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Tuesday, 5 February 2013

Liver cancer: lose weight to reduce the risk

Liver cancer is a serious complication of cirrhosis.

"Treat the cause of cirrhosis before the latter expresses is essential, says Dr. Serfaty (Saint-Antoine Hospital, Paris). The risk of liver cancer " is 3 to 4% per year in patients with cirrhosis and overweight plays an aggravating role, especially abdominal fat. This is explained by the fact that fat tissue produces growth factors play a significant role in the growth of tumor cells "Insists Professor Hillon (CHU Dijon).

This risk is even greater than it is a man, that we have passed the 40 years that we have inherited a particular genetic mutation (called the PNPLA3 polymorphism, found in 2-3% of the general population) due to this mutation, the enzyme that breaks down fats in the liver plays less role, where their accumulation at this level. The risk of cancer of the liver is then multiplied by two. "Diabetics who are obese and this polymorphism are at the forefront. Only positive point: they may have less risk of vascular complications, probably because bad fats, which are stored in their liver, do not settle on their vessels, "says Dr. Hillon.

Mediterranean diet
If overweight increases the risk of gastrointestinal cancer in general, on the contrary, weight loss followed with a Mediterranean diet and practicing regular exercise (at least three hours per week) reduces this excess risk . These dietary measures are most useful there are few treatments now capable of preventing the passage of cirrhosis and liver cancer. "Metformin seems well reduce the risk of liver cancer, but this oral antidiabetic may be required in cases of diabetes and is cons-indicated in patients with cirrhosis and liver failure, which greatly limits the interest. About the possible protective effect of statins, it is still a hypothesis studies are underway to learn more, "says Professor Hillon.

To test
Meanwhile, we also monitor the liver closely. And to avoid having to multiply unnecessary liver biopsy (a test that requires several hours then remain elongated and avoid effort in days), simpler tests are developed. "In addition to conventional examinations such as palpation looking for a big hard liver, a blood test to check liver function and coagulation factors are very disturbed and ultrasonography of the liver, others appeared . This is the case of Fibroscan, which is to measure the elasticity of the liver and goes a little like an ultrasound. Or Fibrotest from FibroMeter or Hepascore, based on the measurement of biochemical markers (blood tests), "says Dr. Nalet (Hospital, Montelimar).

These reviews do not replace biopsy, but can better select those who really need it. A step towards better support ...

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