What Caused Joe Frazier's Liver Cancer?

Former heavyweight boxing champion Joe Frazier has lost his biggest fight—against liver cancer. Renowned for being the first to beat Muhammad Ali in the 1971 “Fight of the Century,” with a left hook seen around the world, Smokin’ Joe is also remembered for the dramatic rematch with his legendary rival, the 1975 Thrilla in Manila. The sports world was stunned to learn of the Olympic gold medalist and Hall of Famer’s death Monday at age 67—just one month after his diagnosis.

As recently as September, he was in Las Vegas signing autographs at the MGM Grand Hotel. Earlier this month, his health declined so rapidly that he reportedly began receiving hospice care. Here’s a look at the medical story behind his battle with liver cancer, which strikes about 24,000 Americans a year. Rates of the disease have been rising in the United States over the past several decades, the American Cancer Society reports, and, in other countries, it ranks as a leading cause of death.

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Who gets liver cancer?

 The disease is about twice as common in men as women, with the highest rates among Asian Americans, Pacific Islanders, and African Americans, followed by Native Americans and Latinos. The disease typically strikes people in their 60s, like Frazier.

What are the risk factors?

In the U.S., the #1 risk factor is infection with the hepatitis C virus (HCV). Frazier’s family hasn’t announced if he had HCV, a chronic disease that affects more than 4 million Americans. If he did have hepatitis C, there are several ways he could have caught it. The disease is usually spread through exposure to the blood of an infected person, which could have occurred during a boxing match, since the brutal sport frequently causes blood loss.

Common ways the virus is transmitted include using contaminated needles for IV drug abuse, medical injections, tattooing, or sharing personal items, like razors, with an infected person. Getting a blood transfusion before 1992—when screening of the U.S. blood supply for the virus began—is another possible scenario, since he could have received one to treat boxing injuries in the 1970s. HCV can also be spread through unprotected sex, but sexual transmission is much less common than infection through exposure to tainted blood.

What else can trigger liver cancer?

In other countries, infection with hepatitis B virus is the most common risk factor. HBV is spread in similar ways, but has a higher rate of sexual transmission than HCV. Hepatitis B is more likely to spark noticeable symptoms, such as a flu-like illness and yellowing of the eyes or skin (jaundice), while HCV can silently damage the liver over decades, sometimes leading to cirrhosis or liver cancer. Only a small percent of people with HBV become chronic carriers, while HCV frequently becomes a chronic infection. Other causes of liver cancer include heavy alcohol use, certain inherited metabolic diseases, diabetes (mainly in diabetics who drink heavily), obesity, exposure to toxic chemicals, and use of anabolic steroids, a particular risk factor for athletes.

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What’s the prognosis for people with liver cancer?

The disease is often fatal within a year of diagnosis. Only 10 percent of people with all stages of the disease combined survive 5 years, and those with advanced disease, as seems to be the case with Frazier since he needed hospice care, the rate is only 2 percent, according to American Cancer Society.

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