The liver is a “silent” organ, and we are often “silent” because of its “silent” while neglecting its health. Hepatocellular carcinoma (HCC) is the fifth most common tumor in my country with the second highest mortality rate, with 410,000 new cases and 390,000 deaths each year.1. Due to the “taciturnity” of the liver, most patients were diagnosed with liver cancer at an advanced stage when they were first diagnosed, thus missing the opportunity for surgery and having a poor prognosis. Liver cancer is one of the high-incidence cancers in my country, how should we scientifically and effectively prevent this “silent killer”?
Know yourself and your enemy, and you will never be in danger
What role does the liver play in our lives?
The liver is our body’s “chemical factory” and performs many functions. It is involved in the synthesis, decomposition and transformation of carbohydrates, proteins, lipids, vitamins and other substances, as well as in the transformation of hormone metabolism, the decomposition and detoxification of drugs or other metabolic wastes2. In addition, the liver also has multiple functions such as secreting bile, producing coagulation factors, regulating blood volume, and hematopoiesis during the embryonic period. What is liver cancer? Primary liver cancer is a cancer that develops in the liver tissue. According to the type of cancer cells, primary liver cancer is mainly divided into: hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and mixed liver cancer (HCC-ICC). Among them, hepatocellular carcinoma is the most common type of primary liver cancer, and its incidence is more than 85%-90%2. Therefore, the “liver cancer” in this popular science refers specifically to hepatocellular carcinoma. What factors quietly increase liver cancer risk2,3? Epidemiological and experimental data show that hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, aflatoxin, drinking water pollution, alcohol, liver cirrhosis , sex hormones, nitrosamines, smoking, trace elements, etc. are all related to the incidence of liver cancer.
- Hepatitis and cirrhosis: As a result of virus or other factors fighting with the body’s immune cells, the liver repeatedly becomes inflamed until it becomes necrotic. In the process of liver self-repair, the liver gradually forms the pathological state of liver fibrosis and sclerosis, and some progress to liver cancer, forming a trilogy of “hepatitis-cirrhosis-hepatic cancer”. The incidence of liver cancer in my country mostly follows the pattern of “hepatitis B – liver cirrhosis – liver cancer”.
- Aflatoxin: Aflatoxin is a class 1 carcinogen, which mainly pollutes grain, oil and animal food, and is a major factor in the occurrence of liver cancer in my country.
- Bad lifestyle habits: Drinking alcohol, long-term consumption of nitrite and nitrite foods, irregular living habits, and smoking will increase the risk of liver cancer.
What are the clinical symptoms of liver cancer2? The onset of liver cancer is relatively insidious, and its onset There are no specific symptoms or pain in the early stage. As the disease progresses, patients present with symptoms such as pain, gastrointestinal symptoms, and bleeding.
- Persistent or intermittent dull, dull pain that worsens as the disease progresses.
- Symptoms such as abdominal distention, loss of appetite, nausea, and vomiting occur.
- Bleeding tendency and bleeding, such as gum bleeding, skin ecchymosis, upper gastrointestinal bleeding, melena, hematemesis, etc.
- Fever, mostly persistent low-grade fever, no chills, and ineffective antibiotics.
- Cancer-associated syndromes, such as idiopathic hypoglycemia, polycythemia, hyperlipidemia and hypercalcemia.
In addition, patients with liver cancer may also show signs of jaundice, ascites, and hepatosplenomegaly. It is worth noting that when the clinical symptoms are obvious, the disease of liver cancer patients may have entered the middle or advanced stage. Therefore, we should pay attention to the physical examination, pay attention to the “help” signals sent by the body, do not listen to partial beliefs, and seek medical treatment in time.
Enjoy life, prevent early p>
In the face of liver cancer, the “Sword of Damocles”, should we just “sit back and wait to die”? of course not! Good preventive measures and early diagnosis can not only help us prevent problems before they occur, but also help liver cancer patients get timely intervention and strive for a better prognosis. The following are common preventive measures4-6:
- Hepatitis B vaccine: Chronic HBV infection is the most common cause of liver cancer in my country The main cause, about 85% of HCC patients carry markers of HBV infection. Hepatitis B vaccination is the most economical and effective way to prevent HBV infection.
- Antiviral therapy: For patients with chronic hepatitis B or C, maximal long-term inhibition of HBV replication or elimination of HCV is their therapeutic goal, minimizing liver damage , prevent the disease from progressing to cirrhosis, and even liver cancer.
- Improve living habits: Minimize the storage time of grain, oil and food, pay attention to the ventilation and dryness of the storage environment, and avoid the use of moldy kitchen utensils and tableware. Minimize smoking, including active smoking and passive “second-hand smoke”, reduce alcohol consumption, eat a reasonable diet, and maintain a healthy weight and blood sugar.
- Early screening: Early screening is helpful for early detection, early diagnosis, improved cure rate and survival rate. People at high risk of liver cancer need to pay special attention to early screening. High-risk groups in my country include: HBC and/or HCV infection, long-term alcoholism (alcoholic liver disease), non-alcoholic steatohepatitis, consumption of aflatoxin-contaminated food, schistosomiasis and other causes of liver cirrhosis and family history of liver cancer crowd.
Common detection methods include imaging (eg, liver ultrasound) and serology (eg, serum alpha-fetoprotein, abnormal prothrombin). High-risk groups can have serum alpha-fetoprotein, abnormal prothrombin and liver ultrasonography at least once every six months6.
Have you gotten the above little knowledge about liver cancer? Liver cancer is scary, but it’s even scarier if you don’t understand liver cancer and use unscientific methods to prevent and fight cancer. Caring for health, please start with scientific prevention.
1. Latest global cancer data: Cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020[J]. IARC.2020.
2. China Anti-Cancer Association. China Anti-Cancer Association Guidelines for Patients with Primary Liver Cancer[M].
3. Editorial Board of “Chinese Journal of Liver Diseases”, Liver Cancer Group of Chinese Society of Hepatology. Multidisciplinary expert consensus on the diagnosis and treatment of precancerous lesions of hepatocellular carcinoma (2020 edition)［J］. Journal of Clinical Hepatobiliary Diseases, 2020, 36(3): 514-518
4. Chen Wanqing, Cui Fuqiang, Fan Chunsun, Li Ni, Qu Chunfeng, Shu Weiqun, Wang Yuting, Yin Jianhua, Zou Huaibin. Expert consensus on primary prevention of liver cancer in China (2018) [J]. Journal of Clinical Hepatobiliary Diseases, 2018, 34(10):2090-2097.
5. Nan Yuemin, Gao Yanhang, Wang Rongqi, Li Wengang, Zhao Suxian, Yang Ming. Primary liver cancer secondary Consensus on prevention (2021 edition)[J].Journal of Clinical Hepatobiliary Diseases,2021,37(03):532-542.
6. Guidelines work of Chinese Society of Clinical Oncology Committee. Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Primary Liver Cancer [M]. Beijing: People’s Health Publishing House, 2020:1-131.