June 5, 2017

It seems drinking coffee significantly reduces one’s risk of liver cancer.

Examining data from 26 studies involving over 2.25 million participants, researchers from the University of Southhampton and University of Edinburgh found that people who drank more coffee are less likely to develop Hepatocellular Carcinoma (HCC), the most common form of primary liver cancer.

Consumption of 1 cup of caffeinated coffee per day reduces one’s risk of HCC by 20%, and this percentage increases to 35% by drinking 2 cups and subsequently, 50% with 5 cups. The effects of coffee against HCC are less evident in decaffeinated coffee, though still present. Professor Peter Hayes, of the University of Edinburgh, said “We have shown that coffee reduces cirrhosis and also liver cancer in a dose-dependent manner… Our research adds to the evidence that, in moderation, coffee can be a wonderful natural medicine.”

The primary caffeine metabolite, Paraxanthine found in coffee has been found to suppress the synthesis of CTGF (connective tissue growth factor), which slows the progression of liner fibrosis, alcoholic cirrhosis and liver cancer. Some epidemiological studies did not find an association with tea, suggesting that the mechanism of action might not be dependent on caffeine solely. Other potentially anti-carcinogenic components in coffee are kahweol and cafestol, while the chlorogenic acids and caffeic acid in coffee have been shown to be capable of preventing hepatitis B virus replication.

The study states that “by 2030 the number of new cases annually will have risen by 50% to over 1.2 million”, with “highest [incidence] in East and South-East Asia, with China alone accounting for 50% of cases worldwide.”

Liver cancer is the sixth most common cancer globally, and the second leading cause of cancer-related mortality. HCC is the most common form of liver cancer, making up 85-90% of cases, developing in people with cirrhosis (scarring/damage) of the liver due to Hepatitis B or C, excess alcohol consumption and/or non-alcoholic fatty liver disease.

In Singapore, HCC is the 4th most common cancer among men (more common among Chinese males than Malay/Indian counterparts), but the 2nd leading cause of cancer death in males. It is the 4th leading cause of cancer death among women, despite not figuring in the top 10 most common forms of cancer for women in Singapore.

If left untreated, most HCC patients do not survive beyond 6 months, and surgery is currently the only treatment allowing for a reasonable survival beyond 5 years. However, “surgery for liver cancer is difficult or not possible for a large proportion of patients,” says Dr Choo Su Pin, Senior Consultant and Chief of Gastrointestinal Oncology in Division of Medical Oncology of the National Cancer Centre Singapore, owing to “cirrhosis in other parts of the liver due to alcohol or hepatitis”.

At a recent media briefing by Bayer in Singapore, Prof Josep M. Llovet, the Professor of Research, BCLC Group, Liver Unit of IDIBAPS-Hospital, the Founder and Director of the Liver Cancer Program and Full Professor of Medicine at the Mount Sinai School of Medicine, New York University and the Director, Master in Translational Medicine at the Faculty of Medicine, University of Barcelona, said that “systemic therapy” with the use of certain drugs are the “recommended treatment option [at an] advanced stage of HCC”, potentially raising survival rate by 0.69%, or 8 to 11 months, versus a placebo.