The Iron-Cancer Connection: Risk, Prevention, and Outlook

Hereditary hemochromatosis (HH), also called iron overload disorder, is a common condition in which the body stores too much iron. It is one of the most common genetic disorders in the United States, with a prevalence of 1 in 300 to 500 people.

HH develops from mutations in the HFE gene, which regulates iron absorption in the body. When mutations arise, normal iron regulatory functions break down, causing the body to absorb higher amounts of iron than it needs. Over time, this excess iron accumulates in different areas of the body, including the liver, pancreas, heart, skin, joints, pituitary gland, and endocrine system.

If the body fails to expel the excess iron, it can damage tissues and organs, leading to liver damage, rheumatoid arthritis, heart problems, and diabetes. Moreover, while HH mainly impacts iron metabolism, it may also contribute to cancer development.


Hereditary Hemochromatosis and Cancer Risk

This article explores the relationship between iron overload and cancer risk – a topic of growing interest among researchers and medical professionals.


Case Studies From 2003 and 2021

In 2003, a study published in the journal of the AGA Institute linked iron overload to a potential risk of developing cancer. Individuals with hereditary hemochromatosis may have between 20 to 200 times higher risk of developing intrahepatic cancer (liver cancer). However, the reported risks for non-hepatobiliary cancers (malignancies other than in the liver and bile ducts) are conflicting. The risk of cancer in individuals with one copy of the HH gene (heterozygous individuals) is still uncertain. To clarify these risks, Swedish researchers conducted a more extensive investigation of the link between hereditary hemochromatosis and cancer.

The researchers undertook a population-based cohort study using health and census registers in Sweden. It involved 1847 patients with HH and 5973 of their first-degree relatives. They measured the relative risk using standardized incidence ratios (SIRs).


The Risk of Cancer Is Higher in Men With HH

The results showed that patients with HH had a 20-fold increased risk of developing liver cancer. However, their risk of developing other cancers, such as the gastrointestinal system, remained largely unchanged. During a ten-year follow-up, the absolute risk of liver cancer was 6% in men and 1.5% in women with HH.

For the first-degree relatives of patients with HH, the researchers found no substantial increase in the risk of non-liver-related cancers, including gastrointestinal cancers. They also observed a slightly increased risk of hepatobiliary cancers among the relatives, although the types differed from those in the patients.

Related: Rise in Liver Cancer Incidence and Death Rates Explained


Hemochromatosis Can Lead to Liver and Bile Duct Cancers

In 2021, a study published in the same journal supported these findings. The researchers noted that men with HFE hemochromatosis face significantly higher risks of liver disease, primary liver cancer (hepatocellular carcinoma and intrahepatic bile duct carcinoma), and death than women with the same condition.


What Are the Symptoms of Hemochromatosis?

Individuals with HH may not have noticeable symptoms. When symptoms do appear, they may vary and include:

  • Fatigue and weakness
  • Unintended weight loss
  • Persistent abdominal pain
  • Diminished sexual drive
  • Chronic joint pain
  • Bronze or gray skin tone
  • Frequent infections

Remember, HH is a common genetic disorder. Those at higher risk due to family history should seek medical assistance to diagnose and address the condition.


Is Hereditary Hemochromatosis Manageable?

While hemochromatosis can cause serious health problems if not caught and addressed early, it is also a manageable condition. With the appropriate treatments and lifestyle choices, patients can live a normal, healthy life.


Current Treatments for Hemochromatosis

The following treatments can help manage high iron levels:


1. Phlebotomy

The main treatment for HH is phlebotomy. It involves extracting the blood and excess iron from the body. A healthcare professional inserts a needle into a vein, allowing the blood to flow into a collection bag, similar to the process of donating blood.

During initial treatments, approximately 1 pint of blood will be drawn once or twice a week. As iron levels normalize, the treatment frequency may reduce to every 2 to 4 months.


2. Chelation

This therapeutic approach can help reduce iron levels in the body. A powerful and effective form of therapy, it initially treated people who had painted U.S. naval vessels with lead-based paints in World War II. However, chelation is expensive and not considered a first-line treatment option for hemochromatosis. It may also cause side effects, including pain at the injection site and flu-like symptoms.

A healthcare provider may administer the medication through injections or prescribe pills for the patient. Chelation helps the body remove excess iron through urination and defecation. It may be suitable for those with co-occurring heart problems or contraindications for phlebotomy.


Lifestyle for Living With Hemochromatosis

Patients can manage hemochromatosis and prevent complications through the following:

  • Undergo annual blood tests to monitor iron levels
  • Avoid alcohol, which can damage the liver further
  • Avoid intake of multivitamins and iron supplements
  • Avoid infections by maintaining good hygiene practices and getting regular vaccinations
  • Engage in regular physical activity to boost metabolism and improve circulation
  • Contact a healthcare provider if symptoms change or worsen
  • Follow all doctor’s instructions and attend all appointments
  • Seek counseling if symptoms are affecting quality of life

Note that lifestyle modifications alone may not be sufficient to manage HH, especially in more severe cases. Individuals with HH must work closely with healthcare professionals to develop a comprehensive management plan that combines lifestyle measures and appropriate medical treatments.


General Prognosis for Iron Overload Disorder

The prognosis for hereditary hemochromatosis can vary. If a patient receives treatment and pursues a healthy lifestyle before any organ damage occurs, it can significantly improve the outlook and prevent complications, including the potential for cancer. Treatment may also help reverse existing damage, offering a good chance of leading a long and normal life.


What If Liver Cancer Occurs?

Take action now by seeking alternative treatment options for liver cancer. Your health matters, and early intervention can make a difference in your prognosis. Schedule a consultation with our healthcare professionals to determine the most suitable therapeutic techniques for your specific condition.

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