Why is liver cancer called the “king of cancers”?

  Why is liver cancer called the “king of cancer”?  It is because liver cancer has a high incidence rate and a large degree of malignancy, and its early symptoms are not obvious and difficult to be detected; once detected, it is often at an “advanced stage” and loses the chance of surgical removal; even if surgery is barely done, recurrence or metastasis often occurs soon. Therefore, when liver cancer was diagnosed in the past, it was like an incurable disease and a death sentence.  In fact, there has been a great progress in both diagnosis and treatment of liver cancer. Early diagnosis by medical imaging provides a chance to cure liver cancer; even for the so-called advanced liver cancer, the development of interventional therapy has completely changed the situation of “liver cancer equals incurable disease”.  What can interventional treatment do for liver cancer?  For early stage liver cancer with small lesions, besides surgical resection, minimally invasive ablation therapy under the guidance of imaging equipment can achieve the same effect as open surgical resection, i.e., it may achieve the purpose of cure. Specific methods of ablation include thermal ablation such as radiofrequency, microwave, or cryoablation such as argon helium knife, and chemical ablation such as injection of anhydrous alcohol. The principles of these ablation methods are different, but they all work to completely destroy the liver cancer lesion. In addition, through vascular cannulation, tiny catheters are inserted directly into the vascular branches of liver cancer lesions, and then embolic agents with added chemotherapeutic drugs are used to completely fill these lesions from the capillary level, and the cancer lesions may be completely killed due to lack of blood plus the toxic effect of chemotherapeutic drugs, which also makes it possible to cure liver cancer.  For inoperable intermediate and advanced hepatocellular carcinoma, the interventional treatment of chemoembolization through vascular cannulation (often abbreviated as TACE) has become the preferred method and has gained wide consensus. Over the years, it has been proved that TACE can effectively prolong the life cycle of patients, improve the quality of life, and some patients may also be cured. In other words, some patients can be treated by TACE, the lesion is significantly reduced, turning the original inoperable into operable resection; some patients can be treated with ablation therapy, thus achieving long-term survival. If the patient’s general condition is too poor, there are also more moderate interventional treatments, such as subcutaneous implantation of drug cartridge system, which can provide long-term regular local chemotherapy infusion treatment to the lesion, which can avoid the side effects of systemic chemotherapy and is also a good choice.  In addition, if patients with hepatocellular carcinoma have some serious complications, corresponding interventional treatment can also be implemented to deal with them. For example, if liver cancer grows into the portal vein or inferior vena cava and causes obstruction, it can be opened by cannulation and stent implantation; in case of combined obstructive jaundice, puncture and drainage can often have “immediate effect”; in case of combined splenomegaly and hypersplenism, partial splenic embolization can be performed.  In conclusion, there are many ways to subdue liver cancer, the “king of cancer”. Therefore, the “King of Cancer” is not an incurable disease, so let’s stop “talking about cancer”!