An area of a liver scan is highlighted red.

Understanding the Link Between Obesity and Liver Cancer

Between determining how certain cancers originate, analyzing the unique characteristics of different types of this disease, and discovering new treatments, cancer research is an active and varied field. The team at the Cancer Prevention and Population Sciences Program at the Dan L Duncan Comprehensive Cancer Center has narrowed its focus down to determining new risk factors that can affect people’s likelihood of developing cancer. As the number of people with hepatocellular carcinoma (primary liver cancer) is increasing—especially in Texas—researchers are delving into the potential link between this condition and obesity.

Non-Alcoholic Fatty Liver Disease and Cirrhosis 

It’s normal for a little bit of fat to accumulate in the liver over time, but too much fat can lead to complications. When this buildup occurs in someone who doesn’t drink excessively, we refer to this condition as non-alcoholic fatty liver disease. This excess of fat can lead to inflammation and even scarring, known as cirrhosis. When scar tissue builds up in the liver, this organ isn’t able to do its job as well as it could, which means you might have trouble breaking down medications, removing waste products, or performing a number of other vital processes. The same damage that can transform healthy cells into scar tissue can also turn them into cancer cells. 

Obesity and DNA Damage 

However, researchers are looking into the idea that there’s a more direct link between obesity and liver cancer. Studies suggest that not only does a higher BMI put you at risk for conditions that could eventually lead to cancer, but excess body fat itself can damage DNA to the point of causing uncontrollable cell multiplication.

Fat cells produce many types of cytokines, a family of proteins that interact with cells to tell them how to behave. These proteins have many functions, from signaling cells to divide to inducing inflammation in damaged tissue. A little bit of inflammation every now and then is ok and can aid in the healing process, but chronic inflammation and oxidative stress due to obesity can damage the DNA in cells and create issues with their repair mechanisms. Accumulation of damage can lead to an increased rate of mutation and altered gene expressions, causing the cells to divide rapidly and form cancerous tumors.

“For the first time, we are looking at obesity as not only a precursor for diabetes, heart attacks, and strokes, but we’re seeing actual scientific evidence it raises your risk of certain types of cancer, mainly gastrointestinal cancers,” says Hashem El-Serag, MD, gastroenterologist at Baylor St. Luke’s Medical Center’s McNair Campus and leader of the Texas Hepatocellular Carcinoma Consortium. 

The Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke’s Medical Center is one of only three NCI-designated Comprehensive Cancer Centers in all of Texas. If you’re interested in participating in a research study, learn about the available opportunities, and speak with your CHI St. Luke’s Health oncologist. They can help you determine if participation is the right option for you. 

Sources: 
Dan L Duncan Comprehensive Cancer Center | Annual Report 2019
AASLD | Obesity and hepatocellular carcinoma: Hype and reality
AASLD | Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?
AASLD | Metabolic syndrome increases the risk of primary liver cancer in the United States: A study in the SEER‐medicare database†‡
National Cancer Institute | Obesity and Cancer
American Cancer Society | Liver Cancer Risk Factors
NCBI | Obesity, DNA Damage, and Development of Obesity-Related Diseases
VeryWell Health | Cytokines and How They Work
Healthline | Nonalcoholic Fatty Liver Disease
Everyday Health | Cirrhosis and Liver Cancer