Understanding The Risks of Liver Cancer
- NFL legend Dan Marino, who played 17 seasons with the Miami Dolphins, is focusing on healthy living after being diagnosed with MASH, a liver disease caused by fat buildup that can lead to inflammation, cell damage, and cancer.
- Common risk factor for liver cancers (also termed hepatocellular carcinoma HCC) is viral hepatitis, a type of liver inflammation. Obesity, type 2 diabetes, heavy alcohol use, and metabolic dysfunction-associated steatohepatitis– which Marino has– are major risk factors.
- Early symptoms of liver cancer can be hard to detect as they are often subtle or easily confused for another condition. These symptoms may include stomach pain on the right side, yellowing of the skin and eyes, jaundice, itchy skin, and fatigue.
- Surgery is usually the main treatment option for liver cancer, when a surgeon makes an incision to the affected area to target the cancer. However, a thorough review of the patient’s overall health and details regarding the tumor (size, location, if it spread, etc.) are considered before deciding if surgery is the best option.
- If you’ve been diagnosed with advanced liver cancer, it’s important to remember that treatment options are still available. Even in later stages, there are several effective therapies that can make a difference. Thanks to major advances in medicine, patients now have more opportunities to extend and improve their quality of life.
The 64-year-old loving husband and dad of two, who was diagnosed MASH [a condition formerly referred to as nonalcoholic fatty liver disease (NAFLD)] back in 2006, shared his story with People this week, admitting his diagnosis came after he hadn’t been taking the best care of his body.
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He explained further, “The doctors right away said that can be reversible, it can be taken care of, but, mainly for me, they were saying, like, ‘You gotta work out. You got to lose weight.'”
Since learning of his health condition, he now prioritizes his health as much as possible.
He told People, “It’s the exercise, riding bike, walking, and diet, and then getting back to just being consistent — waking up and making sure you gotta do something every day.”
Marino suspects that when he retired in 2000, his diet changed drastically and he stopped working out as much. He thinks his poor diet “mostly” let to his diagnosis.
Despite living with MASH, Marino is determined to eat healthy, stay active, and go for routine checkups.
“I get the ultrasounds and all that every year and so far it’s been fine,” Marino added, noting his condition is going to keep getting “better and better.”
In an effort to spread awareness about liver disease, Marino has joined Novo Nordisk’s Unordinary Stories campaign.
“With the support of his wife Claire and friends like Terry Kirby, Dan has been proactive in reshaping his lifestyle. Regular physical activity, nutritious eating, and a focus on mental well-being have become cornerstones of his new routine,” the campaign states on their website, promoting Marino’s main goal of “being healthy.”
Marino also informed People that he’s chosen to eat more of a “Mediterranean diet,” something his doctor suggested.
He’s also been told to “cut back on the wine and pizza and candy, ice cream, those kind of things.”
During a Novo Nordisk’s Unordinary Stories campaign video, Marino addressed how “surprised” he was when he was diagnosed and forced to “make that change,” to better his health.
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In the footage, Marino offered some more insight into what MASH is, saying, “MASH is a metabolic disease … it’s a severe form of fatty liver.”
“MASH is a silent killer, and when it goes unnoticed it could be a problem. And that’s why you have to go get checked and you have to take care of your health,” he warned.
All About Metabolic Dysfunction-Associated Steatohepatitis (MASH)
Metabolic Dysfunction-Associated Steatohepatitis (MASH) is a condition where fat builds up in the liver, leading to inflammation and liver cell damage, according to Stanford Medicine.
It falls under the broader category of nonalcoholic fatty liver disease (NAFLD) and is sometimes referred to as “fatty liver.” While many individuals may have fat in their liver without experiencing symptoms or health issues, in some cases, the fat triggers inflammation and harms liver cells, affecting the liver’s ability to function properly.
In more advanced cases, MASH can develop into liver scarring (known as fibrosis), which has the potential to progress to cirrhosis. However, not all individuals with MASH will experience this level of progression.
It’s also importance to understand that although MASH resembles liver disease linked to chronic heavy alcohol use, it occurs in people who consume little or no alcohol.
According to findings published this year in the Clinical Gastroenterology and Hepatology, a monthly peer-reviewed medical journal, over the past 20 years, liver cancer linked to MASH has become more common, though it affects some regions and groups of people more than others.
This rising problem shows that action is needed around the world to help prevent MASH-related liver cancer and to manage the health issues that lead to it.
Understanding Liver Cancer and Its Risk Factors
Hepatocytes are the primary type of cells that form the liver. Most liver cancers are termed HCCs (hepatocellular carcinoma) because they are related to problems within these cells.
“Many people don’t even know what the liver does, but the liver is essential for the body and survival. It’s the biochemical factory for the whole body, and it’s important in digestion, metabolism, production of proteins in the blood, and clearance of toxins from the blood,” Dr. Milan Kinkhabwala, professor of surgery and the director of the hepatobiliary section and transplantation at Montefiore Einstein’s Comprehensive Cancer Center, explains to SurvivorNet.
The most common risk factor for HCC is viral hepatitis, a type of liver inflammation caused by a viral infection. The most common types are hepatitis A, hepatitis B, and hepatitis C.
WATCH: Understanding Liver Cancer Risk Factors
Other risk factors include:
- Gender (HCC is much more common in men than in women)
- Race/ethnicity
- Metabolic dysfunction-associated steatohepatitis (MASH)
- Cirrhosis (a disease in which liver cells become damaged and are replaced by scar tissue)
- Heavy alcohol use
- Tobacco use
- Obesity and other “metabolic” diseases
- Type 2 diabetes
Liver cancer can be tricky to catch in its early stages since its symptoms can be related to other conditions. Known symptoms include:
- Jaundice: yellowing of your skin and the whites of your eyes
- Intensely itchy skin
- White or clay-like stool (acholia)
- Dark urine (choluria)
- Fatigue
- Abdominal pain on the right side, just below the ribs
- Losing weight without trying
- Fever
- Night sweats
Treatment Approaches to Liver Cancer
Often, surgery is the initial treatment for liver cancer, especially if it is caught in its early stages. It should be noted that the patient’s overall health is also a factor in the decision to pursue surgery.
“Primarily, we would like to remove the liver tumor if possible,” Dr. Elliot Newman, the chief of surgical oncology at the Northwell Health Cancer Institute at Lenox Hill Hospital in Manhattan, tells SurvivorNet.
“Assuming that the patient is a surgical candidate (health enough to tolerate the surgery), then we have to look specifically at the nature of the liver tumor that we’re dealing with and whether it can be safely removed,” Dr. Newman adds.
Expert Resources On Liver Cancer
- Advanced Liver Cancer Diagnosis, Treatment, and Symptom Management
- Coffee Reduces Risk of Liver Disease, including Cancer, According to Study; Is There Really a Link Between Coffee and Cancer?
- For Some Patients With Liver Cancer, Surgery Is A Good Option And May Even Offer A Cure
- Understanding All The Words Your Doctor May Use When Talking About Your Liver Cancer Diagnosis
- Bile Duct Cancer and Liver Cancer — Same Organ But Different Diseases
- Liver Cancer: Risk Factors, Screening, and How it’s Diagnosed
One element in determining liver cancer surgery eligibility is the details of the tumor itself. The doctor examines whether the tumor is small (less than 5cm), the number of tumors, and where they are located. For instance, are the tumors easily accessible?
WATCH: Liver Cancer Surgery
Types of Liver Cancer Surgical Procedures
Open surgery involves making a large incision by cutting into the body so the surgeon can treat the affected area directly. This approach often comes with a longer, potentially more painful recovery period.
Minimally invasive surgery differs from open surgery because the surgeon makes small incisions using specialized instruments such as a laparoscope to remove cancer tissue.
“We certainly see benefits in minimally invasive surgery when it’s possible because patients have smaller incisions and can recover more quickly, get out of the hospital more quickly, and get back to full functionality more quickly,” explains Dr. Newman.
Like most procedures, liver cancer surgery has risks and benefits that need to be weighed by you and your care team. Notable benefits include more immediate relief of symptoms and reduced pain and recovery time. Risks may also involve the possibility of infection and extended recovery time if your body does not tolerate the procedure.
Questions for Your Doctor
If you are facing a liver cancer diagnosis and want to assess your treatment options better, consider the following questions for your doctor to learn more.
- Am I a good candidate for surgery?
- What types of surgery will you consider?
- What results can I expect?
- What side effects can I expect, and how will we manage them?
- What part of my treatment is covered by insurance, and how much can I expect to pay out of pocket?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
