In the eyes of many people, having liver cancer is a “death sentence”. But for doctors, even if a liver cancer patient has no hope, they still have to do their best to treat it.
Because of the unyielding nature of medical researchers and the unwillingness of many liver cancer patients to give up on life, there has been one major breakthrough after another in the diagnosis and treatment of liver cancer, and there is hope for the long-term survival of liver cancer patients today.
Today we are going to count the major events and important advances in liver cancer diagnosis and treatment that have occurred over the past half century.
1962: Hepatitis B virus found to be the primary cause of liver cancer
The hepatitis B virus was first identified and isolated in blood by Dr. Baruch Blumberg’s research team in Philadelphia USA. Until then, the virus had been suspected of playing a role in liver cancer, but it took decades to reach that conclusion.
1963: The world’s first liver transplant
Professor Thomas Starzl of Pittsburgh, USA, performed the first liver transplant on three patients, one of whom had liver cancer. In 1967, Professor Starzl’s liver transplant was successful and the patient survived for more than 400 days after surgery.
Liver transplantation became more sophisticated as medical technology improved in the following decades. By the 1990s, liver transplantation had become the standard of care for some patients with liver cancer, effectively extending their survival.
1964: The birth of a method to assess liver function
Many patients with liver cancer have cirrhosis, a condition that often results from scarring and impaired function of liver tissue due to heavy alcohol consumption. 1964 saw researchers develop the first effective method to assess liver function, which became an important reference factor in determining treatment options for liver cancer.
This method has been refined and is now called the Child-Pugh scoring system. This scoring system continues to be widely used in the treatment of liver cancer from the 1970s to the present.
Mid-20th century: The birth of partial hepatectomy
Researchers used perfusion erosion to study the ductal system in the liver, and the results led surgeons to realize that the liver was a segmented organ that could be hepatectomized according to the principles of surgery.
With a more accurate understanding of the anatomy of the liver, over the next two decades, surgeons could more safely remove specific segments and subsegments of the liver where cancer or other disease was present, while preserving healthy liver tissue. This allows many patients to benefit from this.
1965: First use of radioisotopes for liver cancer
For a long time, patients with inoperable liver cancer were “incurable”. The use of the radioisotope yttrium 90 (Y90) has given these patients new hope.
Researchers have chemically fixed Y90 to microspheres of glass or resin, which are then implanted in the liver to deliver radiation therapy directly to nearby tumors and surrounding tissue to shrink or stop tumor growth. Y90 treatment has been effective in some patients, such as those with mild cirrhosis and tumors that invade large blood vessels.
1976: Chemotherapy proven effective in liver cancer
Doxorubicin, a broad-spectrum anticancer chemotherapy drug, was initially controversial for its effectiveness as a single agent in advanced liver cancer. And that year, a groundbreaking study confirmed the effectiveness of doxorubicin. Since then, doxorubicin has been established as the standard of care for hepatocellular carcinoma.
1978: Hepatitis C “latent” causes double the number of liver cancer cases
The number of new liver cancer cases in the United States doubled between the late 1970s and early 1990s, in large part due to the increasing rate of hepatitis C virus infection.
Most of these liver cancers occurred in people who contracted hepatitis C in the 1960s and 1970s, many through intravenous drug use, blood transfusions, or other health care exposures.
It is estimated that at least half of all liver cancers in the United States are associated with hepatitis C virus infection. And today, with advances in medicine, hepatitis C is completely curable with early treatment.
1981: The hepatitis B vaccine was created, and liver cancer from hepatitis B has been preventable ever since
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In 1981, the hepatitis B vaccine received marketing approval from the U.S. Food and Drug Administration (FDA).
In 1994, hepatitis B vaccine production technology was introduced into China. In 1994, the hepatitis B vaccine was introduced into China, and China, which had been plagued for years by the “hepatitis B powerhouse” label, was finally given a powerful weapon to declare war on the disease. Since then, China has invested heavily in free vaccination and catch-up vaccination, and has achieved great success.
1983: Tumor ablation begins for patients with advanced liver cancer
Because of the location of the tumor or other factors, some patients are unable to undergo surgery. And tumor ablation can treat this group of tumor patients.
Originally, doctors used a technique called alcohol ablation, where alcohol is injected directly into the tumor to dehydrate and kill the cancer cells. A decade later, radiofrequency ablation (RFA) was born, and people began using heat and intense radiofrequency waves to kill tumors. Since then, RF ablation has become one of the standard treatments for advanced liver cancer.
1996: Liver transplant advances lead to long-term survival
Researchers have finally demonstrated that liver transplantation is an effective treatment option for some patients with cirrhosis and tumors confined to the liver. Eighty-five percent of such patients survive for at least four years after surgery.
The criteria for liver transplantation are based on tumor size, total number of tumors, and other factors.
1998: Non-alcoholic fatty liver disease was confirmed to be associated with liver cancer
In 1998, an association between non-alcoholic steatohepatitis (NASH) and liver cancer was discovered.
Non-alcoholic steatohepatitis usually stems from inflammation and fat accumulation in the liver caused by obesity or diabetes. Up to 95% of people with obesity and type 2 diabetes eventually develop nonalcoholic steatohepatitis. This study suggests that the risk of liver cancer can be reduced through diet, exercise, and effective control of diabetes.
2002: Discovery of key molecular pathways in pathogenesis
In 2002, the signaling pathways that regulate the development of liver cancer were identified. The findings suggest that the development of liver cancer is caused by abnormalities in numerous signaling pathways.
This discovery explains why the development of gene-targeted drugs has been so difficult over the past decade, and also provides researchers with some potential therapeutic targets.
2002: Embolization chemotherapy improves prognosis for liver cancer patients
Unlike other organs, the liver has two major blood supply pathways. For unknown reasons, cancer occurs only in the lower of these arteries, the hepatic artery, and uses this blood supply to promote its growth.
Doctors have long debated whether temporarily blocking or embolizing this artery can improve the prognosis of liver cancer.
In 2002, two key studies showed that injections of the chemotherapy drug adriamycin and concomitant embolization of the hepatic artery significantly prolonged survival in patients with unresectable liver cancer.
2007: First targeted drug for liver cancer available
A large study demonstrated for the first time that sorafenib prolongs survival in patients with advanced unresectable hepatocellular carcinoma. Sorafenib was the first targeted drug to be shown to be effective in liver cancer.
2008: Improved liver transplant criteria benefit more patients
The new criteria provide more detailed guidance to help doctors screen patients most likely to benefit from liver transplantation based on tumor size, metastasis, and response to prior therapy.
In one study, more than 90% of patients selected by researchers as suitable for liver transplantation based on these new criteria survived 4 years or longer.
2012: Routine screening for hepatitis C begins
In 2012, the Centers for Disease Control (CDC) recommended that all “baby boomers” (born 1945-1965) be screened for hepatitis C virus because this group is 5 times more likely than other adults to be infected. This group is 5 times more likely to be infected than other adults.
Early diagnosis of hepatitis C
Early diagnosis of hepatitis C is critical because the longer the virus is latent, the greater the risk of serious liver disease, including liver cancer and cirrhosis.
Conclusion
From the 1960s, when the association between hepatitis B virus and liver cancer was discovered, to 2012, when the US CDC began recommending routine screening for hepatitis C, the human fight against liver cancer has never stopped.
The history of this half-century shows that many effective tools in liver cancer diagnosis and treatment are available today because many liver cancer patients and doctors do not give up lightly.
We have reason to believe that there will be many more breakthroughs in the future that will benefit more liver cancer patients.