It's a cancer that gets little attention, but it should, because liver cancer has become one of the fastest growing cancers in Canada.
While many cancers spread to the liver in the final stages, doctors are now concerned about the increase in the number of cancers that start in the liver.
Each year in Canada, over 1,700 people are diagnosed with primary liver cancer and those numbers are growing, doctors say. Yet many cases can be prevented and others cured if only those at risk were regularly tested.
Liver cancer rates are thought to be rising because of increased rates of hepatitis C infection, obesity and type 2 diabetes.
Dr. Sean Cleary, a surgeon at Toronto General Hospital, says he's seen a huge jump in liver cancer cases.
"We've seen a significant rise in our cases that need to come to surgery, an increase of perhaps 200 per cent in the last five years," he tells 麻豆影视.
The patient he was treating the day we came to see him was a middle-aged man whose silent cancer wasn't discovered until it had engulfed much of his liver. Dr. Cleary had to remove half of the vital organ in a bid to extend the man's life.
If caught early, liver cancer tumours can be easily treated, but if they are larger than three centimetres in diameter, the prognosis is poor. Cleary says too often they're caught late, so that about one-third to one-half of the cases he sees are untreatable.
"This means we are picking them up to late, we are catching them too late," he says.
The man Cleary treated had had hepatitis, which can damage the liver and allow cancer to grow. But the man had not been going for routine screenings; his liver cancer was found through other medical tests.
Doctors say liver cancer is a silent cancer that can grow for years causing no symptoms until it's too late.
Hepatitis C patient Michele also was recently diagnosed with liver cancer. She, too, was having tests for another problem when doctors found five tumours in her liver.
"It was frightening and I didn't know what to expect," she says, adding no one told her hepatitis C put her at higher risk of developing liver cancer.
"I had no idea that I would end up with liver cancer; that was a big shock," she says.
Hep C is caused by a virus transmitted by blood-to-blood contact, through shared needles, tattoo needles and sexual contact. It's estimated that in Canada, about 243,000 people have hep C, but because there are often no symptoms, nearly 20 per cent don't know they're infected.
Doctors also say more new cases of liver cancer are being triggered by diabetes and obesity. Obese patients often develop fatty livers that seem to increase their risk of liver cancer and their risk of death from liver cancer. Alcohol too, can lead to liver cirrhosis, which has been shown to increase cancer risk.
The key to lowering cancer rates, says cancer researcher Dr. Morris Sherman of the University Health Network, is to monitor patients who are at risk for liver disease, from age 50 on with yearly liver ultrasounds.
He notes that many countries already recommend regular liver screening, which allows doctors to find cancer in the early stages.
"If we get these things when they are small, the chance of survival is 90 per cent," he says.
But instead, he says, many of those most at risk aren't being tested.
"I would say no more than 30 per cent of patients are getting identified. So 70 per cent of patients are NOT getting adequate screening," he says.
"I'd like physicians to be aware of this and screen at a regular basis," he says, noting that he expects that with rising rates of hepatitis B and C infection, there will be a further 50 per cent increase in new liver cancer cases over the next 10 years.
As for Michelle, the cancer's damage to her liver is so extensive, she is now waiting for a liver transplant.
"I think it is important that people know you should get tested for this, because I don't want a lot of people stuck in this situation," she says.
"We need more doctors to get on the bandwagon and start testing them."
