Stopping Liver Cancer Before It Starts
Article Summary
- Liver cancer is the sixth most common cancer and the third-leading cause of cancer deaths worldwide.
- Researchers at Sylvester Comprehensive Cancer Center have been working to pinpoint genetic and behavioral risk factors for metabolic dysfunction-associated steatotic liver disease in Latinos.
- Dr. Patricia Jones says social factors like diet and where you live, as well as genetics, play a role in MASLD.
The sixth most common cancer and the third-leading cause of cancer deaths worldwide, liver cancer ranks among the deadlier cancers, with an average five-year survival rate of only around 22%. And in the U.S., rates of liver cancer are on the rise, especially among Latinos.
One of the major risk factors for liver cancer is a chronic condition called metabolic dysfunction-associated steatotic liver disease, or MASLD (pronounced “massold”). Formerly known as non-alcoholic fatty liver disease, MASLD refers to an excess of fat in the liver that, if left untreated, can lead to cirrhosis.
The good news is that the effects of MASLD can be reversed if caught early, before liver scarring happens. Researchers at the University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center have been working to pinpoint genetic and behavioral risk factors for MASLD and identify measures to prevent it.
The Genetic Underpinnings of MASLD
Patricia D. Jones, M.D., Sylvester researcher, hepatologist and associate professor of clinical medicine at the Miller School, is part of a team investigating the genetic and environmental factors that drive the development of MASLD in Latinos. What differentiates this study is that it aims to identify the genetic underpinnings of MASLD in specific Latino groups — why rates of MASLD are higher in Central Americans than in Cubans, for instance.
“The idea is to understand how each group is different, how they’re similar and what environmental factors people have been exposed to that may increase their risk for developing fatty liver,” Dr. Jones said.
Identifying groups who are at higher risk for MASLD may help promote patient screening, one of the major ways that liver disease gets identified and treated. Nationwide, screening rates for liver cancer are very low, less than 30%.
Dr. Jones envisions a calculator for health care providers that could identify patients at the greatest risk for liver cancer. Those patients could be prioritized for earlier screening.
“One of the bad things about liver cancer is that it’s fairly deadly and often people are diagnosed at later stages, when they often don’t get to benefit from options that may be curative. At that stage, most of the available therapies are palliative,” said Dr. Jones. “When you get screened, it doesn’t prevent you from developing cancer, but it does lead to earlier detection, which gives you more options.”
Beyond genetics, social factors also play a major role in MASLD. How people eat, where they live, whether or not they have time to exercise and their level of nutritional literacy all play a role in risk for liver disease.
Because social factors contribute significantly to liver disease risk, research on MASLD focuses on fostering awareness of healthy behaviors in at-risk populations.
For instance, individuals with Mexican ancestry have a higher prevalence of a risk allele or a small change in the DNA code that changes the way fats are metabolized in the liver. Over time, individuals with this risk allele in their DNA may be at higher risk for more serious stages of liver disease, including cancer.
“This isn’t to say that if you have that risk allele, you are condemned to have liver disease,” said Melissa Lopez-Pentecost, Ph.D., RDN, a post-doctoral research fellow and registered dietician. “It just means that we need to pay closer attention to what we’re eating, especially if we have that risk allele, because then there may be an interaction with what’s going on with that risk allele and what we consume.”
Diet and Liver Disease
Dr. Lopez-Pentecost hypothesizes that the Mediterranean diet, widely touted as the gold standard of healthy eating, is similar to a traditional Mexican diet. She sees value in encouraging those with Mexican ancestry to tap into their gastronomic roots.
Unlike the modern Mexican diet, which is full of processed foods and sugar-sweetened beverages, the traditional Mexican diet contains mostly whole foods like fresh fruit and vegetables, whole grains, legumes and plant proteins. Just like the Mediterranean diet, the traditional Mexican diet is high in fiber and limited in red meats and processed vegetable oils.
“We’re talking about going back to the ways we used to cook, going back to those recipes that a lot of people are still cooking in their homes,” said Dr. Lopez-Pentecost.
Beyond the benefits of the food itself, Dr. Lopez-Pentecost sees value in how the traditional Mexican diet promotes social connectivity, an important aspect of health.
“My focus is to find a way that we can promote healthy eating in a way that’s more culturally relevant, and that helps because not only are you promoting a healthy diet pattern, you’re promoting going back to asking your abuelita for recipes, you’re getting together to make family meals,” said Dr. Lopez-Pentecost. “We’re talking about sitting down and sharing that social connection that comes with following a traditional Mexican diet, something that’s also part of the Mediterranean diet. You don’t have to go across the ocean to eat like them. What we have here locally may be just as beneficial.”
Tags: cancer research, Dr. Patricia Jones, lifestyle medicine, liver cancer, MASLD, metabolic dysfunction-associated steatotic liver disease
Social Factors in Liver Disease