Liver Cancer And Alcohol

Overview

Cancer, according to the Centres for Disease Control and Prevention, is described as the uncontrollable growth of cells in the body. Hence, liver cancer is a cancer that occurs primarily in the liver. Across the globe, liver cancer is now the second leading cause of cancer death worldwide.¹ There are many factors that can contribute to liver cancer, and heavy alcohol consumption is commonly associated. Alcohol consumption is responsible for 7% of liver cancer cases in the UK, meaning that 7 out of every 100 cases are linked to drinking alcohol.

This article will explore the connection between liver cancer and alcohol, highlighting the importance of preventing excessive alcohol consumption or abstaining entirely.

Alcohol and liver damage

Alcohol is a globally used psychoactive, toxic substance that is consumed for recreational, social, and cultural purposes, often to induce relaxation or alter mood. But what people are unaware of are the long-term detrimental effects it can have on them, such as cancer.²

Metabolism of alcohol in the liver 

When alcohol enters the body, it is broken down in the liver. The liver usually breaks down alcohol with the help of an enzyme called alcohol dehydrogenase, resulting in water and carbon dioxide that are removed from the body eventually.^3,4

Effects of alcohol on the liver 

There can be short-term and long-term effects of alcohol on the liver. The short-term effects are:

1. Fatty liver  can be caused temporarily due to the buildup of fat in liver cells
2. Inflammation of the liver resulting in a condition known as acute alcoholic hepatitis
3. Reduced function of the liver, thereby making it less efficient in breaking down toxins, thus leading to the buildup of toxic waste products in the body

Long-term effects include:

1. Chronic fatty liver
2. Cirrhosis, also known as scarring of liver tissue, thus severely impairs its functional capacity. People suffering from cirrhosis have a high incidence of progressing to liver cancer
3. Liver cancer 

Liver cancer and alcohol

There are various ways in which alcohol can be related to liver cancer. 

1. Alcohol, which is broken down by the liver, can result in a very harmful by-product called acetaldehyde. This substance damages cellular structures like DNA, causing mutations
2. Chronic alcohol consumption can lead to liver inflammation, which over time can result in irreversible scarring, a condition referred to as cirrhosis. Scar tissue builds up and replaces most of the liver cells. Cirrhosis, in turn, increases the risk of liver cancer
3. Long-term alcohol intake also increases the risk of liver infections such as hepatitis, thus further elevating the likelihood of liver cancer
4. Alcohol interferes with the normal process that controls how cells grow and when they should die. This can cause damaged cells to survive and keep growing instead of being removed from the body

Consumption patterns

So, how can we determine if we're consuming excessive alcohol? First, it's important to note that no level of alcohol consumption is completely safe for health.⁵ However, if you're not ready to quit, let's explore the safety guidelines and preventive markers to help manage your intake.

14 units of alcohol per week, with some alcohol-free days, is the recommended standard guideline globally for adults. This guideline applies to all adults. Any consumption beyond these guidelines can be considered excessive, potentially classifying you as a binge drinker or someone with alcohol dependence.

You can find out about the units of alcohol you take using the unit calculator.

In the UK, alcohol accounts for around 7% of liver cancer cases, equating to about 1 in 14 cases. This results in at least 400 cases annually, with the majority affecting men.⁶

Liver cancer symptoms

Liver cancer can present with symptoms or even without.⁶ Some symptoms that can lead to suspicion of liver cancer are : 

1. Yellowish discolouration of eyes and skin
2. Itchy skin
3. Dark urine
4. Pale stools
5. Loss of appetite
6. Unintentional weight loss, where you may feel like your clothes have become baggy and do not fit you anymore
7. Constant tiredness
8. Pain may sometimes be present at the right side of the tummy or towards the right shoulder

However, confirmation should be done by a series of tests, which are explained further in this document. The above symptoms may be associated with liver cancer, but it is important to consult with your healthcare provider for a proper evaluation.

Types of liver cancer

Liver cancer can be presented in two ways: Primarily in the liver, which means its origin is in the liver, and the other is secondary liver cancer or liver metastasis. Secondary liver cancer does not originate from the liver but spread of cancer to your liver, which originally started in another organ.

In this article, we will be focusing on the primary liver, which is of 5 types: 

1. Hepatocellular carcinoma (HCC) - the most common type of liver cancer, which is often linked to alcohol consumption ⁷
2. Fibrolamellar carcinoma - a rare form of liver cancer that affects younger individuals and is not typically associated with alcohol use
3. Bile duct cancer (cholangiocarcinoma) - cancer in the bile ducts, some of which are inside the liver; thus, if a cancer is present here, it can cause intrahepatic cholangiocarcinoma, which is a primary type of liver cancer
4. Angiosarcoma - cancer within the blood vessels that supply the liver
5. Hepatoblastoma - It is a  rare type of liver cancer which is associated with children 

Diagnosis 

Liver cancer can be diagnosed through a combination of methods. Blood tests are used to check for markers that indicate liver damage or cancer. Imaging scans, such as ultrasound, CT scans, or MRI scans, help identify abnormal growths or tumours in the liver. Also, a biopsy can be performed, which involves taking a small sample from the liver and then observing it under a microscope to see if there are any changes tallying with liver cancer. Note that these tests would be according to the advice from your GP or a group of specialists who will look after you. 

Treatment options for liver cancer

Treatment is typically determined after a thorough evaluation by a team of medical professionals. They consider factors such as the type and stage of cancer, and how well the liver is functioning. Based on this, common treatment options may include surgery, heat therapy, medications, and radiation therapy. ⁸

Tips for cutting down on alcohol

1. Choose a weaker alcohol for a start. Try lighter beers under 4% ABV. As a rule of thumb, white and rosé wines are lower in strength than reds 
2. NHS Drink Free Days is an app where you can set a goal and track your progress
3. Set a budget for your alcohol consumption monthly
4. If your social plans involve going for drinks, then try alternatives like going for a coffee or movie nights
5. Get involved in support groups (Alcohol anonymous)
6. Seek support within your family and friends to start your alcohol abstinence journey⁹

Summary

Liver cancer is a leading cause of death worldwide, and it has a strong connection to excessive alcohol consumption. Long-term alcohol use can lead to liver damage through the buildup of toxic by-products during its metabolism. Chronic alcohol consumption can also make the liver more vulnerable to damage, leading to conditions like cirrhosis. As a result, this significantly increases the likelihood of developing liver cancer. Hepatocellular carcinoma, the most prevalent type of liver cancer, is particularly linked to excessive alcohol use. Symptoms may include jaundice (yellowing of the skin), abdominal pain, weight loss, and loss of appetite, as outlined in the article. However, this can only be confirmed with the aid of tests. Limiting alcohol intake to 14 units per week and seeking support for alcohol reduction can help reduce the risk of liver cancer.