Consultation, prevention and treatment of liver cancer

  ”In fact, liver cancer can be controlled and prevented, and the key is to achieve “early detection, early diagnosis and early treatment”.  As liver cancer starts insidiously and most of the clinical symptoms appear in the middle and late stages, therefore, how to achieve early detection is the key to treatment effect. Clinical practice proves that the treatment effect of small liver cancer with diameter less than 3 cm is very different from that of middle and late stage liver cancer. Middle and late stage liver cancer, often accompanied with metastasis inside and outside the liver, cannot be removed surgically, and interventional embolization and drug treatment are hardly effective. However, for small hepatocellular carcinoma diagnosed in early stage, surgical resection, embolization, ablation and other treatments are good.  The prevention of liver cancer mainly focuses on avoiding hepatitis transmission, avoiding liver damage such as alcohol and drugs, and maximizing the prevention or mitigation of liver fibrosis progression, etc. How to achieve early detection? This requires “three investigations”.  The “three checks”: three-level census management, i.e., different checks according to three categories of people.  According to the risk level of liver cancer, people who are prone to liver cancer are generally divided into three categories. The first category is high-risk group, such as patients who develop cirrhosis due to chronic viral hepatitis (hepatitis B or C); the second category is medium-risk group, such as patients with chronic viral hepatitis but without family history of cirrhosis and liver cancer; the third category is low-risk group, such as patients with non-viral causes of cirrhosis.  The three-level screening means different examinations according to the three categories of people. Generally, the high-risk group should do relevant examinations (liver function, methemoglobin and ultrasound) every three months; the medium-risk group should do at least one examination every six months; the low-risk group should do one relevant examination every one year. When suspicious cases are detected, further CT, MRI or arteriography should be performed until liver cancer is excluded.  How to treat liver cancer detected in early stage? It is “four treatments”.  ”Four treatments”: that is, four types of treatment measures commonly used for liver cancer.  At present, in China and abroad, liver resection is the only chance for patients to obtain long-term survival. China is a high prevalence area of hepatitis B. The surgical treatment of cirrhosis combined with hepatocellular carcinoma is in the leading level.  Local treatment, represented by radiofrequency ablation, which is less invasive, less damaging to the liver and can be used repeatedly, has become the treatment of choice for small hepatocellular carcinoma.  Portal vein perfusion therapy, which avoids the possible complications of biliary sclerosis caused by hepatic artery chemotherapy. Interventional embolization therapy, whose efficacy is limited by the blood supply of tumor arteries, is difficult to completely kill hepatocellular carcinoma cells and has no significant therapeutic effect on lesions in liver tissue surrounding the cancer foci.  Drug therapy includes chemotherapy, immunotherapy, Chinese medicine therapy, gene therapy and so on. Drug therapy is only auxiliary to surgical treatment, and its efficacy is limited when applied alone.