize glucose, their food source. The investigators then added metformin, a diabetes drug, and in a separate experiment the liver cancer sorafenib. Both combinations acted like one-two punches against cancer cells and could lead to new therapies in the future. Metformin and sorafenib are respectively sold under the names Glucophage and Nexavar. Finally, when surgery is not possible, as is the case when there are several tumors, ablation is an option. The process destroys [...]

With October being recognized as Liver Cancer Awareness Month, the National Foundation for Cancer Research (NFCR) presents to you a quick overview of the disease—and too insight into the importance of early detection and recent advances to that end. According to a July 2018 report from the U.S. Centers for Disease Control and Prevention, deaths from liver cancer soared 43% in the years spanning 2000 to 2016. With the exceptions of ethnic Asians and Pacific Islanders, increased mortality rose for all groups across racial and gender lines. This spike actually pushed the disease to the sixth leading cause of cancer death in 2016, whereas it had been ninth at the turn of the millennium. “And unfortunately, the symptoms are nothing—patients usually have none at all to start,” says Dr. Talal Adhami, a member of the American Liver Foundation’s National Medical Advisory Committee, highlighting why this particular cancer is so notoriously hard to recognize. “That’s why they have to go on a surveillance protocol with an ultrasound every six months.” By the time symptoms do present themselves—often in the forms of abdominal pain, fatigue, jaundice, liver failure and/or swelling around the belly—it is a dire sign that the cancer has progressed into its advanced stages. But it is also not unusual for even advanced liver cancer to present no symptoms. Adhami admits that when liver cancer is finally diagnosed, most often the prospects for a cure are already dim. But that is not to say science is completely in the dark. While liver cancer itself can fly under the radar, only very rarely does it spontaneously occur. Adhami stresses that any sort of liver scarring, no matter the cause, increases risk. Smoking and obesity are two conditions also known to contribute to liver cancer, and even poisoning via some molds and mushrooms. However, liver cancer most often precipitates out of standing liver conditions whose symptoms are far more easily recognized. In the case of hepatocellular carcinoma, the most common type of primary liver cancer, people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infections, are considered most at risk. Both present symptoms that are difficult to go unnoticed, such as dark urine, vomiting, itchy skin, abdominal swelling and swelling of the legs. Alcoholism is also, perhaps famously so, a cause of cirrhosis. Alcoholic hepatitis presents symptoms including jaundice and also vomiting. It is due to the high-risk factors of these diseases that patients are put under surveillance. Unfortunately, each of these conditions themselves are very gradual in their development. Indeed, Dr. Jiaquan Xu, the author of the CDC report, suggests the present rise in liver cancer deaths may stem all the way back to before 1992, the year it became mandatory for blood transfusions and organ transplants to be screened for hepatitis C, whose progress is extremely slow. The CDC lists both procedures as a one-time most common means of hepatitis C transmissions. Adhami adds that hepatitis B infection, also slow-acting, now most often occurs during pregnancy from mother to child. “But if you bring hepatitis B under control,” he goes on to say, “you […]