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Is Reckless Youth Putting Your Liver at Risk?

Liver cancer rates are booming among boomers. Discover the surprising reasons.

Demographers tend to divide the boomer generation between “early,” “middle” and “late” groups, to analyze the specific challenges facing each. But no matter which group you belong to, experts say you’re at risk of developing liver cancer — and you might not even realize it.

Liver cancer is “the fastest-growing cause of cancer death in the U.S.,” says Dr. Ahmed Kaseb of the M.D. Anderson Cancer Centers. Fortunately, you can proactively address the underlying issues that could speed its onset.

Written in the Scars

Liver cancer generally arises from cirrhosis, a scarring of the liver often brought on by heavy drinking. But teetotalers are far from in the clear. “Cirrhosis is a generic term,” says hepatologist W. Ray Kim, associate professor of medicine at the Mayo Clinic College of Medicine. “It refers to the end-stage in the sequence of the liver accumulating scars. Any chronically damaged organ becomes scarred. With the liver, this scarring can arise from many underlying causes — alcohol abuse, fatty liver, hepatitis C, or any kind of hepatitis, really.”

(Learn more about cirrhosis and liver cancer from our editorial partners at Medline Plus.)

While there is no cure for cirrhosis, you can control some of the underlying causes of liver scarring.
Alcohol abuse remains a primary risk factor. If you're a man who consumes more than two drinks a day, or woman who consumes more than one daily, you should cut back. If you have trouble controlling your alcohol intake, seek advice for treatment from your doctor.

Aside from alcohol abuse, what causes the scarring that brings on cirrhosis? Inflammation. Chronic inflammation of the liver eventually causes the organ to fill with scar tissue. Among boomers, the leading cause of inflammation is the hepatitis C virus, or HCV. Never had hepatitis, you say? Maybe, maybe not. The scary truth is you may have contracted HCV 30 or more years ago and not even know it.

“The key words are Summer of Love,” Kim says. “An exchange of body fluids, and exposure to blood, are the two main ways people contract HCV, and anyone who ever experimented with injectable drugs or had sex with multiple partners is at risk for having contracted hepatitis C.” The recipients of blood transfusions prior to 1990, when screening of the national blood supply for hepatitis C began, may also be at risk. 

Boomers represent two-thirds of all people living with hepatitis C in the United States, according to the Centers for Disease Control and Prevention. But HCV produces no physical symptoms, like pain or jaundice, until it’s at an advanced stage, so screening in advance of symptoms is crucial for boomers. That's why the Centers for Disease Control's new Know More Hepatitis campaign identifies boomers as a priority population to be screened for the disease.

If Your Doctor Doesn’t Ask, Tell
Not all physicians do a good job of asking patients about prior drug experimentation or sexual partners, especially if the patient is a middle-aged professional with a solid marriage. And many boomers who traded tie-dyes for jackets-and-ties might feel embarrassed admitting they shared needles or multiple partners in their youth. Still, no matter how long ago it happened, Kim says, “if you ever shared a needle, even once, you need to let your doctor know,” even if he or she doesn't ask. “Early diagnosis of hepatitis C is crucial,” Kim says, “in order to treat it and try to stop it from advancing to liver cancer. If you belong in that age group, definitely get tested.”
The CDC is weighing a change in its existing guidelines that would advise everyone born between 1945 and 1964 to receive a routine, one-time HCV screening. But don’t wait for the official recommendation. It’s just a simple blood test. Get screened now.
Lighten Your Liver

The second-leading risk factor for liver scarring is having a fatty liver. According to Kaseb, “A review of the M.D. Anderson database over the past 10 years showed that over 50 percent of liver cancer patients (treated there) had no hepatitis history.” What many of those patients did have was a history of obesity.

If your liver gets bombarded with too much fat for it to process, it sets aside some of the fat to process later. But if you keep feeding the liver fat, it never gets around to processing those earlier batches. Instead, it encapsulates them in scar tissue.

“Fatty liver can be reversed by lifestyle modification,” Kaseb says, “but cirrhosis cannot. In general, people need to eat healthy and exercise” to avoid developing fatty-liver cirrhosis.
In general, don’t let past indiscretions hold you hostage at midlife. If you're a boomer, get screened for hepatitis. Control your alcohol intake. And if you’re overweight, work to reduce your waistline. These steps can help you keep liver cancer, and other ailments, at bay.

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