Ask Canadians what one of the fastest-rising forms of cancer is in Canada and few would likely think of liver cancer.
But in fact, the number of new patients being diagnosed with liver cancer is soaring, tripling in Canadian men and doubling in women since 1970. And few Canadians are likely aware of how to prevent it.
The Canadian Cancer Society has just released its annual Canadian Cancer Statistics report for 2013, in collaboration with the Public Health Agency of Canada and Statistics Canada. They say that though the incidence rates of many cancer types are either stabilizing or falling, the number of men being diagnosed with liver cancer rises every year by 3.6 per cent and 1.7 per cent in women.
An estimated 2,100 Canadians will be diagnosed with liver cancer in 2013 -- 1,550 men and 490 women -- and an estimated 1,000 will die from it.
Part of the reason liver cancer’s death rate is so high is that the disease typically causes no symptoms so it’s often not caught until it's in final stages, says surgical oncologist Dr. Sean Cleary of Toronto General Hospital.
“If we catch someone's liver cancer early, their chance of beating the disease is 70 to 80 per cent. If we catch it late, the average person survives about a year after diagnosis,” he tells CTV News.
The key to bringing down liver cancer rates in Canada is prevention, yet most Canadians do not know much about the disease, says Gillian Bromfield, the head of cancer control policy at the Canadian Cancer Society.
“Only about 20 per cent of patients who are diagnosed with liver cancer live for five years past their diagnosis,” Bromfield told CTV’s Canada AM Wednesday morning.
“But there is also some good news and that is that many cases are preventable because a lot of the risk factors for liver cancer are preventable. So this is one of the things that we want to make sure Canadians are aware of.”
Those risk factors include heavy alcohol use, obesity, diabetes and smoking. But the biggest risk factors for liver cancer are chronic hepatitis B and C, two infectious diseases of the liver.
Hepatitis C accounts for approximately 30 to 50 per cent of primary liver cancer cases in North America (meaning cancer that starts in the liver rather than spreading to the organ from other sites), while hepatitis B accounts for about 23 per cent of cases in the developed world.
Approximately 600,000 Canadians are currently living with a chronic hepatitis B or C infection, according to the Public Health Agency of Canada. Yet, many are not aware until they go on to develop liver cancer decades later, says Dr. Cleary.
"It takes about 20 years for Hep. C to develop into liver cancer. So we are seeing it as a trend as more older people develop liver cancer," he says.
Royston Crew, who is turning 71 this year, went to a Toronto-area emergency room with stomach pain in 2011 and, after additional tests, was diagnosed with liver cancer.
“I was actually in shock…to the point where the first thought in my mind was: ‘What am I going to do now?’” he told CTV News.
“Liver cancer was a complete surprise. Prior to this pain in my stomach I had no other symptoms. I had no other pains, nothing else that could be connected with liver cancer.”
Crew underwent surgery to remove a part of his liver and has since gone back to the hospital several times for check-ups.
“There may well be recurrence down the road but at the moment we are very happy with the progress so far,” he said.
Last year the U.S. Centers for Disease Control and Prevention recommended that all baby boomers born between 1945 and 1965 get a one-time blood test for hepatitis C. They noted that it's possible that many boomers picked up the virus years ago though sex, IV drug use, or through the blood supply before hepatitis testing became more stringent and may not be aware they still have the infection.
Dr. Cleary says Canadians should get tested too, because hepatitis infections can be treated before they cause liver cancer.
"We'd like to see people who think they might be at risk go to their doctors and get tested, because early diagnosis can mean a cancer prevented," he said.
The Canadian Cancer Society would also like to see more routine hepatitis testing, especially among newcomers to Canada who arrive from parts of the world where hepatitis B, hepatitis C or liver cancer are common.
They also note that while there’s not vaccine available for hepatitis C, there is one for hepatitis B and they’d like to see doctors offer it to at-risk people, including newcomers to Canada.
As well, the Canadian Cancer Society recommends that family doctors counsel patients about the other ways they can reduce their risk for liver cancer, including cutting back on heavy alcohol use, treating obesity and quitting smoking.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
