Liver Cancer Awareness Month is celebrated each year in October to create public awareness about liver cancer, its symptoms, risk factors, and prevention methods. According to the World Health Organization (WHO), liver cancer ranks among the top three causes of cancer-related deaths globally, responsible for more than 800,000 deaths each year. This year’s campaign “Liver Cancer Doesn’t Discriminate,” serves as a reminder that liver cancer can affect anyone, regardless of age, gender, or background and highlights the importance of liver health in everyday life.  

In this blog, we spotlight recent publications from the BMC Series journals, including BMC Cancer, BMC Gastroenterology, and BMC Psychiatry, that explore how metabolism, lifestyle, and mental wellbeing influence the occurrence and recurrence of liver cancer. 

BMC Cancer – Basal metabolic rate shapes the development and progression of hepatocellular carcinoma 

Hepatocellular carcinoma (HCC) is one of the most common types of primary liver cancer. A study published in BMC Cancer explores how the basal metabolic rate (BMR) influences the development and progression of HCC. Using a customized animal model, the researchers compared two lines of laboratory mice divergently selected for BMR. When liver cancer was chemically induced, the high-BMR mice developed tumors faster, showed greater disease progression, and had larger, more active livers than their low-BMR group.  

The study suggests that a genetically determined high BMR may put extra stress on liver cells, activating certain metabolism-related genes that can drive tumor formation. It also highlights how biological factors, such as genetics, and environmental, such as diet and nutrient intake shape cancer risks. The study further reinforces the importance of maintaining metabolic health through balanced nutrition, exercise, and routine check-ups, to reduce the risk of liver cancer.

BMC Gastroenterology – Liver cancer risk and changes in lifestyle habits after successful hepatitis C virus therapy post-DAA) 

Hepatitis C virus (HCV) infection is the leading cause of chronic liver disease, fibrosis, and cirrhosis conditions that can eventually lead to hepatocellular carcinoma. The introduction of direct-acting antiviral (DAA) therapy has revolutionized treatment by curing most cases of HCV. However, a recent study published in BMC Gastroenterology reveals that post-cure lifestyle habits can affect long-term outcomes.  

In this questionnaire-based study, researchers assessed individuals who had been cured of HCV using DAA combinations to understand how their daily habits changed post-treatment. Participants who become more relaxed about their health and shifted to unhealthy habits such as alcohol consumption, gained weight, and had a sedentary lifestyle were observed having slightly increased risk of liver-related complications, even after the virus was cleared.  

The authors emphasized the importance of lifestyle counseling and regular monitoring for these patients after HCV treatment. The prevalence of obesity and low physical activity among the cohort also highlights the need for targeted prevention strategies. This study highlights that liver health requires lifelong care. Staying active, eating well, avoiding alcohol, and attending follow-ups are essential for preventing disease recurrence. 

BMC Psychiatry – Chronic stress impacts the prognosis of hepatocellular carcinoma patients after curative treatment by establishing a novel comprehensive classification: a cohort study and systematic review 

Cancer patients often experience chronic stress as they navigate diagnosis and treatment, leading to insomnia, anxiety, and emotional strain. A recent study published in BMC Psychiatry explored how chronic stress affects survival outcomes in patients who had undergone curative treatment for HCC.  

The researchers developed an innovative Chronic Stress Index (CSI) combining three measures - hair cortisol concentration (a biomarker of long-term stress), a Stress Score derived from physiological readings, and the Perceived Stress Scale (PSS-10) questionnaire. Using this index, they categorized patients based on their stress levels and compared disease-free survival (DFS) and overall survival (OS). The results showed that patients with higher CSI scores had significantly shorter DFS and OS compared to those with lower stress levels. Chronic stress weakens the body’s immune system, disrupts hormone balance, and promotes inflammation - all of which can lead to cancer recurrence. 

By recognizing stress as a clinical factor, healthcare professionals can provide personalized psychological support, helping patients strengthen both their physical and emotional recovery. This study shows that caring for emotional wellbeing through counseling, mindfulness, and community support can profoundly enhance recovery and quality of life for cancer patients. 

Reflections and the Road Ahead 

The evidence from recent studies published in BMC Series journals reinforces a powerful message: liver health is a lifelong responsibility. Understanding how our body functions is vital for prevention; maintaining healthy habits demands daily commitment; and caring for mental wellbeing is part of medical care. Strengthening awareness, early detection, and emotional support can help reduce the burden of liver cancer and promote collective wellbeing.