The death rate from all cancers in the United States has dropped steadily since 1991 (CA: A Cancer Journal for Clinicians, published online Jan 4, 2017). The total drop of 25 percent, or 2.1 million fewer cancer deaths over the past 25 years, is explained largely because people are smoking less.

However, deaths from cancer of the liver are increasing every year. Each year, more than 35,000 North Americans develop liver cancer and 25,000 die from it. Less than 20 percent of liver cancer patients are alive five years after being diagnosed. If the cancer is diagnosed after it has spread to surrounding tissues, the five-year survival rate drops to 11 percent.

Lifestyle Factors that Increase Risk for Liver Cancer
Liver cancer is primarily a lifestyle disease caused by what you do, rather than by your genes. Inflammation, an overactive immunity that can attack and destroy your liver, is associated with obesity, diabetes and liver infections. Risk factors for liver cancer include:
• fat stored in the liver (non-alcoholic fatty liver disease)
• obesity that puts fat into the liver. Most obese people, even those who do not have diabetes, have excess fat in their livers (Clin Obes, Apr 2016;6(2):117-23).
• diabetes, which can be caused by a fatty liver. Even thin, non-diabetic people with liver cancer have a high incidence of high blood sugar levels (The American Journal of Gastroenterology, 08/26/2016)
• a faulty diet that increases risk for a fatty liver
• alcohol that can destroy cells throughout your body but particularly in your liver because your liver is the only organ that can break alcohol down
• cirrhosis, a severe form of liver damage
• any chronic infection, particularly Hepatitis B and C and HIV
• aflatoxins (poisons produced by molds that grow in certain stored crops)
• exposure to some types of toxic chemicals
• smoking, recreational drugs and narcotics

The Role of Colon Bacteria
A possible breakthrough on cause and potential treatment for this largely incurable disease is that liver cancer patients have colon bacteria that specifically turn on their immunities to cause inflammation (Japan Digestive Disease Week 2016, Abstract IP-31_H, November 4, 2016). Anything that turns on your immunity and keeps it active can cause cancer. Previous animal studies show that certain colon bacteria can cause inflammation that causes liver cancer. This study shows that people with liver cancer have these colon bacteria, called Streptococcaceae, while those who had hepatitis C that can cause liver cancer did not have large numbers of these inflammatory bacteria. Additionally, transplanting these bacteria into the colons of healthy mice causes them to develop liver cancer, while transplanting bacteria from humans with hepatitis C, but no liver cancer, did not cause liver cancer. The patients with colon cancer had increased numbers of the pro-inflammatory bacteria in their colons that caused the liver to produce chemicals and bile acids that cause inflammation. If these bacteria can be shown to cause some cases of liver cancer, the prevention and treatment may be to change the colon bacteria with drugs, diet or fecal transplants.

My Recommendations
At this time there is no effective treatment for liver cancer. One approved therapeutic option for advanced liver cancer is a drug called Sorafenib (Nature Communications, 2016; 7: 13781). You can help to prevent liver cancer with lifestyle habits that reduce inflammation: eat mostly anti-inflammatory foods, get plenty of exercise and avoid smoking, obesity, alcohol, recreational drugs and sources of chronic infections.

Checked 1/1/20