Mr. Hu, aged 62, has had hepatitis B for seven to eight years. In early August, he began experiencing abdominal pain. He delayed seeking medical attention for nearly three months before undergoing examination, which revealed a massive tumor measuring 15 cm in diameter—the size of a grapefruit—growing in the center of his liver!
China is a major country for liver cancer, ranking first in incidence and mortality rates.
China is unquestionably a "major country for liver diseases," simultaneously holding the highest incidence and mortality rates for liver cancer globally. Over 52% of liver cancer patients worldwide are in China, and among new liver cancer cases each year, one in every two occurs in China.
Since most patients are diagnosed at an advanced stage, the overall five-year survival rate for liver cancer is only 12.5%.
Liver cancer is often diagnosed at an advanced stage—be alert to early warning signs
All cancers become difficult to treat in their late stages. Missing the optimal treatment window increases treatment complexity and compromises patient survival. Therefore, prioritizing early diagnosis and treatment is crucial.
Early symptoms of liver cancer include liver region pain, occurring in over 50% of cases. This pain typically manifests in the right rib cage or below the xiphoid process, presenting as intermittent or persistent dull ache, dull pain, or stabbing pain.
Nearly 40% of liver cancer patients mistake digestive symptoms for "stomach problems," delaying diagnosis and treatment. These digestive symptoms primarily include decreased appetite, postprandial upper abdominal fullness, belching, indigestion, and nausea.
Additionally, liver cancer patients often experience weight loss, fever, and sweating. These symptoms require careful differentiation and prompt medical attention.
Is surgical resection the only option for liver cancer?
Currently, surgical resection remains the most conventional treatment for liver cancer. Advances in curative resection techniques have elevated the overall five-year survival rate for resectable liver cancer to over 50%, reaching approximately 70% for early-stage cases.However, clinically, only 20-30% of all liver cancer patients undergo surgical resection.
Factors such as large tumor size, invasion of surrounding blood vessels, or distant metastasis deprive patients with advanced liver cancer of surgical options. They must rely on combined therapies including radiotherapy, chemotherapy, interventional procedures, radiofrequency ablation, targeted therapy, and immunotherapy to pursue survival.
Given the large diameter of Mr. Hu's tumor and its proximity to the portal vein, hepatic artery, hepatic vein, and hepatic duct, direct surgical resection was not feasible due to the risk of massive hemorrhage.
Faced with this high-risk scenario, the medical team convened an emergency treatment planning meeting and ultimately decided on a comprehensive sequential treatment approach for Mr. Hu.
This involved first using interventional and chemotherapy methods to block the tumor's blood supply, slow its growth, induce necrosis in part of the tumor, and reduce its size. Following this, surgical resection would be performed to maximize the chances of a curative outcome for Mr. Hu.
Doctors performed hepatic artery chemoembolization via interventional techniques. The procedure successfully removed the tumor while preserving healthy liver tissue.
Professor Wen Tianfu, Director of Hepatobiliary Surgery at West China Hospital, emphasized that targeted and immunotherapy hold immense potential in liver cancer treatment. For some patients, combining drug therapy with localized treatments like radiotherapy can shrink tumors or reduce their stage, transforming initially inoperable liver cancers into resectable ones.
This transformative approach to liver cancer treatment opens up possibilities for long-term "tumor-free survival." However, clinical exploration of combined treatment strategies remains ongoing.
Liver cancer patients often have underlying liver disease, with 80% linked to hepatitis B.
Mr. Hu's postoperative pathology confirmed his tumor was hepatocellular carcinoma.Doctors emphasize that liver cancer patients often have underlying liver disease, with 80% linked to hepatitis B.
The progression from hepatitis B infection to liver cancer typically takes about 30 years. During this period, there are countless opportunities to prevent cancer development.
Since the hepatitis B virus is a key factor in liver cancer onset, preventing its infection is crucial.Administering the hepatitis B vaccine to newborns effectively prevents hepatitis, and this preventive measure has proven highly successful.
In the 1990s, China's hepatitis B carrier rate stood at 9.75%. By 2006, it had dropped to 7.18%, and by 2014, the carrier rate among individuals aged 1 to 29 was approximately 2.6%.
Given the infectious nature of HBV, adults should prevent transmission by avoiding unprotected sexual contact and sharing personal items like razors or toothbrushes. Regarding healthcare-associated transmission, strict adherence to single-use syringes and thorough sterilization of medical instruments is essential.
Beyond HBV, non-alcoholic steatohepatitis (NASH) can also progress to liver cancer.Repeated inflammatory damage to the liver triggers continuous self-repair processes. This cycle disrupts normal liver cells, leading to genetic mutations that increase the risk of liver cancer. Therefore, proactive preventive measures are crucial for preventing liver disease and liver cancer.
For high-risk individuals already diagnosed with hepatitis, regular screening is essential. Since liver cancer often shows no obvious symptoms in its early stages, earlier prevention leads to higher survival rates after treatment.