Liver Cancer Surveillance and Treatment Roadmap

  In today’s medical world, cancer and cardiovascular diseases are the two major problems that plague people, because the long-term efficacy of cancer treatment and the high recurrence rate are not satisfactory, regardless of the method used. Cardiovascular diseases also tend to take drugs for life, and life becomes extremely fragile.  Because the causes of cancer are complex, related to autoimmunity, diet, viral infection, and living environment, but in the final analysis, the cause is unknown and related to genes. Cancer treatment nowadays still needs to continue to be explored.  However, after decades of exploration, mankind has still made solid steps in attacking cancer, and even entered the era of siege. Take liver cancer as an example: ultrasonic interventional local ablation for liver cancer has been called one of the three major techniques for radical treatment of liver cancer along with surgical resection and liver transplantation, together with radiation interventional hepatic artery embolization, radiotherapy, chemotherapy, immunization and drugs as palliative, so that liver cancer treatment has a more complete and effective methods.  Hepatitis B virus infection may be closely related to liver cancer as one of the initiating factors of liver cancer, so vaccination against hepatitis B virus is an important means to prevent hepatitis B virus infection, thus preventing the occurrence of liver cancer.  On the basis of active treatment of chronic hepatitis, fibrosis and cirrhosis, close monitoring of liver cancer nodules, experienced professional ultrasound examination and blood AFP check every 3 months are the easiest and effective economic monitoring methods. It facilitates early treatment. When abnormal nodules are found in the liver, ultrasonography or enhanced CT or MRI should be performed to understand the nature of the nodules, and combined with blood AFP should be able to clinically diagnose whether it is hepatocellular carcinoma, and of course, puncture biopsy can be performed under ultrasound intervention to obtain pathological diagnosis, who is the gold standard for hepatocellular carcinoma diagnosis. After early diagnosis, the cancer cells can be “burned” by hot microwave ablation, or surgically removed, and the cancer cells can be “starved” by embolization of tumor vessels through hepatic artery, so as to eliminate or control the growth of cancer. And several methods can be combined. Among these methods, ultrasound interventional percutaneous microwave ablation is the most effective, the least expensive, the least damaging, and the most widely used. The recommended roadmap is as follows.  The roadmap is: chronic hepatitis, cirrhosis —– ultrasound, CT, MAR regular examination, blood AFP test (preferably once every 3 months) —– abnormal nodules found —- ultrasonography —– fast in and fast out rich blood supply nodules —- hepatocellular carcinoma (prediction accuracy 95%) —- ultrasound interventional aspiration biopsy —— pathological diagnosis —— percutaneous microwave ablation , chemical ablation or surgical excision of the lesion or transhepatic arterial vascular embolization or other palliative treatment, or a combination of several approaches.  The goals are: complete necrosis or elimination of small lesions to achieve clinical cure, ablation and embolization of mid- to late-stage cancer to reduce tumor, control the growth of cancer tumor, achieve coexistence with cancer, prolong life and improve quality of life.