1.What is primary hepatocellular carcinoma?
Primary liver cancer (hereinafter referred to as liver cancer) is one of the common malignant tumors in China, it is a malignant tumor that occurs from hepatocytes or intrahepatic bile duct epithelial cells. The malignancy of liver cancer is so high that it was once called “the king of cancers”. The occurrence of liver cancer in China is mainly related to hepatitis B and C virus infection, long-term heavy alcohol consumption, aflatoxin and drinking water pollution.
2.How to detect liver cancer in early stage?
Simply put, early stage liver cancer has no symptoms, and those with symptoms are often not early stage liver cancer. Middle and late stage liver cancer often has symptoms such as pain in liver area, loss of appetite, weakness, lethargy and hepatomegaly. Therefore, early detection of liver cancer is not enough based on symptoms alone. For those who are at high risk of liver cancer, they should be well monitored, including
(1) Hepatitis B patients or hepatitis B virus carriers of more than five years.
(2) Men over 40 years old with a history of chronic hepatitis.
(3) Those with long-term alcoholism.
(4) Those with a clinical diagnosis of cirrhosis.
(5) Those with a family history of liver cancer
(6) Those who currently have symptoms such as discomfort or pain in the liver area and have had abnormal fetoprotein tests, but have not been confirmed to have liver cancer.
(7) People who belong to high incidence areas and high incidence age groups should preferably have their blood tested for AFP and liver ultrasound once every six months or less for early detection of liver cancer.
When liver cancer is suspected but not diagnosed, in addition to non-invasive examinations such as CT, MRI, radioisotope liver scan, invasive examinations such as vascular intervention, liver aspiration biopsy and laparoscopy should be actively received. Don’t delay the diagnosis and treatment because of fear.
3.How long can liver cancer live?
The natural course of liver cancer is difficult to determine precisely. It is generally considered that the duration of middle and advanced stage liver cancer without any treatment is about three months to six months, which is very pessimistic. However, with the continuous advancement in the level of diagnosis and treatment technology of liver cancer, the survival period of liver cancer patients has been significantly extended, and even some of them survive for a long time.
4.What treatment methods are available for liver cancer?
There are many treatment methods for liver cancer. They include hepatectomy, liver transplantation, microwave/radio frequency/freezing/chemical ablation, vascular intervention, radiotherapy, biological therapy, gene therapy, chemotherapy, Chinese medicine and so on. Each treatment method has its advantages and limitations. The modern treatment concept of liver cancer is to follow the principles of individualization, standardization and systematization, and to carry out liver cancer treatment featuring the individualized application of multiple treatment methods. The aim is to improve the long-term survival rate and life quality of patients.
5.What are the advantages and limitations of hepatocellular carcinoma surgical treatment?
Surgical treatment of liver cancer includes hepatectomy and liver transplantation. The advantage of surgical treatment is that it can basically achieve the goal of eliminating the tumor lesions and is the preferred treatment method for liver cancer. Hepatectomy has strict requirements on patient’s general condition, liver function, tumor stage and tumor location, and only 20%-30% of patients have the chance to undergo surgery. Liver transplantation, on the other hand, has problems such as insufficient liver source and expensive.
6.Why does liver cancer recur after surgery? What can be done after recurrence?
Recurrence of liver cancer after surgery is firstly related to the biological characteristics of liver cancer, which is usually said to be related to the malignancy of the tumor; secondly, most liver cancers are combined with cirrhosis, which greatly restricts the choice of intraoperative liver resection methods; in addition, even if some patients receive preoperative CT, MRI and other sophisticated equipment, the microscopic lesions still cannot be completely detected, and even intraoperative ultrasound examination cannot be completely detected. Therefore, microscopic lesions that are missed become the cause of recurrence after surgery. Therefore, some domestic and foreign experts now recommend preoperative hepatic arteriography in order to detect small metastases and guide the formulation of reasonable treatment plan for hepatocellular carcinoma, so as to reduce the blindness of surgery.
Postoperative recurrence is a difficult problem that cannot be completely avoided and not overcome at home and abroad, but it is not irredeemable, so do not give up on yourself. Treatment methods include surgical re-excision, radiofrequency ablation, vascular intervention, gene therapy, targeted drugs, immunotherapy, etc., which can still achieve good results. The key is to have early detection and systematic treatment through regular review after surgery.
7.What is radiofrequency ablation of liver cancer? What are the characteristics?
Radiofrequency ablation for liver cancer is to inactivate the tumor in situ and achieve the effect of eliminating the tumor lesions through local heat production in the liver by physical means. For strictly selected cases, this method can achieve similar effects as surgical resection. For large tumors, this method can usually have the effect of palliative treatment, which can slow down the tumor process and prolong the survival.
Radiofrequency ablation for hepatocellular carcinoma is divided into three ways: percutaneous, trans-laparoscopic and open intraoperative radiofrequency ablation. It is applicable to different cases. Radiofrequency ablation is a major breakthrough in the treatment of hepatocellular carcinoma. It has significantly lower requirements on patient’s general condition and liver function than hepatocellular carcinoma resection, which gives more patients the opportunity to fight against liver cancer. Because it is relatively less invasive, patients often recover more smoothly. It has now become a powerful tool for doctors and a blessing for patients.
Radiofrequency ablation for liver cancer can be applied alone or often in combination with intervention and surgery to achieve the purpose of maximizing the advantages and eliminating the lesions. Radiofrequency ablation for hepatocellular carcinoma is mainly used for patients with early to mid-stage hepatocellular carcinoma, waiting for liver transplantation and postoperative recurrence. Large tumors or multiple tumors sometimes need to be ablated in stages.
8.What is the role of intervention in the diagnosis and treatment of hepatocellular carcinoma? Is interventional treatment considered only when surgery is not possible?
Intervention is divided into vascular intervention and non-vascular intervention, and the former is usually referred to as intervention. It is used to control tumor through embolization of tumor supplying vessels and local medication. In the treatment of hepatocellular carcinoma, the commonly used techniques are hepatic arteriography and hepatic artery embolization and perfusion chemotherapy. Hepatic arteriography is mainly used for diagnosis of hepatocellular carcinoma, determination of lesion distribution before treatment and review after treatment; hepatic artery embolization and perfusion chemotherapy are mainly used for treatment of hepatocellular carcinoma to achieve the so-called endoscopic resection of hepatocellular carcinoma.
Hepatic artery intervention has a wide range of application and can be useful in almost all stages of hepatocellular carcinoma with no contraindications. In addition, it is also used for the descending treatment of giant hepatocellular carcinoma before resection or liver transplantation and the management of residual lesions in the liver after surgery. It is generally believed that interventional treatment of hepatocellular carcinoma belongs to the category of palliative care. Therefore, modern view is that interventional treatment should be closely combined with radiofrequency ablation, surgery, chemotherapy, gene therapy, immunotherapy, etc. to complement each other in order to achieve the maximum effect.
9.Which is the best method to treat liver cancer?
To be precise, there is no single method that can solve different cases of liver cancer. No single method is a panacea. Liver cancer treatment emphasizes individualization, standardization and systematization. It is more important to receive the most reasonable treatment plan than to blindly pursue the most advanced, expensive, complicated or fashionable treatment.
10.What are the common misunderstandings in liver cancer treatment?
①Refusal of treatment because of the fear of cancer and the belief that all treatments are useless In fact, through active treatment, liver cancer can be cured or its survival period can be prolonged.
②Superstitiously believe in ancestral secret recipes and partial prescriptions
③ Superstitious belief or exaggerating the effect of single technology Some are patients’ superstitious belief in the power of single technology and still cling to it when the disease has changed and needs to change the treatment method; some are because individual doctors are good at a certain technology, coupled with the backwardness of liver cancer treatment concept and the influence of many social factors, intentionally or unintentionally exaggerating the role of single treatment technology and not maximizing patients’ benefits.