Liver Disease Visit Myth #3: Is treatment more important than follow-up?

For diseases, treatment is certainly important, but the importance of follow-up should not be neglected in general. As a doctor in the Department of Hepatology, I often deplore the fact that I see many patients in their forties and fifties who are already suffering from cirrhosis of the liver, and some of them have already progressed to the advanced stage of liver cancer. When I understand the medical history in detail, I will find that they have a common problem – neglecting regular follow-up. And many patients have questions in their minds, “When the doctor said there was no problem and no need for treatment, how can it be so serious today?” When it comes to chronic liver disease, many people have a clear roadmap in their mind: hepatitis – cirrhosis – liver cancer, in fact, a small portion of hepatitis develops into cirrhosis, and a small portion of cirrhosis develops into liver cancer. The best purpose of treatment is to cure the disease, followed by controlling the development of the disease and slowing down the progression of the disease, while the purpose of follow-up is to monitor the changes of the disease, discover the bad signals at an early stage and eliminate them at an early stage, which is in line with the idea of “treating the disease before it gets sick” of traditional Chinese medicine. As the king of cancers, liver cancer has a very poor prognosis, mostly because it is found in the advanced stage of the disease and the time for treatment is lost. If it is detected at an early stage and undergoes surgery or other treatments, most of the cases have a good prognosis. Therefore, for patients with chronic liver disease, follow-up and treatment are equally important. In fact, many patients are followed up for review on a regular basis, and when they have been examined for three or five consecutive years and found that their condition is the same as before and has not progressed, they relax their vigilance and prolong the follow-up cycle, and some of them simply do not undergo any review. Generally speaking, the possibility of chronic liver disease progressing to the next stage is greatly increased after 5-10 years without treatment, and this point in time is also easily ignored by many patients. After many years of clinical experience, combined with the consensus opinion of expert diagnosis and treatment, it is generally believed that the following conditions should be paid special attention to: 1, family history, including family history of liver disease and family history of liver cancer; 2, age greater than 40 years; 3, history of chronic liver disease for more than 10 years; 4, cirrhosis patients; 5, higher values of viral quantitative values; 6, recurrent abnormalities of liver function; 7, mild elevation of alpha-fetoprotein. Please follow the doctor’s instructions, standardized diagnosis and treatment, and regular follow-up.