Cancer Awareness Society hails Bihar Government's prohibition decision

People engaged in creating awareness about liver cancer hailed the Nitish Kumar government's decision on prohibition as "historic" which would have positive impact on the health of people.

A team of Cancer Awareness Society met the CM to support the October 2 notification enforcing prohibition in the state.

Two days after the Patna High Court quashed its order on prohibition, Bihar government on October 2 came out with a new law banning liquor with harsher provisions.

The Society team told Mr. Nitish Kumar that the World Health Assembly, the decision making body of WHO, had in 2010 taken a decision for controlling usage of alcohol of which India was one of the signatory, according to a statement of the Society.

Action was desired in this direction after being signatory to the decision. By fulfilling this, the Bihar government has initiated a historic step which deserves praise. The team told Kumar that they are with him in the campaign against alcohol.

The statement said about short term and long term medical effects of alcohol on consumer.

The short term effects included slurred speech, drowsiness, vomiting, diarrhea, breathing difficulties, anemia and blackouts.

The long term effects included unintentional injuries like alcohol poisoning, high blood pressure, stroke and heart related diseases, liver disease, sexual problem and cancer of liver, mouth and throat among others.

Banned Chemical dyes poisoning our food and can cause liver damage

That yellow-tinted appetizing dum biryani from restaurants or the silver-coated kaju barfi from sweet shops that we love to treat ourselves may not be all safe for consumption and have severe health implications. Despite a government ban on toxic chemical dyes like metalin yellow and silver, food adulteration using these chemical colours is going on unchecked in India.

In fact, biryani samples collected recently from some of the restaurants in Vishakapatnam revealed the presence of metalin yellow. This banned chemical substance was also found in daal and other cooked curries and biryani in eateries. Similarly, the chemically-induced silver colour layer is used by most sweets shops to make the products look attractive. Ideally, a thin silver sheet should be placed on the sweets but lab analysis found that almost all sweet shops, with an eye on profits, use cheap tin foil that is a toxic heavy metal.

Most of cities in India with hundreds of eating joints have only few food inspectors and no exclusive food safety inspection department to keep an eye on things.

Had there been proper and unbiased inspection of all small and big eateries, many food centres will fail the lab test either for adulterating food with banned chemical colours or for using food colours beyond the FDA (Food and Drug Administration) permissible limit.

According to experts, the presence of these toxic and carcinogenic chemical dyes used in food has several adverse impacts on health and can cause irreparable damage to the kidneys and also affect the liver, the two most vital organs. The chemical dyes affect the nephrons and when the kidney can't filter the chemicals, they get deposited in the kidneys and lead to chronic kidney diseases. Again, the toxic and poisonous substances are sent by the body to the liver for treating or processing. When they can't be treated, they start depositing the substance in the liver. After a while, the deposits cause degeneration of the liver and eventually cause liver cancer.

Apart from the more harmful synthetic dyes used as food colouring substances in eateries, bakeries and confectionaries, at times relatively less harmful metal salts are used in raw food, for instance copper sulphate to impart green colour to vegetables. Metal salts usually escape the screening process meant to detect chemical dyes. They pass off as natural colours in High Performance Liquid Chromatography (HPLC) Test.

Variations in liver cancer attributable to hepatitis virus variations

Significant clinical variations exist among patients with the most common type of liver cancer called hepatocellular carcinoma (HCC), depending on the viral cause of the disease -hepatitis B virus (HBV) or hepatitis C virus (HCV). These differences suggest that hepatitis status should be considered when developing treatment plans for newly diagnosed patients, according to researchers.

These findings, from the largest single-center studies of its kind will be presented on May 31 in an oral presentation at the 2015 Annual Meeting of the American Society of Clinical Oncology (ASCO). The research builds on previous studies of differential effects of demographics, geographical distribution and risk factors, including hepatitis status, on treatment outcomes among patients with inoperable HCC. In these earlier studies, researchers observed different outcomes based on demographics and geographic patients distribution (Asia versus Europe and USA) among patients receiving the same local or systemic therapy approaches. They hypothesized that these differences might be attributed to variations with regard to hepatitis type, among other factors.

Currently, a patient's form of hepatitis is not a factor in treatment planning, but the two types of the virus result in different disease impacts and some variations in outcomes. Most likely, this is related to the difference in how hepatitis leads to cancer development, in addition to the differences in the natural history of both hepatitis forms. This might be the result of treating technically different diseases the same way. This study provides more evidence that future clinical trials should stratify patients by hepatitis type to help identify better drugs and create personalized treatment modalities.

In the current study, researchers investigated detailed characteristics of 815 HCC patients treated at MD Anderson between 1992 and 2011, assessing a range of disease-state variables and survival rates. HBV is a DNA virus and HCV is an RNA virus, and it has previously been unclear whether this difference might influence the clinical-pathologic features of HCC or patient outcomes.

Researchers found that patients with HBV were more likely to develop HCC at a younger age than HCV patients and presented more aggressive disease, marked by:

• Advanced diagnosis stage (3-6);
• High alpha-fetoprotein, a cancer signal and measure of how well treatments are working;
• Poorly differentiated tumor cells, which tend to grow and spread more quickly;
• Larger tumor size;
• Extent of cancer in the liver ( >50% of the liver volume), a factor for metastases; and
• Portal thrombosis, a blockage or narrowing of the vessel that brings blood to the liver from the intestines.

Patients with HCV-associated cancer were more likely to exhibit:

• Underlying cirrhosis;
• Have a history of greater alcohol and cigarette use; and
• A higher rate of diabetes.

The median survival rates were 10.9 and 9.3 months for HCV and HBV, respectively. At ASCO, the research team will also present the specific survival outcomes based on different therapies.

Roughly 700,000 patients are newly diagnosed with HCC each year, and more than two-thirds of new cases are from the Asia-Pacific region -- mainly linked to chronic HBV infection. Recent studies have reported a rise in the number of cases in the U.S. and Western Europe, largely due to an increase in HCV-related liver disease, which accounts for roughly half of all U.S. cases. However, most patients are not candidates for any curative treatments because of advanced disease at diagnosis and/or a background of advanced chronic liver disease.

Eligibility for certain treatments depends on cancer staging at diagnosis. Thus, this study has major implications for determining how we treat new HCC patients. Especially for patients with HBV, who might need more aggressive treatment even at the outset.

Even moderate drinking can cause liver cancer

Researchers have confirmed that even moderate drinking can cause liver cancer. A survey was published by the World Cancer Research Fund covering 8.2m people which established that three drinks a day can cause liver cancer.

The World Cancer Fund recommends men and women should try to limit their alcohol intake and if possible avoid it completely.

The link between alcohol and cancer is undeniable yet it is something of which many people aren’t fully aware. This research from the World Cancer Research Fund helps highlight the important fact that as little as three alcoholic drinks a day can be enough to cause liver cancer.

Like tobacco, alcohol is a group one carcinogen. As many people are not aware of link between alcohol and cancer, the Governments should run campaigns making people aware of the harm alcohol can cause and make health warnings compulsory.

Most people who suffer alcohol-related health problems are not alcoholics or binge drinkers. They are people who have been drinking at or above the recommended limits on a daily or almost daily basis over a number of years.

Men-Only Hepatitis B Mutation Explains Higher Liver Cancer Rates among Men

A team of researchers has identified a mutation in the hepatitis B virus (HBV) in Korea that appears only in men and could help explain why HBV-infected men are roughly five times more likely than HBV-infected women to develop liver cancer.

Although some women do progress to cirrhosis and liver cancer, the mutation is absent in HBV in women. This is the first mutation found that can explain the gender disparity in incidence of hepatocellular carcinoma.
In the study, the researchers collected and analyzed serum samples from 292 patients with chronic HBV infection who visited one of 3 hospitals in Korea from 2003-2005.

Because previous studies had suggested that a gene mutation known as W4P/R was associated with higher incidence of liver cancer and cirrhosis, the researchers developed an assay to specifically identify HBV with the W4P/R mutation. When compared to patient outcomes, the W4P/R mutation was significantly associated with severe liver disease and was found exclusively in male patients.

The investigators believe the assay they developed to discover the mutation may hold promise as a diagnostic tool for predicting male progression to cirrhosis and liver cancer.

However, they caution that larger studies are necessary to confirm their findings, as only 67 of the 292 samples came from women.

Pre-tumor Liver Cancer Progenitor Identifiable

In a major breakthrough in the arena of medical science, Californian researchers have been able to identify progenitor cells that cause tumors in human anatomy that ultimately develops into liver cancer. According to researchers, damaged livers are the best source for generating HcPC tumors. Damages to liver are often results of viral infections such as hepatitis or habits of consistent alcohol consumption.

It was never established whether dysplastic lesions are just a regenerative (healing) response of the liver triggered by tissue damage or are actually pre-malignant lesions that harbor tumor progenitor cells.

HcPC that originates from dysplastic lesions would develop into malignant tumors with the passage of time ultimately turning into cancer of liver. However the progress is largely dependent on the surrounding microenvironment. Achievement of the researchers was that they were able to distinguish HcPC cells from their normal counterparts and the process of their activation.

New approaches for Liver Cancer Treatment provides renewed hope

In Taiwan, recently clinical experts outlined promising new approaches to treating liver cancer using radiosurgery with advanced imaging and motion management technology. Presentations on non-invasive radiosurgical approaches to treating hepatocellular carcinoma (HCC) were made by leading clinicians last week at a medical meeting organised in Taipei.

HCC, the most common type of liver cancer, is globally the third leading cause of cancer mortality after lung and stomach cancer, and a significant problem in Taiwan, mainland China, and other parts of Asia. Most patients with HCC are not eligible for surgery or liver transplant and currently there is not much done with radiotherapy for the liver cancer patients as there is a lack of ability to focus the dose on the tumor and minimize exposure of the rest of the liver. That will potentially change with advanced approaches like stereotactic ablative radiotherapy (SABR).

Stereotactic ablative radiotherapy (SABR) is a type of radiosurgery that involves the careful use of modern technologies for 3-D image guidance, motion management, and beam shaping. SABR can be customized for for each patient according to a model that has been developed based on treatment data from over large number of HCC cases. This model helps determine the optimal radiation dose to use given the volume of liver to be treated. High doses can be given safely if enough normal liver can be spared.

New insight found in the cellular process of development of liver cancer

The death of numerous liver cells in the context of chronic inflammation due to apoptosis, a form of programmed cell death, can promote the formation of tumor cells in the liver. This new insight by scientists significantly contributes to a better understanding of cellular processes in liver cancer development and thereby opens up new therapeutic approaches. This was reported in the current issue of the scientific journal 'Cell Reports'. Liver cancer due to chronic inflammation: tumour growth follows programmed cell death (apoptosis)

Liver cancer (Hepatocellular Carcinoma, HCC) usually arises as the result of a chronic, inflammatory liver disease. The most common causes are excessive alcohol consumption as well as a high-fat diet and also chronic infection with the hepatitis viruses B and C. In the course of the inflammatory process, the liver cells (hepatocytes) die more frequently due to programmed cell death. The result is increased cell growth, also referred to as compensatory proliferation, which can lead to tumour development.
 

A distinction is made between the two most important forms of self-induced cell death, namely apoptosis (programmed cell death) and necroptosis (programmed necrosis), which are based on different cellular mechanisms. Until now, it was not clear which form of cell death is decisive for the development of malignant liver tumors. The scientists have now been able to verify that apoptosis precedes the development of abnormal liver cells. The scientists showed this using mouse models. Moreover they discovered that in contrast, necroptosis prevents uninhibited cell proliferation and consequently the development of liver cancer.

These findings could form the basis for new approaches to therapy for liver cancer, which until now has been a form of cancer that cannot be adequately treated and that kills 800,000 patients around the world each year. We now know which cellular signalling pathways are involved in liver tumor development. As a next step, the scientists want to develop new treatment options using this information, for example, by attempting to pharmaceutically block the apoptosis itself or its signalling pathways. But any new therapy can also cause undesirable effects: In their experiments, the scientists saw that blocking apoptosis under inflammatory conditions can result in bililary obstruction (cholestasis) in the context of liver inflammation.

In the near future, the scientists want to verify their findings on the development of liver cancer and search for active substances that inhibit apoptosis while simultaneously causing the mildest possible side effects. The objective is to further develop the research in order to provide concrete benefits for society.

Liver cancer can be avoided with lifestyle changes and precautions

Liver cancer, the third most frequent cause of cancer death in India, can be avoided with simple actions. Health profiling of patients who reported to a tertiary care hospital in Delhi between 2000 and 2012 has revealed that most cases could be prevented with simple lifestyle changes such as avoiding excess alcohol, having protected sex and getting vaccinated against the hepatitis B virus.

According to the study, which involved 140 patients, hepatitis B was the most common cause of liver cancer affecting as many as 56 (39%) patients, followed by alcohol which affected 31 (22%) patients. Other causes included cryptogenic or unknown causes but characterized by high incidence of diabetes and hepatitis C.

The prevalence of diabetes was found to be 25% in liver cancer patients. When the presence of diabetes was analyzed in different liver cancer patients, it was found that the prevalence of diabetes was higher in patients cryptogenic (58%) when compared to other etiologies. There was no significant difference in the prevalence of diabetes in alcohol group (19%) compared to the viral group (17%.

The study, published in a recent issue of the Journal of Clinical and Experimental Hepatology, also states that liver cancer caused by hepatitis B infection spreads faster. Hepatitis B-related cases have extremely poor prognosis with median survival less than 16 months - 36% to 67% after one year and 15% to 26% after five years of diagnosis.

Intravenous drug abuse, body piercing and use of contaminated or used syringes cause hepatitis C infection leading to liver cancer. Hepatitis viruses are 30 times more prevalent than HIV in Southeast Asia. Due to the asymptomatic nature of these infections, about 60% of infected individuals remain unaware until they show symptoms of cirrhosis or liver cancer which may take over 20 years.

Hepatitis B - One of the main causes of liver cancer in Thailand

In Thailand, chronic hepatitis B is the most significant factor leading to liver cancer. Up to 75 per cent of Thais with liver cancer had previously had chronic hepatitis B. 

The hepatitis B virus is the most commonly transmitted virus in the world. Two billion people have contracted this virus at one point in their lives, which means that one out of three have once had hepatitis B. More importantly, 350 million to 400 million people develop chronic hepatitis B. 

Between 6 and 12 per cent of Thais over 40 develop chronic hepatitis B. After the launch of a campaign to promote the anti-hepatitis B vaccination of new-born infants in 1992, the rate of infection fell to 4 to 6 per cent, or four million Thais. 

How do we catch the hepatitis B virus?

* Mother to unborn child

This form of transmission is the most common cause of infection in Thailand. It is expected that 90 per cent of pregnant women who are infected with hepatitis B will pass the virus on to their unborn baby. 

* Sexual contact

Hepatitis B can be contracted via sexual activities. A married person whose spouse has a chronic infection of the virus should take a test to see if they have contracted the virus. In case that no virus is found, it is advised that they take a course of three vaccine injections. 

* Sharing syringes or needles

This form of transmission can be caused by the use of syringes, tattooing, acupuncture, or the use of shared contaminated items, including toothbrushes, razor blades, etc.

* Infection from the lymph of an infected person through open wounds or conjunctiva 

Once the hepatitis B virus has attacked the cells of the liver, it will split and cause acute hepatitis. Patients will have low fever, feel tired, lose their appetite, and experience pain in the lower right side of the abdomen. 

After having these symptoms for five to seven days, the patient will pass dark urine and develop jaundice. At this stage, the patient will recover from the jaundice and the hepatitis B virus, and will also recover from the acute hepatitis within one to three months. If the disease develops in the liver for over six months, it will become chronic hepatitis B. 

Statistically, around 3.5 per cent of adults with acute hepatitis B virus have a tendency to develop chronic hepatitis B, while over 90 per cent of newborn babies who catch the disease will become chronic hepatitis B virus carriers. 

More importantly, over 90 per cent of babies with the hepatitis B virus will not display the symptoms of acute hepatitis. The disease will not heal. Instead, it will develop into chronic hepatitis B virus, damaging liver cells and causing scar tissue, which will eventually lead to cirrhosis in 20 to 25 per cent of cases within eight to 10 years. 

Annually, cirrhosis is found to result in a lung failure in 3 to 5 per cent of those infected and develops into liver cancer in around 3.8 per cent of the infected population. In Thailand, chronic hepatitis B is the leading cause of liver cancer. Around 70 to 75 per cent of Thai patients with liver cancer have a history of chronic hepatitis B. 

More importantly, the hepatitis B virus can cause liver cancer regardless of whether patients develop cirrhosis. However, such a possibility is lower than in patients who develop cirrhosis.

Scientists find new insights into genetic basis of liver cancer

An international team of researchers has used whole-genome sequencing to track down recurrent genetic abnormalities in hepatocellular carcinoma (HCC), a deadly form of liver cancer.

Hepatocellular carcinoma (HCC) is one of the most deadly cancers worldwide and has no effective
treatment, yet the molecular basis of hepatocarcinogenesis remains largely unknown. Liver cancer is the fifth most frequently diagnosed cancer and the third leading cause of cancer mortality worldwide. Hepatocellular carcinoma (HCC), the most common primary liver malignancy, is refractory to nearly all currently available anti-cancer therapies. Hepatitis B virus (HBV) infection causes the majority of HCC cases worldwide and is the leading etiological agent in epidemic regions of China, South Korea, Southeast Asia and sub-Saharan Africa (Parkin 2006).

In their study, published online in Genome Research, the researchers found that the tumor suppressor gene TP53 was mutated in more than one-third of tumors when they sequenced tumor and normal tissue samples from 88 HCC patients. Patients with tumors containing TP53 mutations were also less likely to survive. Liver cancer is intractable to nearly all currently available anti-cancer targeted therapies. The findings in this study provide a better understanding of molecular basis of hepatocarcinogenesis and provide new clues to improving the diagnosis and treatment of liver cancer in the future.