Recently, the British Daily Mail published a report that the World Cancer Research Fund, through a large-scale, systematic study of relevant data, analyzing the relationship between liver cancer and diet, weight and physical activity, finally concluded that alcohol intake is inextricably linked to the prevalence of liver cancer. Three alcoholic beverages a day can lead to the development of liver cancer. When the news came out, the public was in an uproar. Why does alcohol induce the occurrence of liver cancer? And how to prevent it? Study: 45 grams of alcohol per day can trigger liver cancer It is reported that the researchers conducted a comprehensive analysis of 34 relevant literature on diet, weight, physical activity and liver cancer worldwide, involving a total of 8.2 million participants, of whom 24,500 suffered from liver cancer. Strong evidence was obtained that consuming more than 45 grams of alcohol per day, equivalent to three glasses of wine, can lead to liver cancer. Approximately 4,700 people in the UK are diagnosed with liver cancer each year, and experts say at least a quarter of these would not occur if people were able to maintain their weight and not drink alcohol. The World Cancer Research Fund recommends a daily intake of alcohol of no more than two drinks for men and one for women. In addition, make sure to get at least 30 minutes of physical activity every day. The concept of “alcohol hurts the liver” has been deeply rooted in people’s minds. Only 10% of alcohol (ethanol), the main component of alcohol, is excreted from the stomach and intestines after entering the body, while 90% is metabolized by the liver. Alcoholic liver disease, including alcoholic fatty liver, alcoholic hepatitis, liver fibrosis and liver cirrhosis, and the tendency to develop into liver cancer. How much is the right amount to drink? Because of individual differences in the metabolism of ethanol and acetaldehyde, the amount and activity of acetaldehyde dehydrogenase varies from race to race and from individual genotype to individual, so the tolerance level for alcohol consumption can vary greatly. For Asian people, it is recommended that the daily intake of ethanol should not exceed 20 g. Alcohol intake (g) = volume of alcohol consumed (ml) × alcohol concentration × 0.8. Drinking within this range is converted into 1 tael of 50 degree white wine, which is equivalent to one bottle (600 ml) of beer. In addition, some studies show that for every 10 grams of alcohol (equivalent to one alcoholic beverage), the risk of liver cancer increases by about 4%. At present, most liver cancers in China are caused by viral hepatitis and cirrhosis In Europe and the United States, alcoholic liver disease is the most important factor that induces liver cancer, while about 85% of liver cancer patients in China are transformed by viral hepatitis and cirrhosis. “China is a large country with liver disease, and there are about 120 million hepatitis B virus carriers. And Guangdong has a large mobile population and many 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 percent of hepatitis patients will develop cirrhosis within five years, and 10-15 percent of cirrhosis patients will develop liver cancer. In addition to hepatitis B and alcohol, aflatoxin, nitrite, drinking water pollution, parasitic infection and genetic factors can also lead to liver cancer. According to the Survey on High Risk Factors of Liver Cancer in Guangzhou Community, hepatitis virus, aflatoxin contamination, alcoholism, drinking water contamination and liver fluke infection are the five major risk factors for liver cancer. People with high risk of liver cancer need to have liver function, fetoprotein and liver ultrasound monitoring every six months Most patients are already in the middle and late stages when liver cancer is detected, resulting in poor treatment effect. Therefore, early diagnosis of the disease is crucial for liver cancer patients. For high-risk groups, liver cancer can be diagnosed early with blood sampling for liver function, serum alpha-fetoprotein (AFP) and liver ultrasound. Who are the high-risk groups? Patients with family history of liver cancer, B/C virus infection, more than 5 years of hepatitis, more than 5-8 years of alcohol abuse, and patients with confirmed cirrhosis are all at high risk for liver cancer. Such patients should preferably have blood tests for liver function and alpha-fetoprotein every 3-6 months, an ultrasound examination of the liver every six months, and additional CT or MRI examinations for those suspected of liver cancer to help detect liver cancer at an early stage. “Otherwise, by the time symptoms such as liver pain, wasting, jaundice and ascites appear before examination, the vast majority of patients are already in the middle and late stages of the tumor.” To screen for liver cancer, one should check for methemoglobin, which is currently the most sensitive and specific tumor marker for liver cancer. Clinically, 70-80% of patients with hepatocellular carcinoma will have elevated alpha-fetoprotein, which is greater than its upper limit of normal (20ng/mL). 70%-80% of hepatocellular carcinoma patients lose the chance of radical surgical resection At present, there are fewer patients with hepatocellular carcinoma who can be detected early. Clinically, 70%-80% of hepatocellular carcinoma patients have lost the chance of radical surgical resection when they are first diagnosed. The individualized treatment plan of liver cancer should not only be combined with the tumor itself, but also be decided according to the patient’s systemic condition and the degree of liver damage. In principle, surgical resection is the main treatment for early-stage liver cancer, and local radiofrequency/microwave ablation can also be considered for some tumors below 3 cm in diameter. For patients with liver cancer combined with severe cirrhosis, liver transplantation is an effective method to address both cirrhosis and liver cancer. For patients with advanced hepatocellular carcinoma who are deprived of radical treatment, the survival rate of patients with tumor can be improved by multi-disciplinary integrated treatment with intervention, immunotherapy, local radiotherapy and molecular targeted drugs. Tips: Five things to do to prevent liver cancer What are the ways to prevent liver cancer? Five suggestions are given below: First, extensive vaccination against hepatitis B can effectively control the spread of hepatitis B; second, anti-hepatitis virus treatment. Patients with hepatitis B who have liver function damage and active virus replication should consider active anti-virus treatment, which can reduce the damage of virus to liver and inhibit the progress of liver disease; third, the damage of alcohol to liver should not be neglected, and it is recommended to quit smoking and drinking. Fourth, the diet should be fresh, with more fresh fruits and vegetables and less pickled foods; Fifth, avoid the application of drugs that have clear damage to the liver, including anti-tuberculosis drugs, antipyretic and analgesic drugs, some antibiotics and a large number of long-term herbal treatments.