Liver cancer is not only “liver pain”, but in the advanced stage, liver cancer may “suggest” the human body in many forms, such as cough, back pain, abdominal pain, abdominal distension and so on. The most important thing is early detection and early treatment of liver cancer, and early surgery is the fundamental treatment method. Even patients who have undergone radical hepatocellular carcinoma surgery should not take it lightly and must be reviewed regularly after surgery. Xiao Chen has just passed the age of majority. In the past six months, he often had an inexplicable dry cough, accompanied by pain in his right shoulder and right lower chest, but no problem was found after several chest films. Doctors at the local hospital diagnosed him with chronic pharyngitis, but no improvement could be seen with medication and injections. Chen came to Sun Yat-sen Memorial Hospital of Sun Yat-sen University for medical treatment. After imaging, it was found that his right upper diaphragm bulge was irritating his lungs, which caused his cough. The reason for the bulging right upper diaphragm was actually a large tumor growing on his liver. ”Many citizens think that liver cancer will be ‘liver pain’, but in fact, when liver cancer develops to an advanced stage, it is likely to ‘suggest’ the human body in many manifestations, such as cough, back pain, ascites, etc. ” Professor Liu Chao, deputy director of Sun Yat-sen Memorial Hospital South Campus and deputy director of hepatobiliary and pancreatic surgery at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, introduced that if a cough remains untreated for a long time, one should be alert to the possibility of liver cancer. “Since this disease spreads quickly, it is very important to observe it closely and have regular checkups.” Liu Chao reminded. Symptoms manifest in various ways Liu Chao introduced that there are few patients like Xiao Chen clinically, unfortunately, many patients often miss the best treatment time when they find out liver tumor. Experts pointed out that when it comes to liver cancer pain, many people first think of “liver pain”, but in fact, the manifestations of liver cancer are very diverse. “Besides coughing, the protruding liver tumor will stimulate the diaphragm and cause radiating pain in the back; some liver cancer patients will have abdominal pain and abdominal distension; some other patients have pain when eating because the protruding tumor compresses the stomach and duodenum, thinking it is indigestion and treating it according to gastric disease, which results in delaying the condition.” Liu Chao introduced that if a patient with chronic cough at home is not cured for a long time despite the combination of Chinese and Western medicine, the possibility of liver cancer should be considered. No specific symptoms in early stage Liu Chao introduced that liver cancer has no specific symptoms in early stage, which also makes it difficult to be detected in early stage. ”This is because only the liver envelope has nerves, unless the cancerous tissue invades the envelope, even the largest tumor will not be painful, and the liver can still maintain normal functions as long as the remaining part is not less than 1/3, so it is not until the patient develops to the point that the liver is destroyed by 2/3 that the body will produce symptoms related to liver dysfunction.” Liu Chao said, therefore, patients with liver cancer may not feel anything for a long time after the disease, and only when the tumor grows and presses the neighboring organs, nerves or blocks blood vessels will they gradually produce some symptoms such as pain in the liver area, loss of appetite, fatigue and weakness, and gradually lose weight, etc., and in the advanced stage, they will have jaundice, ascites, vomiting blood, coma and other manifestations. The prognosis is closely related to the state of liver function Liu Chao reminded that, like Xiao Chen, the tumor was found only after dry coughing for more than half a year, the tumor has exceeded 10 cm, even if it was surgically removed, the prognosis is not ideal, so the most important thing for liver cancer is early detection and early treatment. ”Clinically, liver cancer less than 3 cm is called small liver cancer, and the 5-year survival rate of such small liver cancer can reach 65%; for liver cancer larger than 3 cm and less than 5 cm, the 5-year survival rate is also 57%.” According to the introduction, early surgery is the fundamental treatment method, and at present, early lobectomy for small liver cancer can have the hope of radical cure. However, 70% of patients have already lost the chance of surgery when liver cancer is discovered in clinic, and the 5-year survival rate of non-surgical treatment patients is only 20%. In addition, the state of liver function when liver cancer is detected also determines the prognosis. Domestic statistics show that only 10% to 20% of liver cancer patients are accompanied by chronic active hepatitis, but 70% to 80% of liver cancer patients are combined with post-hepatitis cirrhosis, which indicates that the status of liver function is very important to treatment and prognosis. Clinical observation shows that if accompanied with decompensated cirrhosis, liver cancer may die from liver failure in the early stage. Therefore, the lighter the existing liver disease when liver cancer is detected, the better the treatment effect and the lower the death rate. Even patients who have undergone radical hepatocellular carcinoma surgery should not take it lightly. Within six months after surgery, they must go to the hospital every month for blood sampling and imaging examination; within two years after surgery, they must be re-examined every three months. ”Don’t think it doesn’t matter much if you are one or two months late for checkup, liver cancer can double in the fastest month, such as 2 cm to 4 cm; in another month, 4 cm can grow to 8 cm, and the prognosis of 2 cm liver cancer and 8 cm liver cancer is worlds apart.” Liu Chao reminded that patients should also pay attention to the fact that imaging examinations such as ultrasound, CT and MR must be performed at the same time as the examination of tumor indicators when performing post-operative review. “Because about 30 percent of patients are not sensitive to methemoglobin, the test result will show false negative, which does not mean that the tumor does not exist, and only in combination with imaging tests can a more accurate judgment be made.” Liu Chao explained. ”I am often asked by patients which is the most ideal way to review liver cancer, B ultrasound, CT or MR?” Liu Chao introduced, “This must be treated on a case-by-case basis. For the characterization of intrahepatic masses, MR works well, while for the clarity of tumor invasion of blood vessels, CT can take advantage. And B-ultrasound is the most commonly recommended examination by doctors because it is inexpensive without radiation and can be used as a routine physical examination. Further CT or MR is needed only when there is suspicion in B-ultrasound,” said Chao Liu.