Liver Cancer: Tied to Hepatitis B

Liver cancer is the fifth most common cancer in the world that kills nearly all of its victims within a year. The incidence rates of liver cancer in Asian American groups are 1.7 to 11.3 times higher than the rate among Caucasians. Vietnamese American males have the highest incidence rates of liver cancer out of any other group in the US. Among women, Korean Americans have the highest rates. Asian Americans are three times more likely to die of liver cancer than Caucasians.

These staggering rates among Asian Americans are largely due to the high incidence rates of chronic hepatitis B among the Asian population. How hepatitis B causes liver cancer is not well understood, but liver is oftentimes the end stage of chronic hepatitis B infections.

The liver is the largest organ inside the body responsible for many vital functions: the breakdown and storage of nutrients, clotting of the blood needed to stop bleeding from an injury, the secretion of bile into the intestine, and the removal of toxic wastes from the body. Because the liver is comprised of many different types of cells, many different kinds of tumors can form in the liver. The prognosis for liver cancer is dependent on the type of tumor.

The most common diseases associated with liver cancer are chronic viral hepatitis B and C, alcoholism and cirrhosis. Studies have shown that people with chronic hepatitis have a 34-fold risk increase for liver cancer compared with the general population. Additionally, people with both chronic hepatitis and cirrhosis have a 118-fold increase. Alcoholism results in a two-fold risk increase and alcoholics with cirrhosis, a 22-fold risk increase. Moreover, chronic hepatitis is common in alcoholism and alcoholism is a leading cause for cirrhosis.

Other risk factors for liver cancer include eating aflatoxin, a harmful substance made by certain types of mold that form on peanuts, corn and other nuts and grain (a common problem in Asia); being male, as men are twice as likely to develop liver cancer, having a family history of the disease, being diagnosed with hemochromatosis (high retention of iron), having diabetes, being overweight, being a smoker, using steroids, and being over 60 years of age.


Symptoms of liver cancer are variable by stage of the disease. Most people will not notice any at all. Some of the most common symptoms include: abdominal bloating, weakness, fatigue, unexplained fever, jaundice and a dull pain in the upper part of the abdomen, back or shoulder, signifying a large tumor. For people suffering from cirrhosis, these symptoms are more pronounced.


The biggest factor for developing liver cancer is infection with hepatitis B or C. Hepatitis B can be prevented by taking a vaccine and reducing high risk behavior. There is no vaccine for hepatitis C, but prevention is based on knowing how it spreads (similar to hepatitis B): blood transfusions, dirty needles from drug use, unprotected sex, and through childbirth.

Maintain a healthy lifestyle and limit alcohol and tobacco use. Alcohol is a major cause of cirrhosis which can eventually develop into liver cancer. Smoking may also increase the risk of liver cancer. Eating a healthy diet and exercising regularly may help reduce the risk for diabetes and prevent obesity—both risk factors for liver cancer.

If you are at a high risk for liver cancer, regular surveillance of the liver is recommended. Early detection of liver cancer increases the likelihood of survival through treatment and surgery. The five year survival rate for early stage patients who receive surgery is 30% to 60%, compared with less than 5% for patients in the more advanced stages of liver cancer.


Early cancer can be treated by surgical removal, destruction of the individual tumors or liver transplantation. People with cirrhosis, however, do not have enough healthy liver to undergo the stresses of surgery. Chemotherapy and radiation treatment are also common treatments during later stages of the disease.