Why can't liver cancer be detected early through symptoms? What are the steps to prevent liver cancer?

Why can't liver cancer be detected early through symptoms?

Many people want to detect liver cancer early through symptoms, but it is understood that the liver is a "silent organ" and liver cancer almost never causes symptoms such as fatigue and weight loss until it is in the late stage. Experts say that the correct way to detect liver cancer in its early stages is through physical examinations. Generally speaking, the combination of "ultrasound + alpha-fetoprotein" can effectively detect early liver cancer.

Why can't liver cancer be detected early through symptoms?

Many patients have questions. When the liver area hurts, it is already in the late stage of liver cancer. Are there no symptoms in the early stage of liver cancer? Experts say that there are no special symptoms in the early stage of liver cancer, because there are nerves in the capsule on the surface of the liver. If the liver cancer grows in the center of the liver and does not stimulate the liver capsule, the patient will not feel pain. Even if there are symptoms, they may manifest as fatigue, malnutrition or even other parts such as stomach discomfort. These are not specific symptoms of liver cancer itself, so they are difficult to identify. When typical symptoms appear, most of them are already in the late stage.

How to detect liver cancer early?

Early detection of liver cancer and early diagnosis and treatment of patients are important ways for liver cancer patients to achieve long-term survival. The natural course of liver cancer is about 2 years from the beginning of liver cell carcinogenesis, and symptoms mostly appear in the last half year or so. Before the symptoms appear, alpha-fetoprotein can be positive 8 months later, so when there are no symptoms, checking alpha-fetoprotein may detect early liver cancer. Physical examinations in healthy people or regular examinations in high-risk groups for liver cancer can effectively detect early liver cancer. For high-risk groups, especially patients with liver disease, it is recommended to have a liver cancer test once every six months, and for others, once a year.

The liver cancer examination items for different groups of people are also different. Generally speaking, the combination of "ultrasound + alpha-fetoprotein" examination can effectively detect early liver cancer. Alpha-fetoprotein can be tested through blood tests, but this alone is not enough, because the use of alpha-fetoprotein alone will miss about 1/3 of liver cancer patients. At present, ultrasound examination can screen liver space-occupying lesions, and lesions less than 1 cm can be found.

What are the key links to prevent liver cancer?

85% of liver cancer is caused by hepatitis and cirrhosis

"85% of liver cancer patients are transformed from chronic hepatitis and cirrhosis." Chen Yajin emphasized, "my country is a country with a high incidence of liver disease. On average, one in every 10 people is a hepatitis B carrier. Guangdong has a large floating population and a large number of hepatitis patients, so the incidence of liver cancer is also high." The development of liver cancer generally goes through the "trilogy" of hepatitis-cirrhosis-liver cancer. Research data shows that 15%-20% of hepatitis patients will develop cirrhosis within 5 years, and 10%-15% of cirrhosis patients will develop liver cancer. After developing liver cancer, patients are often accompanied by basic liver diseases such as hepatitis and cirrhosis, which greatly increases the difficulty of treatment.

In addition to liver cancer caused by cirrhosis due to hepatitis B, about 15% of liver cancer patients are not caused by hepatitis, but by other reasons, such as alcohol, hepatitis C virus, parasites, aflatoxin, drinking water pollution, lack of certain trace elements, genetic factors, toxic chemicals containing benzene, certain drugs, etc. Especially in spoiled rice, soybeans, peanuts, melon seeds and other foods contain a lot of aflatoxin, which is the main factor inducing cancer.

Therefore, prevention of liver cancer requires two aspects: one is not to get hepatitis, and the other is not to add carcinogenic substances to your body, so as to block the occurrence of liver cancer at the cause.

People at high risk of liver cancer should check alpha-fetoprotein every six months

Most patients with liver cancer are already in the middle or late stages when they are discovered, and the treatment effect of the disease is poor. Therefore, early diagnosis of the disease is crucial for liver cancer patients. Chen Yajin said that early detection of liver cancer is not difficult, and it only requires an abdominal B-ultrasound to check serum alpha-fetoprotein (AFp).

Chen Yajin emphasized that patients with a family history of liver cancer, a history of hepatitis for more than 5 years or positive hepatitis B surface antigen, a history of alcoholism for more than 5-8 years, and patients diagnosed with liver cirrhosis should have their alpha-fetoprotein (AFp) checked every 3-6 months, and an ultrasound examination every six months. If there is any doubt, a CT or MRI examination should be performed to help detect liver cancer at an early stage. "Otherwise, when symptoms such as abdominal pain, weight loss, jaundice, and ascites appear, it will already be in the middle or late stages." With the development of medical imaging, the liver cancer lesions that can be detected are getting smaller and smaller, and the latest liver cell-specific contrast agents can detect tiny lesions less than 1 cm.

If you are not in a high-risk group, it is also recommended to have an annual physical examination for AFp. Chen Yajin said: "AFp detection for liver cancer requires quantitative testing. Qualitative testing sometimes misses the opportunity for early diagnosis. When AFp is significantly elevated, it often indicates liver malignancy and has a high specificity."

In addition to early detection and early treatment, what other methods can be used to prevent liver cancer? Chen Yajin proposed four points: First, widespread vaccination with hepatitis B vaccine can effectively control the spread of hepatitis B; second, active antiviral treatment for hepatitis B patients can reduce viral damage to the liver, protect liver cells, and inhibit the progression of liver disease. Third, the damage of alcohol to the liver cannot be ignored, and quitting smoking and drinking can avoid irritation to the liver. Fourth, patients with liver disease should avoid smoking, drinking and spicy food in terms of diet, eat more fresh vegetables and fruits, increase protein intake appropriately, and patients with severe liver damage should reduce animal protein intake and avoid greasy food.

Treatment of liver cancer emphasizes individualized treatment plan

There are relatively few liver cancer patients who can be detected at an early stage, and correspondingly, not many patients can get the opportunity for surgical resection.

"For the treatment of liver cancer, it is no longer an era where all the heroes show their magical powers, but an era where individualized treatment plans emphasize multidisciplinary collaboration," said Chen Yajin. "Individualized treatment of liver cancer should not only be based on the tumor itself, but also on the patient's overall condition and the degree of liver damage."

However, liver cancer patients are often overtreated. Some patients, once diagnosed with liver cancer, are often treated surgically; some patients, who clearly have the opportunity for radical surgery, choose conservative treatment; some even choose to be treated with the method of the department they first visit. In 2011, the Ministry of Health organized experts to formulate the "Primary Liver Cancer Diagnosis and Treatment Guidelines" to improve the diagnosis and treatment of primary liver cancer.

Chen Yajin said that in principle, surgical resection is the main treatment for early liver cancer. Local ablation can also be considered for tumors with a diameter of less than 3 cm. Liver transplantation is also an option. Some patients in the middle stage can undergo palliative surgical resection and other comprehensive treatments. For most patients with middle and late stage liver cancer, surgical treatment is not recommended. It is necessary to emphasize a multidisciplinary comprehensive treatment method including intervention, ablation, local radiotherapy and molecular targeted drugs.

Chen Yajin emphasized that liver cancer is not so much a local cancer as a systemic disease. Especially in the middle and late stages, some patients are too confident in some new treatments. Although the disease has spread widely throughout the body, they are still undergoing various local treatments for localized liver tumors, which causes serious damage to the patient's liver function. Some patients eventually die not from tumor consumption and destruction, but from liver failure caused by treatment. Therefore, no matter what kind of treatment is used, damage to non-tumor tissues and cells must be avoided to the greatest extent possible. Targeted therapy has brought hope and is also the hope for conquering cancer in the future, but it must also be used correctly under the guidance of experts.