Liver Cancer FAQs

Although liver cancer is one of the most common forms of cancer in the world, it is uncommon in the United States. The American Cancer Society estimates 28,720 people will be diagnosed with liver cancer this year, and numbers have been rising by approximately 3-3.6% each year since 1992. Approximately 20,550 deaths will occur, with incidence and death rates both being higher in men than in women.

The numbers are not encouraging. Liver cancer is not discussed as often as some other cancers, possibly because the death rates are so high and 5 year survival rates tend to be low (approximately 14%). But that doesn't mean there are no prevention steps that could (and should) be taken in order to decrease one's risk. The numbers mean it's even more important to know your risks, the symptoms, and what you can do to prevent it.

In the United States, alcohol-related cirrhosis, and possibly non-alcoholic fatty liver disease associated with obesity, account for the majority of liver cancer cases. In fact, colorectal, breast, and many other cancers list obesity as a risk factor.

Cancer of the liver that did not originate there is not called liver cancer. It is the result of a metastasis of cancer from another part of the body such as the colon or ovaries, and is named after the first, or "primary" site.

Unfortunately, screening has not been proven to improve survival in liver cancer, so being familiar with signs and symptoms are especially important. Common symptoms include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• An enlarged liver (occurs in 50%-90% of patients)
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

More information on liver cancer, and what you can do to reduce your risk, can be found at the Mayo Clinic website.

Cancers on the Rise

As we have shared with you in the past, the incidence rates of many cancers have been on the decline in recent years. This is the result of many behavioral and environmental changes that individuals have been making, and policies that our government has instituted that have cleaned up the air we breathe and the land we live on. However, there are still some cancers that are on the rise, and in an effort to keep you well-informed, we want to share some information about them with you. All of the following information is available from the American Cancer Society via their Cancer Facts & Figures 2012 publication.

Kidney and Renal Cancer       

Between 1999-2008, kidney cancer rates significantly increased for men and women of every race/ethnicity except American Indian or Alaska Native men, for every age group, and most dramatically for localized tumors from 7.6 (per 100,000) in 1999 to 12.2 in 2008. Research suggested that the trend may be due to an increase in imaging procedures such as ultrasound, computed tomography and MRI, which detect early stage cancers that may have been undiagnosed in previous study periods.

Rates during 2004-2008 were 2 times higher for men than women, and highest for African American and American Indian and Alaska Native men, perhaps reflecting the higher rates of obesity in these groups of individuals.

Cigarette smoking is a risk factor for both kidney and renal cancers, but is most strongly associated with renal pelvis cancer. Risk of kidney cancer increases with both quantity and duration of smoking, and accounts for approximately 20-30% of cases among men and approximately 10-20% of cases among women. For cancer of the renal pelvis, smoking accounts for approximately 70-82% of cases among men and approximately 37-61% of cases among women.

Obesity increases risk of kidney cancer, and accounts for 30-40% of cases. High blood pressure is also shown as a risk of kidney cancer, and there are inherited forms of the disease that account for a small fraction of cases.

Prevention techniques include stopping the use of tobacco products, maintaining a healthy weight and avoiding high blood pressure (through diet and exercise) and treating existing high blood pressure.

For more information about kidney and renal cancer, including symptoms and treatment information, visit the Mayo Clinic page.

Esophageal Adenocarcinoma       

Overall, the incidence rates of esophageal adenocarcinoma have shown declines, but while African American males have traditionally been more likely to be diagnosed with this type of cancer, there has been an increase in non-Hispanic white men to be diagnosed in recent years. Although the two most common types of esophageal cancer are related to smoking, only one of them (squamous cell carcinoma) has shown a decline that corresponds with decreased smoking rates. So, what's going on with the other one - adenocarcinoma?

Obesity is associated with a 16-fold increased risk of this type of cancer. Obesity is also associated with gastroesophageal reflux and Barrett's esophagus, which can progress to esophageal adenocarcinoma. Rates for this kind of cancer increased significantly among white men (1.8% per year), white women (2.1% per year), and Hispanic men (2.8% per year) during 1999-2008. These increasing trends coincide with rises in obesity and gastroesophageal reflux disease.

Maintaining healthy body weight may reduce the risk for esophageal adenocarcinoma. Treatment of gastroesophageal reflux disease with proton-pump inhibitors, which reduces gastric acid, thereby slowing or preventing the development of Barrett's esophagus, may also lower risk, although the most effective regimen to reduce cancer risk in these patients is not known. Medical surveillance for people diagnosed with Barrett's esophagus may also be beneficial; however, the timing and frequency of such screening is unclear.

More information on esophageal cancers can be found on the Mayo Clinic website.

Bladder Cancer Facts

Bladder cancer doesn't get a lot of attention, but it affects more people each year than leukemia and almost as many as melanoma (skin cancer). The American Cancer Society's annual Cancer Facts and Figures report estimates over 73,000 new cases will be diagnosed in 2012.

Bladder cancer is usually found in early stages when more easily treated. However, it also has a high recurrence rate, which means follow-up tests may be necessary for many years after initial treatment. Common symptoms for bladder cancer include blood the in urine (called hematuria), frequent and/or painful urination, back pain and pelvic pain. Blood in urine can appear dark yellow, bright red or cola colored. At times the blood can even be undetectable except through microscopic inspection.

It's not always clear what causes bladder cancer, but it is known that about half of all bladder cancers are linked to smoking. Smoking increases the risk for bladder cancer four times over a non-smoker's risk due to the chemicals in cigarettes that are processed and secreted through the bladder. Individuals who work in industries that use arsenic (textile, paint, dye, rubber and leather manufacturing) or live in communities with high levels of arsenic in the drinking water are also at an increased risk for similar reasons. Additional risks as reported by Mayo Clinic include:

• Aging. Bladder cancer can occur at any age, but it's rare in people younger than 40.
• Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide (Cytoxan) is known to increase the risk of bladder cancer. Radiation treatments focused on the pelvic area may also elevate the risk.
• Diabetes medication. People who take the diabetes medication pioglitazone (Actos) for more than a year may have an increased risk of bladder cancer. Other diabetes medication that contain pioglitazone include pioglitazone and metformin (Actoplus Met) and glimepiride (Duetact).
• Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as may happen with long-term use of a urinary catheter, may increase your risk of a squamous cell bladder cancer.  
• Personal or family history of cancer. If one or more of your immediate relatives have a history of bladder cancer, you may have an increased risk of the disease, although it's rare for bladder cancer to run in families. A family history of hereditary nonpolyposis colorectal cancer, also called Lynch syndrome, can increase your risk of cancer in your urinary system, as well as in your colon, uterus, ovaries and other organs.  

To read more information about bladder cancer you can visit the following links:

The Mayo Clinic 

American Urological Association

In the News: Sunscreens and Vaccines

May is Skin Cancer Awareness Month. Since we shared information recently on skin cancer awareness and prevention, we're sharing some related but unique information this week that has recently made the news.

New Sunscreen Labels

In 2009 the U.S. Food and Drug Administration approved new labeling for sunscreen products that will finally go into effect next month. There have always been guidelines in place, but they were adopted on a voluntary basis - which meant many companies didn't adopt them at all. Using terms such as "All Day Protection" and "Waterproof" were not only misleading, they were downright inaccurate. The new guidelines are mandatory.

Here are the major changes in labeling that will help consumers buy exactly what they need, and know exactly what they're getting:

Sunblocks: No product on the market today can completely shield your skin from the sun. For this reason, sunscreens will no longer be labeled as "sunblock".

SPF level: A sun protection factor (SPF) of 15 or more means the product lowers the risk of skin cancer and aging. For SPFs from 2-14, this is not the case. Those products prevent sunburn at best. Sunscreen labels will have to be clear about how much SPF they provide - and whether they actually reduce your risk of developing skin cancer and curb visible aging or just prevent sunburns. The highest level of SPF allowed with the new guidelines will be 50.

One common misunderstandings that lingers today is that the higher the SPF number on a bottle of sunscreen, the better. In truth, a product with a number above 30 really doesn't add enough additional protection to make it worthwhile. That said - you should always choose a sunscreen with an SPF of at least 15.

Broad Spectrum: To be labeled "broad spectrum," sunscreens must provide equal protection against the sun's two types of radiation: UVB and UVA. Both types can lead to cancer - but UVA gives you more wrinkles and UVB causes sunburns.

"Waterproof" and "sweatproof" claims will disappear . Sunscreens can only say how long they offer water resistant protection. And, the company marketing the products must be able to back up their claims with text results.

Instant protection: Sunscreens can't say they provide "instant protection" or protect skin for more than two hours unless the FDA approves the claims for the specific sunscreen in question.

There is a 2-2-2 rule that goes hand in hand with these new requirements, even though it's been around a while:

2 tablespoons. Use at least this much sunscreen on each part of your body.This is about the size of a golf ball. Rub it in until it disappears.
2 hours. That’s how often you should reapply it. Evaluate and apply more often if you're involved in active water activities such as skiing.
2 years. That’s how long you should keep it. The ingredients lose their effectiveness after 2 years. Be sure to check expiration dates if you find overstock sunscreens for sale at thrift stores.

Melanoma Vaccine

Recently, The Mayo Clinic announced that their researchers are working on a melanoma vaccine to combat skin cancer. Melanoma is the most deadly form of skin cancer, with the major risk factor being exposure to UV light. Incidence rates continue to rise, with the largest increase being seen in young women.

The research has been done on mice, using a genetic combination of human DNA from melanoma cells and a cousin of the rabies virus. In early studies, 60 percent of the mice with tumors were cured in fewer than three months with minimal side effects. Human clinical trials related to this research aren't anticipated for a few more years, but the results look very promising. More information on this research can be found in the story originally shared by Mayo Clinic here.

October Awareness

This week we take note of two kinds of cancer that are being recognized during the month of October. One you may already know quite a bit about, but the other may be less familiar.

Breast Cancer

The number of breast cancer survivors has risen over the last couple of decades thanks in part to the efforts of national organizations like Susan G. Komen for the Cure and the Breast Cancer Research Foundation. Under the umbrella of these organizations, thousands of small groups and local initiatives have been created with the mission of educating friends, neighbors, sisters and daughters about the need for routine exams and screenings in order to catch breast cancer in earlier and more effectively treated stages.

More people are surviving, but it's also good to know that incidences of breast cancer have been declining since 2000. This decrease (almost 7%, according to the American Cancer Society) can be attributed to reductions in the use of menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT). The Women's Health Initiative produced a report in 2002 that found that the combination of estrogen plus progestin was associated with increased risk of breast cancer and coronary heart disease. The report led to a reduction of therapies and birth control options combining both of those hormones.

At Hope Cancer Resources we approach breast cancer on many levels. We have certified health educators on staff who work in the community to spread information about early detection and screenings. Through our Save-A-Life program, we also help the under- and uninsured pay for their required mammograms. Finally, we share information about local support groups offered for women who are going through breast cancer treatment or who are survivors of the disease.

You can find breast cancer news and information at the following websites:
Susan G. Komen for the Cure
The Breast Cancer Research Foundation
Young Survival Coalition

Liver Cancer

Liver cancer is not common in the United States, with just over 26,000 new cases expected to be diagnosed this year. That is about 2% of all new cancers expected to be diagnosed. In contrast, liver cancer accounts for up to half of all cancers in many underdeveloped countries, mainly because of the prevalence of hepatitis, caused by contagious viruses, that predisposes a person to liver cancer. In the U.S., new cases have been increasing by about 3.4% in men and 3% in women each year since 1992. Incidence rates are highest among Asian Americans/Pacific Islanders and Hispanics.


The liver can be affected by primary liver cancer, which begins in the liver, or by cancer which begins in other parts of the body and then spreads to the liver through the bloodstream. Most liver cancer is secondary or metastatic, meaning it started elsewhere in the body.

Symptoms for liver cancer include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• An enlarged liver
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

More information on liver cancer can be found at the following websites:
Mayo Clinic
National Cancer Institute

What is a Sarcoma?

A sarcoma is a type of cancer that develops from certain tissues, like bone or muscle. There are 2 main types of sarcomas: bone sarcomas and soft tissue sarcomas. Soft tissue sarcomas can develop from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. Although they can be found in any part of the body, most of them - about 60 percent - develop in the arms, hands, feet or legs. They can also be found in the trunk, head and neck area, internal organs, and the area in back of the abdominal cavity. Sarcomas are not common tumors. Only about 10,000 soft tissue sarcomas are diagnosed annually in the United States.

On the American Cancer Society's webpage about sarcomas there are no fewer than forty kinds of sarcomas listed. For that reason, we will not try to list them all here, but instead suggest that if you are truly interested in that many different kinds of sarcomas, you can take a look at their list. We don't mind.

A soft tissue sarcoma usually produces no signs and symptoms in its early stages. As the tumor grows, it may cause:

• A noticeable lump or swelling
• Pain, if it presses on nerves or muscles
• A blockage in the stomach or intestines or gastrointestinal bleeding if the tumor is located in the abdomen or digestive tract

Generally, the cause of most soft tissue sarcomas is unknown. One of the few soft tissue sarcomas that has a known cause is Kaposi's sarcoma. It occurs in people with defective immune systems and is caused by a virus known as human herpes virus 8 (HHV8). Some types of sarcomas are believed to be hereditary. You can see this list here.

Talk to your doctor if you discover a lump that persists or if you notice signs or symptoms that may indicate a soft tissue sarcoma, such as worsening abdominal pain or blood in your stool. 

Information for this post was gathered from the Mayo Clinic website and the American Cancer Society's page about sarcoma.