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Hepatitis C, Killing Us Not So Softly

hepatocellular carcinoma

Do you know your liver cancer risk?

I lost another friend today to liver cancer. He had hepatitis C for many years, and developed cirrhosis and liver failure. He was transplanted about six years ago, but hep C eventually took his second liver. He didn’t respond to antiviral treatment, developed liver cancer (hepatocellular carcinoma), and is now dead.

This has to stop.

If you have cirrhosis, you are at a higher risk for liver cancer (hepatocellular carcinoma or HCC). When it comes to risk of HCC it doesn’t matter if your hepatitis C is now cured if you still have cirrhosis. However, it is not a high risk—it is still relatively low. Just as people have regular mammograms and colonoscopies, you will need to have lab work and ultrasounds if you have cirrhosis. In some ways, I wish we all had to have these, since I lost three friends to liver cancer in 2014, and not one had hep C. (I also lost two hep C-positive friends to liver cancer that same year.) Liver cancer is on the rise.

One thing you can do to help protect yourself is try to lose excess weight if you have any, since fatty liver disease is a huge problem in the U.S. Fatty liver disease is on its way to replacing hep C as the #1 cause of cirrhosis. Abstain from alcohol, avoid raw or undercooked shellfish, use caution with medications and supplements (prescribed and over-the-counter), and keep  immunizations current. Aim for the healthiest lifestyle you can.

The American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA) HCV Guidelines recommend the following for patients who achieve a sustained virologic response (SVR) but still have cirrhosis:

Surveillance for hepatocellular carcinoma with twice-yearly ultrasound testing is recommended for patients with advanced fibrosis (ie, Metavir stage F3 or F4) who achieve an SVR. A baseline endoscopy is recommended to screen for varices if cirrhosis is present. Patients in whom varices are found should be treated and followed up as indicated.”

Many people live a long and full life despite having cirrhosis. Most do not develop liver cancer.  But, some do, and the earlier it is detected, the better your chances of a good outcome.

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