Hep B Blog

Get Tested for Liver Cancer, Your Life May Depend on It

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

October is Liver Cancer Awareness Month. It may be a sleeper of a event when compared to other health campaigns, but for us who live with viral hepatitis, it’s an uncomfortable but critical reminder of the importance of monitoring our liver health to prevent cancer.

Viral hepatitis, especially B and C, are viral infections that can cause liver cancer  (also called hepatocellular carcinoma or HCC.) Researchers are still studying why some people are more prone to liver cancer, but we who live with chronic hepatitis B or C have a 25 to 40 percent lifetime risk of developing liver cancer. The infection, which hijacks our liver cells to manufacture more virus, causes inflammation, scarring and even cancer as the liver cells grow out of control.

The longer we are infected with viral hepatitis, the higher our risk of developing liver cancer. While liver cancer often occurs in people with cirrhosis (severe liver scarring), some of us develop cancer without cirrhosis.

Liver cancer is also a threat to us who are overweight and have hepatitis B or C. If you have viral hepatitis and are overweight with fatty liver disease, your risk of liver cancer more than doubles. Today, 20 percent of Americans have fatty liver disease (also called non-alcoholic fatty liver disease or NAFLD).

These are all reasons why we must be willing to save our own life and get checked for liver cancer regularly. Getting screened gives you information about your body. If cancer is present, wouldn’t you rather know about it sooner, when it’s still treatable?

Medical guidelines currently recommend regular screening in hepatitis B-infected men starting at age 40 and in women at age 50. But there are also people who should get cancer screening sooner, including:

  • Anyone with cirrhosis and/or a family history of liver cancer
  • People of Asian and Pacific Islander descent. Liver cancer is the third-leading cause of cancer deaths among Asian-Americans and the eighth-leading cause of cancer deaths among Caucasian Americans.
  • Younger Asian-Americans with chronic hepatitis B who smoke or have a family history of liver cancer
  • Men born in Africa appear to be at higher risk of liver cancer at a younger age, so screening is recommended starting at age 20
  • And, people co-infected with HIV and/or hepatitis B or C, and/or with fatty liver disease

What kind of cancer screening should we get?

Tests for liver cancer should be performed using ultrasound imaging every six months, according to the American Association for the Study of Liver Diseases (AASLD). This device uses sound waves to examine the liver for tumors or abnormal growth or shapes. The alfa-fetoprotein (AFP) blood test is not sensitive or specific enough to be used alone for screening, but it can be used in combination with ultrasound screening.

Early-stage liver cancer often causes no symptoms, which is why regular screening is so important for early detection. So what are the symptoms of advanced liver cancer?

  • Pain in the upper abdomen (belly) on the right side
  • A lump or a feeling of heaviness in the upper abdomen or a swollen abdomen
  • Loss of appetite, feelings of fullness and weight loss
  • Weakness or feeling very tired
  • Nausea and vomiting
  • Yellow skin and eyes (jaundice)
  • Pale stools and dark urine
  • Fever

These symptoms could result from other health problems, so it’s very important to see a knowledgeable health care provider early so problems can be diagnosed as soon as possible.

In the past 20 years, the prevention and treatment of liver cancer have improved tremendously. Today, liver cancer can often be prevented, detected at an early stage, and effectively treated if caught early enough. So get monitored, it just might save your life.

For more information about liver cancer, visit the Liver Cancer Connect website. Learn more about Liver Cancer Awareness Month on Twitter using the hashtag #LCAM2015!

Comments on this blog are closed. If you have questions about hepatitis B or this blog post, please email info@hepb.org or call 215-489-4900.

16 thoughts on “Get Tested for Liver Cancer, Your Life May Depend on It”

  1. I was diagnosed with hepatitis b on the 10 sept 2015. I have no symptoms and my liver function test was pronounced normal and the ultrasound scan. Am now waiting for a viral load to see what recommendations the doctor gives me. I am thankful for the hep foundation for all this information. It made me feel better

    1. Thank you for your comment, we are glad the information is useful. Good luck with your viral load test. Make sure you get tested again in six months to determine if you have chronic or acute hepatitis B.

  2. I had hepatitis C for over 30 years and have level 2 liver fibrosis. I was recently treated with Harvoni for the hapatitis C and the virus is now gone.
    Unfortunately, while being tested, I found out that I also have hepatitis B, and it is in it’s “inactive” state.
    My liver specialist says it can remain “inactive” indefinitely and we just need to monitor it.
    I am 72 years young (!), and would like to know, if I haven’t got liver cancer in all these years are chances pretty good I won’t get it for the remainder of my life (I’m planning on being around for quite a few more years!)?
    With my past history, should I still get screened for liver cancer?
    Thanks for your input.

    1. Hello: You have asked great questions. Under current medical guidelines, you should absolutely be screened for liver cancer for a couple of reasons. First, you have been coinfected with hepatitis B and C, probably for many years. There is an odd dynamic when you are coinfected with hepatitis B and C. The hepatitis C becomes the “dominant” infection in the liver, and strangely suppresses the hepatitis B virus. You may find that without the hepatitis C infection, your hepatitis B infection may reactivate because it is no longer held in check by the competing infection. As a result, you need to be monitored frequently now for hepatitis B, liver damage (the usual ALT test) and also for liver cancer. Depending on where your doctor practices and the ethnicity of his patients, some doctors know a lot about hepatitis C, but not as much about hepatitis B, so make sure you’re doctor is knowledgeable about hepatitis B and get screened regularly. We want you to be around for quite a few more years too! Good luck.

  3. Good morning.i am an hep b patient.i was detected 3yrs ago and I have been place on tenofovir since jan 2014.i will like to ask,can patient on antiviral drugs like tenofovir still develop liver cancer?
    Also,how many year can it take before an hep b patient on viral drugs develop liver cancer?
    Lastly,i still feel pain on my right side of my stomach,i know it because of the hep b.but am I supposed to still feel pain when am on antiviral drugs.
    The LFT,ultrasound scan and creatinine urea test I did is normal.
    Thank you

    1. Hello: Recent studies show that being on an antiviral medication reduces your risk of liver cancer. It lowers the amount of virus that are hijacking your liver cells to churn out more hepatitis B virus, so it reduces liver damage, including inflammation that can lead to liver cancer. Antivirals won’t totally reduce your risk of liver cancer, you still need to be monitored regularly even if your viral load is low and your ALT (liver enzymes) show no signs of liver damage. Simply having this infection for many years increases your risk of liver cancer, but your risk is much higher with a high viral load and ongoing liver damage.
      Having abdominal pain is disconcerting when you have hepatitis B, you never know if it’s hepatitis B or something else, such as a gall bladder problem. For more information on abdominal pain, please visit this blog http://hepbblog.org/2015/09/14/when-is-that-pain-hep-b-related-and-when-is-it-something-else/
      Good luck.

  4. Sir
    I am regular reader of the news letter which provides valuable updates.
    I had diagnosed HBV Positive in 1998. My Father suffered HCC and no more during 1998. Since then iam monitoring HBe Ag which is – ve since then and
    HBV DNA < 20 IU / ml. ( Last Tested Nov.2014 )
    Annual Liver Function test Normal. Annual follow up with Gastroenterologist.
    All the family members are vaccinated in 1998.
    But the test ultra sound specific for liver cancer detection if any not carried out.
    In 2014 I have diagnosed with Gall Bladder stone of 7 mm. during ultrasound of the whole Abdomen in which the liver status found Normal.
    Please advice specific ultrasound test for Liver cancer if any, I am staying at Mumbai ( India). Any other specific suggestion are welcome
    Warm regards

    1. Hello: Every region has its own standards for liver cancer screening, U.S. guidelines recommend annual ultrasounds (at a minimum) for patients considered at high risk of liver cancer along with AFP tests. Because a member of your immediate family has had hepatitis B-related liver cancer, under U.S. (AASLD) guidelines you should be screened for liver cancer regularly, as determined by your doctor. It sounds like you had an ultrasound last year because of your gallbladder problem. The fact that your viral load is undetectable and your liver function tests are normal is also very good in reducing your risk of liver cancer. Keep eating healthy food, get monitored regularly, and stay away from cigarettes and alcohol, which can increase the risk of liver cancer. Good luck.

  5. Hi Hepblog, after testing hepatitis b positive last month ny doctor recommended a renal function test, a liver function test and an ultrasound scan, all were pronounced normal. My LFT specifications are Albumin 45.2g/l, Total protein 78.8g/l, AST 22U/l, ALT2 48.1U/l, GGT 22.8Ul, Alkaline Phosphate 307u/l, Direct bil 6.32umol/l, Total Bil 2.82umol/l, Urea Bun 2.9mmol/l, creatinine 95.2umol/l, Uric acid 0.29mmol,l. HBV VIRAL LOAD 113 iu/ml. My doctor has not recommended to run a full hbv blood panel yet which I don’t know why. However, what do these current results mean in terms of my current health and future. Would also welcome any recommendations and revelations. Thank you

    1. Hello: Your doctor will give you the best evaluation because he has examined you, but your liver tests appear normal and your viral load is low, which is excellent news. It appears your doctor is running the tests he needs to in order to evaluate your health. It means you’re in good hands. Good luck.

  6. Hi. I recently dignosed with chronic hep B. I’m Hbeag -(ve), hbsag (reactive). I experience a few mild symptoms, before it turned out that i already infected for quite sometime. During Aug 2015, the ultrasound showed the scarring on my liver already turned into Early Cirrhosis (stage 1). I still waiting for my viral load count & the doc said, perhaps would decide on the treatment at next visit (Nov 2015). My question: the reversibility of cirrhosis. What are the chance of the reversibility if i started ART such as TDF, ETV or LdT or even ADV/LAM. I’m treatment-naive, 37 YO, male, my ALT 2-3 fold.. TQ

    1. Hello: I’m sorry to hear of your infection. Cirrhosis is indeed reversible with proper treatment. In the U.S., medical experts recommend either the antiviral tenofovir (brand name Viread TDF) or entecavir (brand name Baraclude) as the first drugs to use to reduce your viral load and liver damage, especially with cirrhosis. The liver is actually a large organ, so it is possible to reverse the damage. It will be important to take the antiviral consistently and probably for many months or even years. Make sure your doctor continues to monitor you regularly. Also, eat low-fat, low sugar foods with lots of fruits, vegetables and lean meat, and do not drink alcohol or smoke. Also, as you know, practice safe sex and make sure everyone in your family has been screened and vaccinated against hepatitis B. Good luck.

  7. I have hep b. Now I’m experiencing pain in the middle of my chest, upper abdomen, spinal chord. Neck, pains in my throats and sore in my mouth. My urine is dark in the night and yellow and it smells bad. Dr what should l do for I’m dying.

    1. Hello: The symptoms you described are not typically associated with chronic hepatitis B. Have you talked to your doctor about these symptoms? I encourage you to see your doctor. In most cases, hepatitis B does not cause abdominal pain, but please talk to your doctor about your condition. For more information about abdominal pain and hepatitis B, please see: http://hepbblog.org/2015/09/14/when-is-that-pain-hep-b-related-and-when-is-it-something-else/
      Good luck.

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