Viral hepatitis is a gateway to liver cancer, warns oncologist from HOL

Inflammations in the liver caused by viruses, associated with excessive use of alcohol, drugs, medications, and even autoimmune diseases, viral hepatitis affects thousands of Brazilians every year, often without presenting symptoms in the early stages. The chronic forms of types B and C are directly linked to the development of liver cancer, one of the deadliest neoplasms. The estimate for the 2023–2025 triennium is 10,700 new cases of liver cancer per year in the country, that is, 5 cases per 100,000 inhabitants, with 6,390 among men and 4,310 among women, according to the Ministry of Health (MS).

The warning comes from oncologist Paulo Soares, from the Ophir Loyola Hospital (HOL), who emphasizes the urgency of increasing awareness, early diagnosis, and prevention. According to him, ignorance and lack of adequate screening are still the biggest obstacles in combating the progression of these dangerous infections, and chronic infection by viruses B and C causes molecular changes in the body that favor the emergence of tumors.

“There is a direct relationship between chronic infection by these viruses and the development of liver cancer. Persistent infection can last for years and alter the DNA of liver cells. The hepatitis B virus is the most concerning, as it has the ability to integrate into the host cell's genome, favoring carcinogenesis even in the absence of cirrhosis, an advanced stage of the disease. Over time, the liver of these patients evolves with fibrosis and chronic inflammation resulting from viral aggression, contributing to the early formation of neoplasms,” clarified Soares.

According to the oncologist, it is essential that patients with chronic hepatitis B and C undergo rigorous oncological surveillance, including periodic imaging tests and monitoring of tumor markers. “The progression from hepatitis to cancer occurs, in most cases, through liver cirrhosis, a condition in which healthy liver tissue is gradually replaced by scar tissue (fibrosis), compromising the organ's function and potentially leading to liver failure,” he emphasized.

In Pará, the Ophir Loyola Hospital (HOL), a reference in oncological treatment, has recorded a significant increase in liver cancer cases over the past three years. In 2022, 95 cases were diagnosed (52 men and 43 women). This number rose to 118 in 2023 (68 men and 50 women) and reached 162 in 2024 (90 men and 72 women). The 70% growth during this period reinforces the need for attention to the chronic forms of the disease and early screening.

In addition to diagnosis and monitoring, the hospital offers specialized treatments for patients with liver cancer. “The hospital offers various therapeutic modalities. Among them, conventional chemotherapy, liver surgeries, and chemoembolization stand out, a procedure in which we inject the chemotherapy drug directly into the artery that supplies the tumor, causing the interruption of blood flow and leading to the death of tumor cells. In some cases, we also use radiotherapy. And soon, we will start the ablation technique as another effective tool in tumor destruction,” explained Paulo Soares.

The detection of liver cancer usually requires a combined approach, which includes laboratory tests, such as blood tests; imaging methods, such as ultrasound, tomography, or magnetic resonance imaging, and, in certain situations, a biopsy. “The interpretation of these data, combined with the patient's clinical history, allows for confirming the diagnosis and determining the stage of the disease,” informed the specialist.

Soares also informs that vaccination against hepatitis B has contributed to a significant reduction in the incidence of liver cancer related to this virus. “Immunization is offered, free of charge, by the Unified Health System (SUS), to all people who have not yet been vaccinated, regardless of age. In the case of children, the vaccine is part of the mandatory national immunization schedule. It is worth noting that the vaccine is the first to prevent a specific type of cancer. On the other hand, there is still no vaccine available for hepatitis C.”

Text by David Martinez, under the guidance of Leila Cruz