Controlling viral hepatitis and liver cancer

January is Liver Cancer and Viral Hepatitis Awareness and Prevention Month. In 2020, liver cancer was the fourth most common cancer and the second leading cause of cancer-related deaths in the country, with more than 10,000 new cases reported in that year.

The liver performs vital functions, including storing nutrients; removing waste products and worn-out cells from the blood; filtering and processing chemicals in food, alcohol, and medications; and producing bile, a solution that helps digest fats and eliminate waste products.

In its early stages, liver cancer may not have noticeable symptoms. Liver cancer is usually diagnosed very late in its course, as symptoms only become apparent when the disease has already reached an advanced stage.

According to the US Centers for Disease Control and Prevention (CDC), common symptoms of liver cancer may include discomfort in the upper abdomen on the right side, a swollen abdomen, a hard lump on the right side just below the rib cage, pain near the right shoulder blade or in the back, jaundice (yellowing of the skin and whites of the eyes), easy bruising or bleeding, unusual tiredness, nausea and vomiting, loss of appetite and weight loss for no known reason.

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, according to the National Nutrition Council (NNC). The NNC said that cirrhosis of the liver precedes 80% of all liver cancers; as such, 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.

The CDC recommends the following steps to lower your risk of getting liver cancer: Maintain a healthy weight; get vaccinated against hepatitis B (the hepatitis B vaccine is recommended for all infants at birth and for adults who may be at increased risk); get tested for hepatitis C, and get medical care if you have it; don’t smoke, and quit if you do; and, finally, avoid drinking too much alcohol.

Viral hepatitis causes more than 1 million deaths per year, including deaths due to liver cancer caused by hepatitis infection, according to the World Health Organization (WHO). In 2019, infection with the hepatitis B virus resulted in an estimated 820,000 deaths worldwide. More than 8,000 new infections with hepatitis B and C virus occur each day, which is more than five new infections every minute. If the current trajectory continues, experts estimate that by 2040 viral hepatitis will kill more people annually than malaria, tuberculosis, and HIV/AIDS combined, the WHO warned.

Many hepatitis infections and deaths can be prevented. Infections with hepatitis A, hepatitis B, and hepatitis D virus can all be prevented with vaccines that are safe, available, and effective. The WHO recommends that all infants receive a first dose of the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by two or three doses at least four weeks apart to complete the vaccination series.

The WHO underscores the need for bringing hepatitis care closer to primary health facilities and communities so that people have better access to treatment and care, no matter what type of hepatitis they may have. To achieve hepatitis elimination by 2030, the WHO calls on countries to achieve the following specific targets: reduce new infections of hepatitis B and C by 90%; reduce hepatitis related deaths from liver cirrhosis and cancer by 65%; ensure that at least 90% of people with hepatitis B and C virus are diagnosed; and at least 80% of those eligible receive appropriate treatment.

TEODORO B. PADILLA is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.

If the current trajectory continues, experts estimate that by 2040 viral hepatitis will kill more people annually than malaria, tuberculosis, and HIV/AIDS combined, the WHO warned.