How to prevent the killer that is liver cancer

MANILA, Philippines - This is not a rare, esoteric health problem. Liver cancer ranks number two among all killer cancers. It is the fourth most common type of cancer, right up there together with breast and lung cancer,” says Dr. Eternity Labio, immediate past president of the Hepatology Society of the Philippines.

A leading cause of liver cancer as well as liver cirrhosis is hepatitis B, an infectious disease caused by the hepatitis B virus (HBV). Eighty percent of infections are found in Asia. As of the latest estimates, about one in seven adult Filipinos carries the virus. “It’s more common than you think,” Dr. Labio says. “However, you can have it and not know it. It often does not manifest any signs or symptoms until the liver damage is already extensive. Patients come in when they already have cirrhosis or liver cancer.”

“It’s a real public health problem,” Dr. Labio remarks. “Yet it’s one that can be prevented with vaccination.”

HBV is transmitted through blood and body fluids, the most common route being from an infected mother to her baby during the birthing process. The DOH says that the baby should be vaccinated within the first 24 hours from birth.  Republic Act no. 10152 provides for the mandatory basic immunization services for infants and children, covering vaccine-preventable diseases including hepatitis B. It is manageable and controllable, but this is not widely known.

No one is too young or too old to get vaccinated. “Yet in spite of the availability of an effective and safe vaccine, which is covered by the Expanded Program of Immunization, there are gaps in implementation. Just like HIV, there’s a lot of stigma associated with hepatitis B,” Dr. Labio observes. “Because of misinformation, people who have been tested positive for hepatitis B are being discriminated. They are often denied employment. Patients who feel healthy are told that they are unfit to work. Eight out of 10 patients who come to my clinic relate this experience. Because of the stigma, people don’t want to get tested.”

“This is what triggered our advocacy. We were crucial in having the DOLE advisory prohibiting discrimination due to being hepatitis B positive,” Dr. Labio shares. “We work closely with government agencies to implement policies, for access to testing, access to treatment, and to give vaccines for both public and private hospitals.”

Dr. Labio is a member of the DOH technical working committee that formulates the national action plan. 

“Our organization, the Hepatology Society of the Philippines, is the only national organization of liver specialists who take care of patients with liver disease,” says Dr. Labio.

“B-Aware is our public health advocacy that aims to raise awareness for hepatitis B, the risk factors, health consequences, treatment, and prevention. We advise our patients to be tested and we evaluate if they need treatment or not. There is still no cure, but there are medicines to suppress it. Our medicines are cheap, especially if the government buys them in bulk.”

The campaign encourages the public to “be aware, be tested, be vaccinated, be treated.”

On Thursday, Jan. 19, the Hepatology Society of the Philippines (HSP) will hold a B-Aware Benefit Gala at the Atrium and Courtyard of Enderun Colleges at McKinley Hill, Fort Bonifacio in Taguig City. Guests will be treated to cocktails and a four-course formal dinner, as well as a silent art auction that will feature the works of emerging and established local artists.  Proceeds from the fundraising activity will go to the B-Aware campaign and other advocacy projects of the HSP.

“The HSP has set its sights on broadening its influence through continuing medical education of primary healthcare providers, supporting research in viral hepatitis, and creation of meaningful health policy on viral hepatitis in the country,” says Dr. Labio, whose specialty is gastroenterology. She took further training in her sub-specialty, hepatology.  “I have been doing this for the last 10 years, since the Hepatology Society was organized in 2006,” she relates. “When I started my private practice, that is when I learned that there are so many cases. I got tired of fixing the trees. I wanted to fix the forest.”

“A strong multimedia effort to raise public awareness will be central to making any health program in hepatitis B successful,” Dr. Labio notes. “This is crucial to ending the vicious cycle of misinformation, transmission of infection, stigma, and discrimination.”

B-Aware maintains an interactive online presence through its Facebook page (www.facebook.com/BeAwarePH) and its website (http://www.beawareph.com/). “A lot of our patients have banded together and are very active in social media,” says Dr. Labio.

January is Liver Cancer and Viral Hepatitis Awareness and Prevention Month.

Be one of the supporters for the B-Aware Campaign Initiative by purchasing tickets to the B-Aware Benefit Gala Night or by acquiring any of the auctioned art pieces which can be previewed on their Facebook page, www.facebook.com/bawaregala. For more information, call the Hepatology Society of the Philippines Secretariat  961-3014, or visit their website, http://www.beawareph.com/. For gala dinner tickets and RSVP, contact angel.cordero@enderuncolleges.com or call  856-5000 local 574. For auction inquiries, contact Dr. Mara Panlilio at 09177020949.