Category: 8. Health

July 29 (UPI) — Liver cancer: In most cases, it doesn’t have to happen, a new global study finds.

Research suggests that 60% of cases of this often deadly disease are preventable by avoiding or treating big risk factors.

Those risk factors include viral hepatitis infection, alcohol misuse or a dangerous, obesity-linked buildup of fat in the liver.

The finding highlights “a huge opportunity for countries to target these risk factors, prevent cases of liver cancer and save lives,” said study first author Dr. Stephen Chan of the Chinese University of Hong Kong.

His team issued its findings Monday in a special report on liver cancer published by The Lancet.

As Chan’s team notes, liver malignancies rank as the sixth most common cancer worldwide and the third-leading cause of cancer deaths.

Some countries are being hit much harder than others: China, in particular, is burdened with more than 40% of the world’s liver cancer cases, largely due to widespread hepatitis B illness.

Without further intervention, cases of liver cancer are expected to nearly double globally by 2050 to more than 1.5 million cases annually, the report found.

When cancer affects the body’s blood-cleansing organ, it can be very difficult to treat.

“It is one of the most challenging cancers to treat, with five-year survival rates ranging from approximately 5% to 30%,” noted report co-author Dr. Jian Zhou of Fudan University in China. “We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action to reverse this trend.”

Many cases of liver cancer can be avoided.

One preventable cause is metabolic dysfunction-associated steatotic liver disease, or MASLD — a slow, steady buildup of fat within the liver, often tied to obesity.

Up to a third of people worldwide have some level of MASLD, according to the researchers, and as obesity rates rise, cases of the condition are expected to follow suit.

By 2040, it is projected that 55% of Americans will have MASLD, upping their odds for liver cancer, the report’s authors said.

“Liver cancer was once thought to occur mainly in patients with viral hepatitis or alcohol-related liver disease,” noted report co-author Dr. Hashem El-Serag of Baylor College of Medicine in Houston. “However, today rising rates of obesity are an increasing risk factor for liver cancer, primarily due to the increase in cases of excess fat around the liver.”

On the other hand, inroads made against viral hepatitis B (HBV) and C (HCV) mean their impact on liver cancer rates are waning.

The authors note in a journal news release that “the proportion of liver cancer cases linked to HBV is expected to decrease from 39% in 2022 to 37% in 2050, while HCV-related cases are projected to drop from 29% to 26% over the same period.”

Better efforts to vaccinate against hepatitis B and screen for (and treat) hepatitis C could drive down liver cancer rates even further, the team said.

Diagnosing and treating MASLD would also help.

“One approach to identify patients at high risk of liver cancer would be to introduce screening for liver damage into routine healthcare practice for patients at high risk of MASLD, such as individuals living with obesity, diabetes and cardiovascular disease,” El-Serag said in the news release.

Better advocacy around healthy diets and regular exercise can also help, he added.

Even cutting liver cancer cases by 2% to 5% per year could mean that 9 million to 17 million new cases of liver cancer could be prevented worldwide by 2050.

That translates to up to 15 million lives saved, the report’s authors said.

More information

Find out more about MASLD and liver cancer at the Fatty Liver Alliance.

Copyright © 2025 HealthDay. All rights reserved.

A recent study by researchers at the University of California San Diego School of Medicine has found that individuals with cannabis use disorder (CUD) are more than three times more likely to develop oral cancer within five years compared to those without CUD. The study highlights the potential long-term health risks associated with problematic cannabis use.

In 2022, 17.7 million people reported daily or near-daily cannabis use. Though CUD requires a formal diagnosis and not all cannabis users develop the disorder, recent research suggests that as many as 3 in 10 cannabis users will develop CUD.

As cannabis becomes more widely available and socially accepted, it is essential to understand its potential health risks. While many consider cannabis to be safer than other drugs, such as tobacco and alcohol, there are still many unknowns about the health impacts of cannabis, particularly how the drug influences cancer risk. The new study sought to determine the relationship between CUD and oral cancer, for which tobacco smoking is known to be a significant risk factor.

Cannabis smoke contains many of the same carcinogenic compounds found in tobacco smoke, which have known damaging effects on the epithelial tissue that lines the mouth. These findings add to a growing body of evidence suggesting that chronic or problematic cannabis use may contribute to cancer risk in tissues exposed to combustion products.”

Raphael Cuomo, Ph.D. associate professor in the Department of Anesthesiology at UC San Diego School of Medicine and member of UC San Diego Moores Cancer Center

By analyzing the electronic health records from over 45,000 patients, of whom 949 developed CUD, Cuomo found:

• After adjusting for age, sex, body mass index and smoking status, people had a 325 percent times higher likelihood of contracting oral cancer within five years compared to those without CUD.
• Tobacco smokers with CUD were 624 percent more likely to contract oral cancer within five years compared to tobacco smokers without CUD.

Because the association between CUD and oral cancer remained even after controlling for smoking status, and because CUD was associated with greater oral cancer risk even when the analysis was restricted to smokers, the researchers hypothesize that there may be other factors underlying this risk in addition to smoke inhalation. For example, THC, the active compound in cannabis is known to have immune-suppressing effects, which may contribute to increased cancer risk.

While more research is needed to fully explain the association between cannabis and oral cancer, the study’s results have immediate implications for cancer screening practices and public health messaging. In particular, the findings emphasize the need for further research on the long-term effects of cannabis use and the importance of integrating oral health awareness into substance use disorder treatment and counseling.

In a major step towards early detection, University of South Australia researchers are investigating the biology behind multiple sclerosis (MS) to help predict people’s genetic risk of developing the disease, long before any symptoms appear.

Funded by an MS Australia Incubator Grant announced today, the Australian-first study will use a powerful new research method known as ‘recall by genotype’ to explore genetic causes of MS.

Specifically, the study will explore links between MS and the Epstein-Barr virus – a common virus best known for causing glandular fever, but increasingly believed to be a trigger for MS.

MS is a chronic autoimmune disease that disrupts communication between the brain, spinal cord and body. Affecting more than 33,000 Australians, the exact cause of MS remains unknown, though genetics and environmental factors are thought to play a key role.

Lead researcher, UniSA’s Dr. David Stacey, says the research aims to untangle how the Epstein-Barr virus might lead to MS in some people but not others.

“For many years we’ve known that the Epstein-Barr virus is a likely precursor for MS,” Dr Stacey says.

“But because the virus affects up to 90% of the population, it’s difficult to pin down why some people go on to develop MS while others don’t.

“We believe the way a person’s immune system responds to the Epstein-Barr virus may be a key factor, and genetics can help us uncover that.”

The study will calculate MS genetic risk scores for more than 1000 South Australian participants without an MS diagnosis, then compare biological traits in a subset of participants with either high or low genetic risk.

By grouping people based on their genetic profile, we expect to find those with a high genetic risk for MS will also show biological differences – even if they don’t have the disease. That could reveal how the Epstein-Barr virus and MS are connected and identify early warning signs or biomarkers for MS.”

Dr. David Stacey, Lead Researcher

To enable this study, the researchers will use an innovative research design called ‘recall by genotype’ – or RbG for short. RbG studies use naturally occurring genetic variants that are strongly associated with a disease to group people for research. Participants are then ‘recalled’ for further testing based on their DNA, allowing researchers to study differences in a more targeted and reliable way.

The researchers have been working to establish resources to enable RbG studies in Australia, which until now have not been possible. This study will therefore help to establish standard operating procedures for participant recall and tackle important ethical questions about sharing genetic risk with research participants.

“If we identify people who are at risk of developing MS, we need to consider how – and whether – to share that information, particularly as this information may not yet be clinically actionable,” Dr Stacey says.

“This study will explore those ethical, legal and social questions to guide how future studies approach personal genetic risk.”

Ultimately, the research team – which includes collaborators from the Perron Institute and the University of Adelaide – hopes the study will pave the way for larger investigations and help support the development of early diagnostic tools and future preventative strategies for MS.

Findings

A study led by investigators at the UCLA Health Jonsson Comprehensive Cancer Center found that while blood-based tests offer a more convenient option for colorectal cancer screening, only 49% of patients completed a follow-up colonoscopy within six months, and just 56% did so at any point during the two-year study period. Follow-up colonoscopy is a critical next step to confirm the presence of colorectal cancer or pre-cancer after an abnormal screening result. These follow-up rates are comparable to those observed with stool-based screening tests, but remain far below optimal levels needed for timely cancer detection and treatment.

The team also found that individuals with Medicare Advantage were significantly less likely to complete follow-up colonoscopy compared to those with private insurance, and that having fewer health conditions increased the likelihood of timely follow-up. Unlike prior studies of stool-based screening, race and ethnicity were not significant predictors of follow-up completion in this cohort.

Background

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. among men and women combined, and regular screening can save lives by detecting it early. While traditional tests, such as colonoscopy or stool-based tests, are effective, many individuals do not get screened due to barriers such as fear, limited access, or challenges with test preparation. Blood-based screening tests offer a non-invasive, more convenient alternative for patients not amenable to the preferred colonoscopy or stool-based screening tests. However, to ensure these tests truly lower cancer rates and save lives, it is crucial to understand how often patients follow through with colonoscopy-a key second step after an abnormal result.

Method

Researchers conducted a retrospective analysis using medical claims data from over 6,000 individuals aged 45 and older who received a blood-based colorectal cancer screening test, called Shield (Guardant Health), between 2022 and 2024. The study focused on the 452 individuals who received an abnormal result and examined how many completed a follow-up colonoscopy within six months.

Impact

This study provides important real-world data on follow-up colonoscopy rates after abnormal results from blood-based colorectal cancer screening. Timely follow-up is critical because it enables early detection and treatment of colorectal cancer.

Blood-based colorectal cancer screening is promising, but it only works if individuals complete the follow-up colonoscopy. More efforts are needed to help patients follow through to actually diagnose and treat the disease.”

Dr. Folasade May, associate professor of medicine at the David Geffen School of Medicine at UCLA and senior author of the study

Journal

The study was published in the journal Gastroenterology. 

Authors

The study’s first author is Dr. Timothy Zaki, a senior gastroenterology fellow at UCLA Health. The study’s senior author is Dr. Folasade May, associate professor of medicine at the David Geffen School of Medicine at UCLA, associate director of the UCLA Kaiser Permanente Center for Health Equity, and member of the UCLA Health Jonsson Comprehensive Cancer Center. The remaining authors include Nicole Zhang, Dr. Shaun Forbes, Victoria Raymond and Dr. Amar Das from Guardant Health.

A newly presented study involving patients with breast cancer treated with anthracycline-taxane chemotherapy revealed significant differences in deep brain regions among those with chemotherapy-associated cognitive impairment, also known as “chemobrain.” Some of these impacted regions overlap with those implicated in small vessel disease and vascular dementia, including parts of the default mode network, which is also disrupted in Alzheimer disease (AD).¹

In the study, researchers enrolled 270 patients with breast cancer who received anthracycline-taxane chemotherapy in the last 12 months, following neurocognitive prescreening tests performed on an artificial intelligence-driven online platform. Among these patients, 18 of them with poorer prescreening scores, along with 19 controls, underwent in-person neurocognitive evaluations and an MRI scan (3-Tesla). Investigators then analyzed the MRI images using region of interest and voxel-based norphometric group-level analysis.

In the region of interest analysis, results showed that patients with chemobrain had significantly lower grey matter volumes (mm³) in the left isthmus cingulate and pars opercularis regions. In addition, this group of patients had reduced grey matter surface areas (mm²) in the same regions, as well as in the left medial orbitofrontal, right isthmus cingulate, lingual, and temporal pole areas. These findings were presented at the 2025 Alzheimer’s Association International Conference, held July 27-30, in Toronto, Canada, by Paul Edison, MD, PhD, professor of neuroscience at the Imperial College London.

For the voxel-based norphometric analysis, investigators reported a statistically significant decrease in the periventricular areas, cingulate gyrus, precuneus, as well as in the parietal and medial frontal lobes, in those treated with chemotherapy. Moreover, in-person neurocognitive assessments displayed significantly poorer semantic and verbal fluency and lower Mini-Mental State Examination scores in patients with chemobrain. Overall, these findings suggest that chemotherapy-induced neuroinflammation may disrupt the neurovascular unit, induce vascular toxicity, and lead to brain morphological changes that contribute to the cognitive impairment observed in the chemobrain phenotype.

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Despite chemotherapy significantly improving cancer survival rates, its mechanism of action can be associated with a range of adverse effects that may impact long-term quality of life.² For example, chemobrain can impact approximately 33% of patients with breast cancer who have undergone chemotherapy, presenting with different degrees of severity. Although some patients may experience temporary symptoms that can resolve in a year, others could have persistent cognitive issues that could elevate the risk for AD. Thus, understanding the underlying mechanisms and characteristics of chemobrain may support earlier detection, targeted interventions, and the development of preventive approaches for patients.

In a similar study published in Pathophysiology, findings revealed significant reductions in both gray and white matter in patients with breast cancer treated with chemotherapy compared with healthy volunteers when using MR morphometry. This analysis demonstrated the utility of MR morphometry in detecting subtle yet statistically significant neuroanatomical changes associated with cognitive and motor impairments in this patient population.³

The prior study enrolled 86 patients who had breast cancer and age-matched 28 healthy female volunteers. Researchers obtained conventional MR sequences in 3 mutually perpendicular planes to exclude an organ pathology of the brain. In addition, investigators used the MPRAGE sequence to perform MR morphometry and assess brain structure volumes. The evaluation was conducted at 2 follow-up visits 6 months and 3 years following completion of breast cancer treatment. Notably, authors did not observe restoration of brain volume structures over the follow-up period of 3 years in patients.

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REFERENCES
1. Edison P et al. Chemotherapy-associated brain morphological alterations in breast cancer: Implications for cognitive decline and neurodegenerative risks. Presented at: 2025 Alzheimer’s Association International Conference; July 27-31; Toronto, Canada. Abstract 103823.
2. Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ. 2023;380:e071726. Published 2023 Mar 15. doi:10.1136/bmj-2022-071726
3. Nikolaeva A, Pospelova M, Krasnikova V, et al. MRI Voxel Morphometry Shows Brain Volume Changes in Breast Cancer Survivors: Implications for Treatment. Pathophysiology. 2025;32(1):11. Published 2025 Mar 12. doi:10.3390/pathophysiology32010011

A new study showed sleep impairment was linked to increased diabetes distress among adults with type 2 diabetes.¹

“The results of this population-based cross-sectional study of people with [type 2 diabetes] demonstrate that sleep impairment is significantly associated with high diabetes distress, even after considering sociodemographic status, BMI, current use of insulin and depression as confounders,” wrote investigators, led by Hilde K. R. Riise, PhD, from the department of health and caring sciences at Western Norway University of Applied Sciences.¹

Type 2 diabetes can put people at risk for many life-threatening events—myocardial infarction, stroke, heart failure, kidney failure, and painful diabetic neuropathy. With all the risks involved, diabetes can negatively impact someone’s psychological well-being, resulting in diabetes distress.

About 40% of adults with either type 1 or type 2 diabetes report significant distress, and the frequent worrying about managing their disease can impact diet, exercise, medication adherence, and glycemic control.² Diabetes distress should not be mistaken for clinical depression; if a patient feels very depressed or sad, they should seek out a mental health professional.

Several factors have been linked to high diabetes distress, including female sex, poor glycemic control, short diabetes duration, and comorbid depressive symptoms. However, there may be another factor—sleep.¹

People with diabetes often have poor sleep, resulting in inadequate glycemic control. Obstructive sleep apnea (OSA) and insomnia are common sleep disorders in patients with type 2 diabetes.

Studies have previously reported the link between sleep impairment and high diabetes stress, but focused on adolescents and young adults with type 1 diabetes, and led to conflicting results.^3,4 One study showed daytime sleepiness are associated with diabetes distress in patients with type 2 diabetes.⁵ Another study found adults with type 1 or 2 diabetes who reported sleep impairments were more likely to experience diabetes distress.⁶

Sleep problems may contribute to diabetes distress by worsening fatigue and psychological distress due to reduced insulin sensitivity, raising HbA1c levels and impairing glycemic control, and hindering cognitive function needed for diabetes management. Poor sleep can also strain social interactions and increase feelings of isolation, further elevating distress.

Despite the research out there supporting the link between sleep impairment and diabetes distress, not enough evidence exists to establish this association in people with type 2 diabetes. Investigators recognized that identifying modifiable risk factors for diabetes distress, such as short sleep duration, disrupted sleep, and misaligned circadian rhythm, may improve self-management and glycemic control. In HUNT, a population-based, cross-sectional study, the team sought to examine the associations between sleep impairments and diabetes distress.

The study included 1954 adults aged ≥ 20 years (mean age, 67.3 years) with type 2 diabetes who completed the 2017 – 2019 HUNT4 survey. The sample had 837 women and 1117 men.

The sleeping HUNT-Questionnaire measured snoring, sleep apnea, troubles falling asleep, waking up during the night, early wakening, restless legs, difficulties coping during the daytime due to sleep issues, and the number of hours respondents sleep a night. The Problem Areas in Diabetes (PAID-5) questionnaire measured diabetes distress.

The analysis showed sleep impairment was linked to increased diabetes distress. This association was seen across modifiable risk factors: ≤ 7 hours of sleep (0.6; 95% confidence interval [CI], 0.2 – 0.9), snoring (0.6; 95% CI, 0.1 – 1.1), trouble falling asleep (1.4; 95% CI, 0.8 – 22), waking up during the night (1.1; 95% CI, 0.6 – 1.6), early wakening (1.2; 95% CI, 0.7 – 1.8), trouble coping during daytime due to sleep problems (2.6; 95% CI, 1.7 – 3.6), and restless legs (0.8; 95% CI, 0.2 – 1.3).

The strong link between coping during daytime and high diabetes distress suggests that the consequences of sleep impairment, such as less energy, more irritability, and focusing problems, are driving diabetes distress.

“Understanding sources of sleep impairments in [type 2 diabetes] may lead to the development of interventions designed to improve sleep and, in turn, have a positive effect on diabetes self-management and psychological well-being,” investigators wrote. “We suggest that the assessment of sleep quality should be part of routine diabetes care in people with [type 2 diabetes]…the long-term effects of poor sleep on diabetes distress warrant further investigation.”

References

1. Riise HKR, Haugstvedt A, Igland J, et al. Diabetes distress and sleep impairment in type 2 diabetes: A population-based cross-sectional study-The HUNT Study, Norway. Diabet Med. Published online July 25, 2025. doi:10.1111/dme.70106

2. Learn about Diabetes distress. Diabetes Distress. https://diabetesdistress.org/learn-about-dd/. Accessed July 28, 2025.

3. Griggs S, Grey M, Ash GI, Li CR, Crawford SL, Hickman RL Jr. Objective Sleep-Wake Characteristics Are Associated With Diabetes Symptoms in Young Adults With Type 1 Diabetes. Sci Diabetes Self Manag Care. 2022;48(3):149-156. doi:10.1177/26350106221094521

4. Nefs G, Feinn R, Chang AM, Wagner J. Longitudinal relations of sleep quality with depressive symptoms, diabetes distress and self-efficacy in young people with type 1 diabetes. J Psychosom Res. 2023;173:111457. doi:10.1016/j.jpsychores.2023.111457

5. Gunn S, Henson J, Robertson N, et al. Self-compassion, sleep quality and psychological well-being in type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care. 2022;10(5):e002927. doi:10.1136/bmjdrc-2022-002927

6. Nefs G, Donga E, van Someren E, Bot M, Speight J, Pouwer F. Subjective sleep impairment in adults with type 1 or type 2 diabetes: Results from Diabetes MILES–The Netherlands. Diabetes Res Clin Pract. 2015;109(3):466-475. doi:10.1016/j.diabres.2015.07.008

High levels of a hormone found in cells in the gut could underlie many cases of chronic diarrhea and help explain up to 40% of cases of patients with irritable bowel syndrome with diarrhea, according to a new study led by scientists at the University of Cambridge.

The research, published in the journal Gut, could help in the development of a blood test and points towards a potential new treatment.

When we eat, the liver releases bile acid to break down fats so that they can be absorbed into the body. Bile acid is released into the top end of the small intestine and then absorbed back into the body at the lower end.

However, around one person in every 100 is affected by a condition known as bile acid diarrhea (also known as bile acid malabsorption), whereby the bile acid is not properly re-absorbed and makes its way into the large intestine (colon). It can trigger urgent and watery diarrhea, and patients can risk episodes of incontinence.

Bile acid diarrhea can be difficult to diagnose as there are currently no routine clinical blood tests. Many individuals are given a diagnosis of irritable bowel syndrome (IBS), an umbrella term for a range of conditions. As many as one in 20 people is thought to have IBS, of which an estimated one in three patients with diarrhea as their main symptom have undiagnosed bile acid diarrhea.

Studies in mice have previously suggested that the gut hormone known as Insulin-Like Peptide 5 (INSL5) – present in cells at the far end of the colon and rectum – may play a role in chronic diarrhea. INSL5 is released by these cells when irritated by bile acid.

Researchers at the Institute of Metabolic Science, University of Cambridge, have been exploring whether this hormone might also underlie chronic diarrhea in humans. This has been possible thanks to a new antibody test developed by pharmaceutical company Eli Lilly, with whom the team is collaborating, which allows them to measure tiny amounts of INSL5.

A study at the University of Adelaide looking at ways to trigger release of the gut hormone GLP-1 – the hormone upon which weight-loss drugs are based – previously found that giving a bile acid enema to healthy volunteers triggered release of GLP-1, but had the unintended consequence of causing diarrhea. When the Cambridge team analysed samples from this study, they found that the bile acid enema caused levels of INSL5 to shoot up temporarily – and the higher the INSL5 levels, the faster the volunteers needed to use the toilet. This confirmed that INSL5 is likely to play a role in chronic cases of diarrhea.

When the team analysed samples obtained from Professor Julian Walters at Imperial College London, which include samples from patients with bile acid diarrhea, they found that while levels of INSL5 were almost undetectable in healthy volunteers, they were much higher in patients with bile acid diarrhea. In addition, the higher the INSL5 level, the more watery their stool samples.

This was a very exciting finding because it showed us that this hormone could be playing a big part in symptoms of this misunderstood condition. It also meant it might allow us to develop a blood test to help diagnose bile acid diarrhea if INSL5 levels are only high in these individuals.

When you go to the doctor with chronic diarrhea, it’s likely they’ll test for food intolerances, rule out an infection or look for signs of inflammation. There has been significant research interest in the microbiome, but gut hormones have been neglected. But it’s becoming increasingly clear that gut hormones play an important role in things like gut health and weight management.”

Dr. Chris Bannon from the University of Cambridge, study’s first author

INSL5 also provides a potential target for treatment. Dr Bannon and colleagues obtained further samples from Professor Robin Spiller at the University of Nottingham, who had given the anti-sickness medication ondansetron – known to block the action of INSL5 in mice – to patients with IBS. Analysis of these samples by the Cambridge team showed that around 40% of these patients had raised levels of INSL5, even though they had had bile acid malabsorption ruled out, and these patients responded best to ondansetron.

Exactly why ondansetron is effective is currently unclear, though a known side effect of the drug is constipation. The team will now be investigating this further, hopeful that it will allow them either to repurpose the drug or to develop even better treatments. Bile acid diarrhea is usually treated with so-called bile acid sequestrants, but these are only effective in around two-thirds of patients.

Dr. Bannon added: “I often get asked why we would have a hormone that gives you diarrhea. I think of it as a kind of poison sensor. Bile acids aren’t meant to be in the colon – they’re an irritant to the colon and they’re toxic to the microbiome. It makes sense that you would have something that detects toxins and helps the body rid itself of them. But a problem develops if it’s always being triggered by bile acid, causing very dramatic symptoms.”

Dr. Bannon is a clinical fellow in the group led by Professors Fiona Gribble and Frank Reimann at the Institute of Metabolic Science, University of Cambridge.

The research was supported by the Medical Research Council and Wellcome, with additional support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.

Head and neck squamous cell carcinomas (HNSCC) are a group of cancers that affect cells in and around our mouth and nose. With 890,000 new cases and 450,000 deaths annually, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths worldwide. Treatment options for HNSCC are very limited, so nearly half of affected patients with HNSCC die from the disease. Current therapies consist of surgery, radiotherapy and chemotherapy, which can be effective but often have limited success and significant side effects.

To meet this unmet medical need, researchers at the University of California San Diego School of Medicine are exploring new approaches to improve the effectiveness of treatments for HNSCC. In a new study of oral cancer, a type of HNSCC, they demonstrate how precisely timing two different treatments can potentially improve treatment outcomes by protecting tumor-draining lymph nodes, which are located close to tumors and have an important role in mediating the immune system’s response to the tumor.

The researchers found:

– In mice with oral cancer, delivering radiation therapy that preserves tumor-draining lymph nodes then later delivering immunotherapy resulted in a complete and durable tumor response, meaning the tumors became undetectable. This happened in 15/20 mice treated with this approach.

– The two treatments synergized to enhance migration of a specific type of immune cell, called activated CCR7+ dendritic cells, from tumors into lymph nodes. These cells helped trigger a stronger immune response to the tumor. This occurred in all treated mice.

The study’s results could have significant implications for the treatment of HNSCC, as well as other cancers that are resistant or unresponsive to current standard treatment approaches. The research also provides valuable biological insight into the role of tumor-draining lymph nodes in cancer biology, which could have further implications for developing new therapies. While it will take further research to fully explore the potential of this timed treatment approach, the findings demonstrate the importance of optimizing the sequence and timing of therapies to maximize their benefit to the patient. The researchers are now conducting clinical trials in collaboration with investigators at Providence Earl Chiles Cancer Center to leverage these strategies to improve outcomes in head and neck cancer patients.

The study, published in Nature Communications, was led by Robert Saddawi-Konefka, M.D., Ph.D.,PGY-8, fellow physician and Joseph Califano, M.D., professor and interim chair in the Department of Otolaryngology and Iris and Matthew Strauss Chancellor’s Endowed Chair in Head and Neck Surgery at UC San Diego School of Medicine. Califano is also director of the Hanna and Mark Gleiberman Head and Neck Cancer Center at Moore’s Cancer Center. The study was supported, in part by a National Cancer Institute funded R01 grant led by. Califano and Andrew Sharabi, M.D., Ph.D., associate professor and Jacobs Chancellor’s Endowed Chair in the Department of Radiation Medicine and Applied Sciences at UC San Diego School of Medicine, as well as a member of the Head and Neck Cancer Center at Moores Cancer Center. 

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RAWALPINDI, Jul 29 (APP):Member of the National Assembly (MNA) Anjum Aqeel Khan has urged the public to treat hepatitis as a serious health threat, calling it a “silent killer” that often causes irreversible damage without showing early symptoms.

He was addressing a seminar held in connection with World Hepatitis Day, aimed at raising awareness about the disease and promoting preventive measures.

The awareness event was organized by Chaudhry Muhammad Naeem, Founder of Savour Food Pakistan and Patron-in-Chief of the Restaurants, Caterers, Sweets and Bakers Association. The seminar brought together lawmakers, medical professionals, social activists, and concerned citizens at a local venue in Rawalpindi.

MNA Anjum Aqeel Khan, the chief guest, emphasized the need for continuous community engagement and awareness campaigns. “This disease does not always present symptoms early on, but it leads to severe liver damage. We must reach out to villages, schools, offices, and mosques to educate people,” he said. “This should not be seen as a one-day campaign, but as a permanent social responsibility.”

Punjab Assembly Member Mohsin Ayub Khan also attended the event and endorsed the need for sustained public health efforts.

Chaudhry Muhammad Naeem highlighted the contributions made under his personal initiative, including the establishment of a dedicated hepatitis laboratory and a modern operation theatre at Benazir Bhutto Hospital. “The objective is to ensure timely and quality treatment for the people of Rawalpindi,” he noted.

President of the Association, Muhammad Farooq Chaudhry, recalled the association’s active role during the COVID-19 pandemic and reaffirmed their commitment to the fight against hepatitis. “Just like we supported public vaccination during COVID, we are equally determined to combat hepatitis,” he said.

The event concluded with a pledge from participants to continue spreading awareness and encouraging early testing and vaccination against hepatitis. Representatives from various business, welfare, and health organizations were present in large numbers, along with concerned citizens.

The majority of liver cancer cases could be prevented by reducing levels of viral hepatitis, alcohol consumption and MASLD (metabolic dysfunction-associated steatotic liver disease – previously called non-alcoholic fatty liver disease), suggests an analysis as part of The Lancet Commission on liver cancer. The Commission highlights several ways to reduce these risks factors, including increasing the coverage of the hepatitis B vaccine and public health policies targeting obesity and alcohol consumption. 

Previous analyses have predicted that the number of new liver cancer cases will nearly double from 870,000 in 2022 to 1.52 million in 2050, primarily due to population growth and ageing populations, with the largest increases expected in Africa. The number of deaths from liver cancer are predicted to grow from 760,000 in 2022 to 1.37 million in 2050.

Liver cancer is already a major cause of death and disability. Globally, it’s the sixth most common cancer and the third leading cause of death from cancer. More than 40% of the global liver cancer cases occur in China, mostly due to relatively high rates of hepatitis B infections in the country.

Chair of the Commission, Prof. Jian Zhou, Fudan University (China) says: “Liver cancer is a growing health issue around the world. It is one of the most challenging cancers to treat, with five-year survival rates ranging from approximately 5% to 30%. We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action to reverse this trend.” 

As three in five cases of liver cancer are linked to preventable risk factors, mostly viral hepatitis, alcohol and obesity, there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer and save lives.” 

Prof. Stephen Chan, First Author, Chinese University of Hong Kong, Hong Kong, China

Changes in the causes of liver cancer 

In a novel analysis, the Commission estimates that at least 60% of liver cancers are preventable via control of modifiable risk factors, including hepatitis B virus (HBV), hepatitis C virus HCV, MASLD, and alcohol.

MASH, a severe form of MASLD, is the fastest growing cause of liver cancer globally, followed by alcohol. The Commission projects that the proportion of liver cancer cases associated with MASH are projected to increase from 8% in 2022 to 11% in 2050, and liver cancer cases associated with alcohol are projected to increase from 19% in 2022 to 21% in 2050 

In contrast, the proportion of liver cancer cases linked to HBV is expected to decrease from 39% in 2022 to 37% in 2050, while HCV-related cases are projected to drop from 29% to 26% over the same period.

A rising risk factor: MASLD

Approximately a third of the global population are estimated to have MASLD. However, only 20 to 30% of patients with MASLD develop the more severe form of the condition with liver inflammation and damage – called metabolic dysfunction-associated steatohepatitis (MASH).

The rate of MASLD-linked liver cancer is expected to rise over the next decade, particularly in the USA, Europe, and Asia, due to increasing rates of obesity. In the USA, MASLD prevalence continues to climb in parallel with the obesity epidemic; by 2040, over 55% of US adults could have MASLD. [For a case study from the USA: ‘MASLD and ALD as the new face of hepatocellular carcinoma’ – see panel 5, page 17 of the report.] 

Commission author, Prof Hashem B El-Serag, Baylor College of Medicine (USA) says, “Liver cancer was once thought to occur mainly in patients with viral hepatitis or alcohol-related liver disease. However, today rising rates of obesity are an increasing risk factor for liver cancer, primarily due to the increase in cases of excess fat around the liver. 

“One approach to identify patients at high risk of liver cancer would be to introduce screening for liver damage into routine healthcare practice for patients at high risk of MASLD, such as individuals living with obesity, diabetes, and cardiovascular disease. Healthcare professionals should also integrate lifestyle counselling into routine care to support patients to transition to a healthy diet and regular physical activity. Furthermore, policy makers must promote healthy food environments via policies such as sugar taxes and clear labelling on products with high fat, salt, and/or sugar.”

Global targets and recommendations 

The Commission estimates that if countries can reduce the incidence of liver cancer cases by 2 to 5% each year by 2050, it could prevent nine to 17 million new cases of liver cancer and save eight to 15 million lives. 

As more patients live with liver cancer than ever before, in addition to prevention efforts, there is an urgent need for increased research and attention for these patients to improve their quality of life.

The Commission suggests several strategies for reducing the global burden of liver cancer, including:

• Governments should intensify efforts to increase HBV vaccination-such as vaccine mandates in high-prevalence countries-and implement universal HBV screening for adults 18+, alongside targeted HCV screening in high-risk areas based on cost-effectiveness.
• Policy makers should enact minimum alcohol unit pricing, warning labels, and advertisement restrictions for alcoholic beverages.
• National health authorities and cancer control programmes should prioritise investments in public awareness campaigns and deployment of early detection resources.
• Professional organisations and the pharmaceutical industry should work together to reduce differences between Eastern and Western regions of the world in the clinical management of liver cancer.
• Hospitals and professional organisations should provide palliative care training, with the aim of integrating palliative care in the early phases for patients in need.
• [For a full list of the Commission’s ten recommendations for action see table 1, page 4]

Commission author, Prof Valérie Paradis, Beaujon Hospital (France) says, “There is an urgent need to raise awareness within society about the severity of the growing health issue of rising liver cancer cases. Compared with other cancers, liver cancer is very hard to treat but has more distinct risk factors, which help define specific prevention strategies. With joint and continuous efforts, we believe many liver cancer cases can be prevented and both the survival and quality of patients with liver cancer will be considerably improved.”