By Judith Tan

MANY people here learn they have liver cancer only after their abdomen swells and their skin takes on a yellow tinge.

But by that time, it is too late because Singapore's second biggest killer among cancers has already taken root. So doctors at the National Cancer Centre of Singapore (NCCS) are hoping to encourage high-risk patients to be screened for hepatitis B, which attacks the organ and causes most of the liver cancer cases here.

The screening, which doctors say should be done every six months, includes a blood test and an ultrasound scan of the liver. Sexually active people in their 20s and 30s, along with those who have a family history of liver cancer, are the most at risk.

Professor London Lucien Ooi, deputy director of NCCS, said the centre and the Health Ministry are reviewing the clinical practice guidelines, which could call on doctors to offer the screening more regularly.

The findings will be published by the end of the year, he said.

He was speaking at a media conference yesterday to mark September as the inaugural Liver Cancer Awareness Month.

The disease was the fourth most common cancer among men between 2001 and 2005. Statistics from the Singapore Cancer Registry show 1,660 men contracted the disease during that period.

'This number is not really coming down,' said Dr Tan Yu Meng, a surgical oncologist with NCCS.

'Patients who come to seek treatment often come too late. Although liver cancer is fatal, there is potential for a cure if the patient goes for screenings and it is detected early.'

Of the more than 11,500 cancer deaths between 1998 and 2002, 13 per cent were from liver cancer, a total that trails only lung cancer.

The majority of liver cancers are a result of a long-term hepatitis B infection.

Hepatitis B is a blood-borne virus that affects primarily the liver. The virus, which is carried by an estimated 1 in 35 Singaporeans, increases the risk of liver cancer by 300 times, Prof Ooi said.

Hepatitis B can be prevented with vaccinations. Under a national immunisation programme, those born from 1987 onwards receive the vaccine.

Still, many Singaporeans have not been immunised. The NCCS hopes Liver Cancer Awareness Month will help raise awareness about hepatitis B.

Prof Ooi, who is also the campaign's chairman, said vaccinations can lose their effectiveness over time.

'Even those who had been immunised should get screened every five years if they engage in a high-risk lifestyle or are planning to have a family.

'They can be given a booster shot if one is needed to protect them.'

According to the World Health Organisation, the vaccine is 95 per cent effective in preventing children and adults from developing chronic hepatitis B infection - if they have not yet been infected.

Apart from raising awareness among the population, forums will be held next month to update family physicians and specialists on the latest advancements in the diagnosis and treatment of liver cancer.

juditht@sph.com.sg

WHAT IS LIVER CANCER?

CANCER can start within the liver or spread to the organ from other places, such as the colon.

A silent killer, the majority of liver cancer patients do not have symptoms in the early stages.

Statistics from the Singapore Cancer Registry showed that from 2001 to 2005, 1,660 men contracted the disease. It is the fourth most common cancer here.

Specialists say liver cancer is the second-biggest killer among cancers, following lung cancer.

Liver cancer is often caused by hepatitis B, which is spread through blood and bodily fluids.

According to statistics from the Health Promotion Board, an estimated one in 35 adult Singaporeans carries the virus.

FIND OUT MORE ABOUT IT

This article was published in The Straits Times on August 20, 2008.

Please refer to » Straits Times for original article.