2023-10-30 08:57:51
by Elena Meli
Mediterranean diet and exercise are the cornerstones, but alcohol is a strong risk. It is also essential to protect yourself from viral hepatitis. Simple checks allow you to monitor the function of the liver which does not give symptoms when it has problems
It does the dirty work for the entire body, cleansing it of toxins and metabolizing drugs; a fundamental energy powerhouse that controls the metabolism of fats, carbohydrates and proteins; produces clotting factors and other essential compounds; a repository for substances ranging from glycogen, an important energy reserve, to minerals such as iron.
Recommendations
The liver, the largest gland in our body, is not just a filter as many think, but an organ with many functions which, moreover, never complains: it has such an ability to compensate for the damage inflicted on it that it shows no signs of stopping. sagging for a very long time. Thus, the risk of realizing that something is wrong when it is too late is real. Avoid it whenever possible, as the experts explained during the Corriere Salute meeting The rules for a healthy liver, which was held in recent days and visible in streaming on time.news: the recommendations are basically the same ones that serve to guarantee a good health in general, because as underlined by Massimo Alberto Iavarone, hepatologist at the Irccs Policlinico of Milan, it is a question of doing regular physical activity and following the Mediterranean diet, reducing industrial foods and fats and giving preference to fruit and vegetables.
The harm of alcohol
For alcohol there is no minimum safe level for the liver
, should be avoided; even more so excessive and concentrated consumption on 1-2 days a week as today often occurs among the very young and not only. Alcohol causes long-term damage: we only have one liver and, although it has an excellent reserve of functionality, after years the cost of mistakes at the table and drinks is paid with an increased risk of fatty liver, or steatosis, and not only.
Lasteatos is very common, estimated to affect 25 to 33% of adults; by changing your lifestyle it can be resolved, but if you don’t take care of the liver there is a risk that the tissue, strangled by fat, becomes inflamed and then, in the organ’s attempt to repair the damage, fibrosis appears, which occurs when parts of tissue harden as if they were scars. The next step is cirrhosis, in which the functionality of the liver is irremediably compromised, and unfortunately over the years the final outcome of this process can be a tumor, hepatocarcinoma, which develops in the liver starting from the damaged areas.
What happens to the liver
Insults to the liver from a bad diet, alcohol or even viral infections (see below, ed.) trigger the need to repair the lesion and to do so the cells duplicate themselves, creating new tissue; year after year, when the damage becomes chronic, something can go wrong because the urge to duplicate in order to heal can get out of hand and the cells can lose the ability to control their replication, transforming into tumors and giving rise to liver cancer. A not uncommon occurrence, given that it is the sixth most frequent cancer in the world: as Tiziana Pressiani of the Medical Oncology and Hematology Unit of the Irccs Humanitas Cancer Center in Rozzano (Milan) explains, every year in Italy approximately 10 thousand new cases of hepatocarcinoma, equal to 90% of all liver tumors (the remainder are liver metastases of a disease originating elsewhere, ed.). The tumor can be asymptomatic for a long time, because the liver is large and in the presence of an initially small nodule it can continue to function without showing signs of problems. Periodically undergoing screening tests to evaluate liver function with blood tests and ultrasound is therefore important, especially in those who are more at risk because they are overweight or have fatty liver disease, have had viral infections or are aware of having an unhealthy lifestyle.
Cancer therapies
Diagnosing liver cancer in time often means it can be resolved with surgery or interventional radiotherapy treatment which literally burns the nodule. Treatment is chosen based on the characteristics of the tumor and the patient, taking into account other concomitant diseases and general health conditions, says Pressiani. As for medical treatments, traditional chemotherapy is not used in hepatocarcinoma because it is not effective; However, new molecularly targeted drugs and also immunotherapy are available which “unmask” tumor cells to make them visible to the immune system, which continuously patrols the body not only in search of germs but also cancerous cells to eliminate. Immunotherapy for hepatocellular carcinoma allows for good control of the disease and medical therapies today are no longer used only in patients with advanced, unresectable forms of cancer, but are also being studied in association with surgery to reduce the probability of recurrence.
Hepatitis
Hepatitis A, B, C, E and delta, named after the viruses responsible: inflame the liver tissue and expose it to serious risks. A and E, which are contracted mainly by consuming contaminated food or drinks, can cause serious infections but mostly cause acute damage which tends to resolve; B, C and delta, on the other hand, often do not manifest themselves with major symptoms at the time of infection, but can cause chronic hepatitis which permanently damages liver cells, causing fibrosis, cirrhosis and increasing the risk of cancer. There is a vaccine for hepatitis B, which has been mandatory in our country for decades for newborns: today those under 44 are protected, specifies Massimiliano Conforti, vice president of EpaC. This virus has a recognized ability to induce liver tumors, making the vaccine mandatory was therefore a winning choice because hepatitis B is slowly disappearing.
Hepatitis treatments and screening
We don’t have vaccines but for hepatitis C and delta, which are associated with a high risk of hepatocellular carcinoma, there are effective treatments. The newest is for delta hepatitis, a drug capable of blocking viral replication and reducing inflammation; For hepatitis C there is a treatment in tablets which resolves in over 95% of cases in 8-12 weeks, says Massimiliano Conforti, vice-president of EpaC. Precisely for the possibility of eradicating the virus in this way, over 70 million euros have been allocated for screening people born between 1969 and 1989. There are various regional projects, directed for example at populations at risk such as prisoners or people being followed by Drug Addiction Services, and programs in hospitals that offer testing to those admitted. It would be essential to make everyone understand how precious the screening opportunity is, says Massimo Alberto Iavarone. In Italy there are an estimated 100-150 thousand positive cases for an infection which often does not cause symptoms but which can be cured with free therapies and for which there are no waiting lists.
October 30, 2023 (modified October 30, 2023 | 07:57)
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