DOCTOR'S VIEW ARCHIVE

The Relationship of Chronic Viral Hepatitis, Alcoholism, and Cirrhosis to Liver Cancer

Medical Author: Jay W. Marks, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD

Cancer can start within the liver (primary liver cancer or hepatocellular cancer) or spread to the liver (metastatic liver cancer) from other sites, such as the colon. Cancer that starts in the liver, which I will refer to simply as liver cancer, is the fifth most common cancer in the world. In the U.S., it is among the 10 most common cancers. This cancer is more frequent among Native Americans, Asians, Pacific Islanders, and Hispanics than among Caucasians.

Liver cancer is a bad cancer. It has frequently spread beyond the liver by the time it is discovered, and only 5% of patients with liver cancer that has begun to cause symptoms survive even five years without treatment. The only hope for patients who are at risk for liver cancer is regular surveillance so that the cancers can be found early. Early cancers can be treated by surgical removal (resection), destruction of the individual tumors, or liver transplantation. Although the current techniques for surveillance are not very good at detecting early liver cancer, newer techniques are being tested and appear to be better.

The most common diseases associated with liver cancer are chronic viral hepatitis, alcoholism, and cirrhosis (scarring of the liver). Moreover, chronic viral hepatitis is common in alcoholism, and both viral hepatitis and alcoholism cause cirrhosis which usually precedes the development of cancer. Therefore, the contributions and interrelationships of alcohol abuse, viral hepatitis, and cirrhosis in the development of liver cancer are complex. Despite the complexity, it is important to try to understand the contributions of each disease so that patients at highest risk for liver cancer can be targeted for surveillance. Theoretically, they also might be targeted with treatments that prevent the development of liver cancer, when such treatments are developed.