Liver cancer in the Philippines holds a staggering mortality rate of 11.6 out of 100,000 individuals, compared to the global death rate of 7.8/100,000. This reflects the significant impact of liver cancer on the public health of our country, highlighting the need for a multi-faceted approach that encompasses patient education, screening and diagnosis initiatives, and access to appropriate medicine.
Liver cancer also ranks as the 4th most common type of cancer diagnosed in the Philippines next to breast, lung, and colon, and the 3rd most common cause of death. Statistics from the Global Cancer Observatory show that as of 2022, the Philippines had 12,544 new cases of liver cancer and 11,653 deaths annually.
With these, one of the diseases that deserves our attention is liver cancer and its most common variant, hepatocellular carcinoma (HCC). This, as the country commemorates World Cancer Day and the National Cancer Awareness Month every February.
As Hepatitis B infection is a major risk factor for developing HCC, increasing vaccination coverage among the population is important. This is more crucial for high-risk populations such as healthcare workers, people with chronic liver disease, individuals with multiple sexual partners, and immunocompromised patients. While the government has implemented national vaccination programs to reduce the incidence of hepatitis B, this remains to be the most common cause for hepatocellular carcinoma.
The US Centers for Disease Prevention and Control (CDC) noted that in its early stages, liver cancer may not have symptoms that can be seen or felt. On the other hand, people may notice one or more of the common symptoms as the cancer grows larger.
The CDC said that liver cancer symptoms may include discomfort in the upper abdomen on the right side; a swollen abdomen; a hard lump on the right side just below the rib cage; and pain near the right shoulder blade or in the back. Also among the symptoms are jaundice (yellowing of the skin and whites of the eyes); easy bruising or bleeding; unusual tiredness; nausea and vomiting; loss of appetite; and weight loss for no known reason.
The CDC added that a person may reduce the risk of getting liver cancer by keeping a healthy weight and getting enough physical activity. Also, one is encouraged to get tested for hepatitis C and get medical care if one has it. Finally, quit smoking and avoid drinking too much alcohol.
As with most cancers, detecting liver cancer in its early stages gives patients the best chance for successful treatment. Early diagnosis means more treatment options, better outcomes, and higher chances for survival.
The Philippine Clinical Practice Guidelines (CPG) for the Diagnosis and Management of Hepatocellular Carcinoma in 2021 recommend the semi-annual screening of patients identified to be at higher risk to develop HCC. Screening would benefit patients who are diagnosed to have late-stage liver damage or cirrhosis, and patients with hepatitis B who have a family history of HCC. For this patient group, tools like ultrasound and alpha-fetoprotein (AFP) testing can help in early detection of liver cancer.
Access to effective treatment is an important factor in cancer care, as the availability of medications directly impacts patient outcomes. In the Philippines, there is a comprehensive range of treatment options for liver cancer. Localized therapies such as interventional radiology and transarterial chemoembolization procedures are available for earlier stage disease. These allow for targeted treatment of liver tumors while minimizing damage to surrounding healthy tissue.
Beyond localized treatments, systemic medications like immunotherapy and targeted therapy are also available for more advanced diseases. These therapies work by either disrupting cancer growth at the molecular level or by enhancing the immune system’s ability to fight cancer, leading not just to prolonged survival, but also a better side effect profile.
By integrating these innovative treatments into clinical practice, physicians can now tailor HCC management to each patient’s disease stage and overall health status, ultimately leading to better disease control, extended survival, and an improved quality of life. It is important for liver cancer patients to speak with their physicians for the most appropriate treatment plan for them.
Despite these advancements, however, there is a need for healthcare programs to be in place to provide financial support for these life-saving medicines. With funding mechanisms, more Filipino patients will be able to access the therapies they need, increasing their chances of receiving optimal cancer care.
Co-creation of strategies from the government, medical experts, and the biopharmaceutical industry is crucial to pivot the condition of HCC in the country. This starts with the swift inclusion of necessary medicines into the Philippine National Formulary, followed by the development of health programs such as PhilHealth’s Z Benefits packages to ensure that medicines get into the hands of patients who need them the most.
Finally, public awareness of liver cancer and HCC is important. Increasing awareness about liver health and the signs and symptoms of liver cancer is crucial to encourage people to seek medical advice promptly.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines which PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
