Early liver cancer is a growing health concern in Bangladesh, as more people are being diagnosed with the disease at advanced stages. According to experts, early detection of liver cancer can significantly improve the chances of survival and reduce the burden on the healthcare system.
According to Prof. Mamun Al Mahtab Shwapnil, one of the major researchers behind the invention of the new cancer test, Bangladeshis experience liver cancer on average 18 years earlier than those in other populations.
“But the big challenge here, like anywhere else, is early diagnosis. It’s common both in Bangladesh and India that patients come at an advanced stage when we basically have little to do to cure them. The only option is supportive care like palliation,” he told Dhaka Tribune on Monday.
With assistance from the Hong Kong-based biotech company HKG Epitherapeutics Ltd, Bangladesh’s icddr,b, Bangabandhu Sheikh Mujib Medical University (BSMMU), and a group of physicians and researchers have created a straightforward test that can identify liver cancer early.
The study’s principal investigator was Prof. Shwapnil, director of BSMMU’s Interventional Hepatology Division. He was also the principal investigator for the development of cutting-edge treatments like Nasvac for hepatitis B.
He said the new test would revolutionize cancer management around the world.
“Most of the patients come with liver cancer between the ages of 30 and 45, the most productive years in our country. It’s because of hepatitis B virus infection,” he said, as there had been no provision for giving hepatitis B vaccine in routine immunization once upon a time.
Using the WHO-recommended schedule, the hepatitis B vaccination was introduced into Bangladesh’s Expanded Program on Immunization (EPI) between 2003 and 2005.
“Early diagnosis is the key to the cure, which the new test can ensure,” he said.
Currently, liver cancer detection is expensive and difficult. Alpha-fetoprotein (AFP) blood tests are the first thing doctors advise. However, detecting elevated AFP levels is not a 100% accurate diagnostic for liver cancer. Many liver cancer patients have normal AFP levels.
Then, a CT scan or ultrasonography are recommended by the doctors. A better image is produced via a CT scan. But for a patient who must have it done every six months, it is expensive and also poses a radiation risk.
AFP levels can also be increased by some non-cancerous diseases and other forms of cancer.
The novel test overcomes the limits of conventional diagnostic approaches by using complex sequencing and multiplexing techniques to distinguish HCC samples from normal tissues, other blood samples, and non-HCC tumours.
Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, typically affects persons with chronic liver conditions including NASH and cirrhosis brought on by hepatitis B or C infection.
554 clinical study participants—liver cancer patients, non-liver cancer patients, people with chronic hepatitis B, and healthy controls—were used by the research team to test the assay.
According to a registry of clinical studies managed by the United States National Library of Medicine at the National Institutes of Health, the results showed a liver cancer detection sensitivity of 84.5% at 95% specificity, suggesting its promising potential for early liver cancer diagnosis.
According to Prof. Shwapnil, he initially received the offer to collaborate on the research for publication.
“I said no. I can be involved with one condition: the test has to be made available in Bangladesh,” he said. “They agreed.”
The BSMMU collected those samples while icddr,b processed them, and the Hong Kong-based lab tested them.
“We are working to start this test commercially. But it’s a well-validated study. They have studied it in the Chinese population as well. The results were the same. So we can go commercial anytime,” he said.
Installing the entire setup for beginning commercial testing will cost $5 million, according to the business.
“We are also encouraging a local company to bring medicine. Once we detect it early, we need to give people drugs to cure it. There is a drug in the world called S-acetyl methionine (SAMe) which is not being produced by the companies. Because it’s not patented and it’s cheap. If we can do it in Bangladesh, we can give them a drug after detecting early. It’s a vitamin-type drug,” he said.
8–12% of admissions to our public medical college hospitals’ medicine wards are for patients with liver problems. Next to stomach and lung cancers, it is the third most frequent malignancy in Bangladesh, according to Prof. Shwapnil.
When asked for advice on how people might avoid developing liver cancer, Prof. Shwapnil underlined the need of spreading knowledge about hepatitis B vaccination as well as carbohydrate restriction and regular exercise to prevent NASH, which are the leading causes of liver cancer in Bangladesh.
