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.

Foods Toxins That Can Cause Cervical, Liver Cancer

Mexican scientists identified and quantified the amount of aflatoxins (carcinogenic) in food such as corn tortilla, rice, chili pepper, processed sauces, chicken breast and eggs, and revealed its relationship with cervical and liver cancer in humans.The research won the National Award in Food Science and Technology in the Science Professional in Foods category organized jointly by National Council of Science and Technology and the Mexican Coca-Cola Industry.

It explains that both types of cancer can be originated by the ingestion of food contaminated with aflatoxins produced by the fungi Aspergilus flavus and A. parasiticus. This is the first time both conditions are related with the presence of aflatoxins that is the most frequent carcinogenic many people eat daily.

The researchers analyzed 800 kilos of tortilla in Mexico City, ten different kinds of chili pepper, rice and corn among others. They also studied how much of this substance stays in animal tissues after ingesting this kind of food, and found that aflatoxins are present in chicken breast, gizzard, liver and eggs -white and yolk.
The researchers explained that such molecule was recovered from tissue samples of liver and cervical cancer in humans, therefore aflatoxins are a very important factor in triggering this diseases.

This research is the first in the world to report that cervical cancer can also be caused by ingesting aflatoxin contaminated food. This carcinogenic has also been detected as a trigger of colorectal, pancreatic, breast and lung cancer. The specialist clarified that Human Papillomavirus is more carcinogenic and prone to trigger cervical cancer than aflatoxins.

The toxins -the researcher said- are in the water, soil and airborne, the fungi that produce them are an olive green mold that can be found in refrigerators, besides they are very resistant to high temperatures.

Every day, each person consumes traces of millionths or milligrams of aflatoxin that accumulate over the years in DNA, decreased resistance in people and generate disease.

To avoid these substances, the researcher suggests properly storing food, which would control the production of the toxin. Also, vary the foods one ingests and preferably consume wheat tortilla and fish, as well as antioxidants.

Cancer especially liver cancer is one of the biggest killer of Hispanic Texans

More Hispanic Texans die from cancer than any other cause, according to a new report by a Texas research group. The report documents cancer as the leading cause of death among Hispanic Texans under the age of 76. Only three percent of Hispanic Texans are older than 75.

Texas’s Hispanic population has more than doubled since 1990. Texans of Hispanic ethnicity now comprise 38 percent of the state’s population. The findings are published in a September 2013 special issue of the Texas Public Health Journal.

Based on data from the Texas Cancer Registry, Medicare claims records and state vital statistics, researchers compared rates and trends for cancer in Hispanics to those for non-Hispanic whites in Texas. Key findings include:

• Hispanic Texans are less likely to be screened for breast or colon cancer.
• Hispanics have lower rates of new cancer diagnoses for breast, colon and lung cancer.
• Of the cancers diagnosed in Hispanics, fewer were in the earliest, most treatable stages – those typically detected through screening. Breast cancer at the most advanced stage was diagnosed at a 12 percent higher rate.
• Cancers more common among Hispanics were stomach and liver cancer in men and stomach, liver and cervical cancer in women. Such cancers can arise from untreated infections.
• Overall mortality from all cancer was lower among Hispanics with the exception of stomach and liver cancer.
• Survival after a diagnosis of cancer is superior for Hispanics compared to non-Hispanic whites. 

These findings were based on 10 years of data about the diagnoses of new cancer cases and 21 years of data about cancer deaths. It was also found that foreign-born Hispanics had lower mortality rates than those born in the United States, according to analyses of regional differences within the state.

New test enables early diagnosis of liver cancer

Researchers have found a way to make early liver cancer show its true colors. They have developed a test that will help pathologists clearly distinguish early liver cancer cells from nearly identical normal liver cells by giving them a distinctive red-brown hue.

The inability to definitively tell the difference often means the disease is detected late when treatment options are less effective. There is no definitive test for early diagnosis of liver cancer.  The new test adds a level of comfort for making the diagnosis. The deadly liver cancer cells seek to recapitulate the appearance of normal liver cells. And they are very good at that, the pathologists agree, which is the frustration they have when trying to give patients definitive answers from looking at the tiny core biopsies of their liver under the microscope.

Unfortunately early liver cancer also is mostly silent. By the time it’s large enough to cause classic symptoms such as abdominal pain and weight loss, the cancer cells look distinctive but the liver is failing. The myriad of treatment options – from removing the diseased portion of the liver to liver transplants to freezing or heating cancer cells – have a high chance of failing as well.

The new probe detects and stains a microRNA called mir-21, which is found in liver cancer but not healthy liver cells. Unlike RNA, microRNA doesn’t make proteins rather helps control proteins that are expressed by RNA.  That means it’s more stable and can survive harsh chemicals normally used to prepare the biopsy for microscopic evaluation. This includes using formaldehyde and replacing natural fluids with paraffin so the tissue can be easily cut and stained with different reagents to help pathologists try to pinpoint a patient’s problem.

For the study, the researchers used their probe on biopsies of 10 healthy livers and 10 livers with early cancers. In every case of liver cancer, the biopsy took on the red-brown hue. The probe was not detected in normal cells. The studies were done retrospectively, so they already knew which patients ultimately were diagnosed with cancer. They are now using the test on 200 similar cases of liver cancer.
 
The group also is exploring this approach in other hard-to-detect-early cancers. Under the microscope, the potentially deadly skin cancer cells look a lot like common mole cells. In the case of diagnosing early liver cancer, the physicians note that cirrhosis, a massive scarring of the liver resulting from chronic infection with hepatitis B and C viruses, further muddies the current diagnostic waters by essentially giving cancer cells cover. These common viruses are the most common cause of liver cancer worldwide, according to the American Cancer Society. Alcohol abuse, a leading cause of cirrhosis in the United States, also is a risk factor for liver cancer. The new probe fortunately does not interact with cirrhosed cells.

V-Chip: A Potential Blue Ocean Inexpensive Test that Could Reveal Liver Cancer Risk

Could an inexpensive but very high value test, used in conjunction with current, traditional HCC testing help reveal one’s liver cancer risk? This is the Blue Ocean Strategy that many researchers are trying to work in USA.

Scientists from the Houston Methodist Research Institute and the University of Texas M.D. Anderson Cancer Center will receive about $2.1 million from the National Cancer Institute to learn whether a small, low-cost device can help assess a person’s risk of developing a common form of liver cancer.

“V-Chip,” or volumetric bar-chart chip, will be used to detect biomarkers for hepatocellular carcinoma (HCC), the most common cause of liver cancer. The device only requires a drop of blood from a finger prick.

The V-Chip allows the testing of up to 50 different molecules in a blood or urine sample.

Most of the burden of HCC is borne by people who have low income, with the highest incidence rates reported in regions of the world where infection with hepatitis B virus is endemic. Developing an accurate and low-cost technology that assesses the risk of cancer could make a big difference to people who ordinarily can’t afford expensive tests.

If successful, the V-Chip will be a Blue Ocean in Liver Cancer Testing. It will provide very high value at low cost to the patients.

The project will test whether the V-Chip accurately detects HCC biomarkers. The researchers will also determine which combination of these biomarkers proves most predictive of disease.

Among the biomarkers the researchers will look at are antigens of hepatitis viruses B and C, aflatoxin (a fungal toxin that at high doses is associated with cancer risk), and metabolic indicators of alcohol consumption, obesity, diabetes, and iron overdose.

Tests of the V-chip will not replace traditional testing methods, but rather be carried out in tandem so that patients’ care cannot be adversely affected.

Hepatocellular carcinoma is believed to be the third-highest cause of cancer death worldwide and the ninth leading cause of cancer death in the U.S. It is most commonly caused by a past infection of hepatitis viruses B or C (HBV or HCV) and cirrhosis of the liver caused by alcohol abuse or other toxic damage.

Potential complications from obesity and type 2 diabetes: Liver Cirrhosis and Liver Cancer

Until recently, hepatocellular carcinoma, a primary malignancy of the liver, was a very rare cancer in North America and most developed countries. However, the recent escalation in the number of overweight, obese and type 2 diabetic individuals has contributed to a corresponding rise in cases of liver cirrhosis and related hepatocellular carcinoma cases.

Being overweight, obese and/or developing type 2 diabetes promotes the deposition of fat into liver cells, primarily due to high circulating insulin levels. As liver cells fill up with fat (triglycerides) it leads to fatty liver degeneration, which later involves inflammation. This condition is known as NASH (non-alcoholic steatohepatitis). As NASH progresses, liver tissue often degenerates into cirrhosis (an irreversible liver condition), whereby liver cells are no longer able to function normally.

With cirrhosis, a host of signs and symptoms occur due to malfunctioning of liver cells, some of which include failure of the liver, swelling of the legs (edema), accumulation of fluid in the abdomen (ascites), bleeding from veins in the esophagus (varices) and mental confusion (hepatic encephalopathy). Cirrhosis also increases the chances that hepatocellular carcinoma will develop. Thus, hepatocellular carcinoma is on the increase in our society, directly as a result of overweight, obese and type 2 diabetes problems.

It should be noted that heavy chronic alcohol consumption can also cause fatty liver problems with associated liver inflammation (steatohepatitis), which resembles NASH upon blood lab investigation, imaging and biopsy findings.

Non-alcoholic fatty liver disease is currently the most common liver disease in the U.S. and worldwide, affecting an estimated 10-24 percent of the global population. In the U.S., the Centers for Disease Control and Prevention reports that currently, approximately one-half of the U.S. adult population is overweight (BMI >25) and one quarter of the U.S. adult population is obese (BMI >30). That means upwards of 29 million Americans have non-alcoholic fatty liver disease, 6.4 million of whom have non-alcoholic steatohepatitis (NASH). Even more alarming than these statistics is the fact that non-alcoholic fatty liver disease is occurring among children in the U.S.

How do we know if a person's overweight problem, obesity status, or type 2 diabetes condition is causing fatty liver changes? The first evidence is a slight rise in serum liver enzymes, especially ALT and AST. Thus, it is a good idea to get these tests done. This also applies to children if they are overweight.

In the early stages, one of the solution is to start eating a low saturated fat / cholesterol / trans fat diet, which should also exclude deep-fried and pan-fried foods. A lower glycemic diet is also helpful, as is the inclusion of regular endurance exercise, all of which pave the way to weight loss, improved blood sugar regulation and lower circulating insulin levels, even in type 2 diabetics. Applying these simple lifestyle modifications often reduces ALT and AST into the normal range within 3-6 months as body fat declines.

In many cases, the family doctor does not emphasize sufficiently the importance of lifestyle changes to help the patient decrease their risk of premature morbidity and mortality associated with NASH. As we know, being diagnosed with hepatocellular carcinoma or even cirrhosis, for that matter, is no walk in the park. Hepatocellular carcinoma is a cancer that is highly preventable. It is a lifestyle-based cancer in our modern society, and thus we should consider overweight problems as a serious health concern.

Apart from lifestyle changes, we can also go for alternative medicines such as Kamalahar if we have already developed fatty liver disease.

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.