If you type in the words “treatment of liver cancer” and search in “Google”, you can get nearly 500,000 search results. There are surgical treatment, radiotherapy, chemotherapy, local treatment, guided therapy, biological treatment, liver transplantation, Chinese herbal medicine treatment, comprehensive treatment and so on. With so many treatment options available, some people may ask: Which is the best treatment option? Yes, which is the best treatment option? The best option is the one that best suits the patient, the one that maximizes the cure rate, improves the patient’s quality of life, and prolongs the patient’s life. What is the best option for one patient is not the best option for another patient, or even harmful. Therefore, the means of treatment is not the most important thing, but the choice of the option is the most important. The condition of the patient is the most important factor in determining the choice and implementation of the plan, therefore, to answer this question, we have to start from understanding liver cancer itself. Although both are liver cancer patients, liver cancer is different from hepatocellular carcinoma. Specifically, they are different in terms of stage of liver cancer, age of disease, underlying diseases, etc. (e.g., some have cirrhosis and some do not; some suffer from heart disease and some do not). From the current treatment situation, the stage of liver cancer determines the choice of treatment plan, while some other conditions (such as underlying diseases, etc.) determine whether this plan can be implemented. in 1977, the National Collaborative Conference on Liver Cancer Prevention and Treatment divided liver cancer into stage I to III. stage I is the early or subclinical stage, which means no symptoms and signs of liver cancer, stage III is the late stage, which means liver cancer with jaundice, ascites, extrahepatic metastasis or malignant fluid, and in between Stage II is in between. This scheme is simple and easy to grasp, but it is too simple. Due to the rapid development of diagnosis and treatment of hepatocellular carcinoma, this staging scheme can no longer meet clinical needs. Because it is too general, it is no longer possible to select the best treatment plan based on this staging scheme. Although this protocol has been refined later, it is still unsatisfactory. The most widely accepted and recognized staging scheme is the Barcelona staging scheme published in 1999 (Barcelona
Clinic Liver Cancer staging classification) published in 1999. This staging scheme divides liver cancer into 5 stages, namely, very early stage (early stage), early stage (early stage), and early stage (early stage).
early stage, early stage, intermediate stage, advanced stage and terminal stage.
stage, early stage, intermediate stage, advanced stage and terminal stage (see the latest liver cancer treatment plan on our website). According to the above stages, there are different treatment options for different stages. Of course, these treatment options are only a choice, and whether they can be implemented depends on the patient’s systemic factors. For example, if a patient in very early stage of liver cancer is not limited by other factors, such as no other serious diseases like portal hypertension or severe heart disease, surgery is the best treatment option, and it would be wrong to take systemic chemotherapy (such as sorafenib treatment). However, if the patient is in an intermediate or advanced stage, it would be inappropriate to adopt surgery. Therefore, there are many factors to consider when choosing and implementing a particular treatment option. The best option to choose and implement is the one that takes into account all factors in a comprehensive manner from the point of view of benefits and risks, and takes specific measures to maximize the benefits to the patient according to the specific situation. Shopping has a philosophy that for the same item, a low price will never buy a top quality product. Treatment and shopping are not the same. There are treatment options that cost a lot of money, but if adopted blindly, not only are they not the best options, they may be harmful. For example, liver transplantation, which is extremely expensive, is inappropriate if done in the middle or late stages of liver cancer. Also, some options, such as anhydrous alcohol injections, may be the best option for some patients with liver cancer, even though they are very inexpensive. The word “cure” must be familiar to all of you, and I think every patient would like to have a cure. Of course, we will never adopt a non-curative approach if we can do so. However, we must respect the fact that for some patients, radical treatment is impossible due to the late detection of liver cancer, and it is counterproductive to pursue radical treatment under such circumstances. I often compare the treatment of liver cancer to fighting a war. In this war, doctors and patients are friends, while liver cancer is our enemy. Our goal is to defeat the enemy and overcome liver cancer. In war, we talk about strategy and tactics, but in actual clinical work, we only talk about “medical skill”, but not “medical strategy”. In fact, there are strategies and tactics in the treatment of liver cancer as well. Strategy here refers to the strategy of implementing various medical techniques in a visionary and systematic manner according to the actual situation of the patient in order to achieve the goal of overcoming liver cancer and returning the patient to health, while tactics refers to various specific medical means. Although it is the same liver cancer, due to different stages of liver cancer, age and underlying diseases, the treatment means should not be the same. Thus, it can be seen that advanced medical tools are not enough in liver cancer treatment, and if they are not used properly, the losses will also outweigh the gains. In addition, there is an undesirable thought, that is, “fear of cancer”, talking about cancer and thinking that cancer is an incurable disease. This was the view in the past. Nowadays, the understanding of cancer has fundamentally changed. Due to the continuous improvement of detection methods, liver cancer that could not be detected at an early stage can be detected instantly and therefore can be treated radically. As more and more liver cancers are detected at early stages, the status quo of liver cancer treatment has been greatly improved. Even if it is detected late, the life of patients is greatly prolonged by taking appropriate treatment measures. Life is only once, and we need to face it bravely and correctly.