2023-04-30 22:00:02
Liver cancer is notorious for its high incidence rate and high mortality rate. The incidence rate is 31.4 per 100,000 people, twice as high as in Japan and three times as high as in the United States. The mortality rate is also high, and liver cancer is the second leading cause of death by cancer type in Korea. The main cause of liver cancer is the hepatitis B virus, and although the infection rate is decreasing due to the development of vaccines and treatments, caution is needed as the number of patients with alcoholic or fatty liver continues to increase. So, along with Professor Lee Seung-hwan of Gangdong Kyunghee University Hospital, we looked into the treatment of liver cancer.
Advances in medical technology have increased survival rates, but… Early symptoms are difficult to detect
Liver cancer is famous for its low survival rate, but recently, the survival rate continues to rise due to the development of surgical techniques and anticancer drugs. Twenty years ago, the 5-year survival rate for liver cancer was 9%, but recently it has risen to 40%.
The problem is that there are still many people who visit the hospital following symptoms appear, not in the early stages. Liver cancer progresses rapidly, so it is very important to detect it early through regular diagnosis, as it is difficult to exceed 6 months in case of advanced cancer.
Early detection is difficult because there are no symptoms. It doesn’t show any symptoms enough to be nicknamed the silent organ, because even if the liver tissue is only 30%, it does not interfere with its function at all. Patients who are detected early through regular health checkups have good grades, with a cure rate of regarding 90% if they are treated aggressively in the early stage. The cancer has not metastasized and the liver function is good, so a cure can be expected with surgery.
For early detection of liver cancer, it is recommended to have a tumor marker blood test (alpha-fetoprotein test) and liver ultrasound at least once a year. In addition, patients with underlying liver disease require more frequent tests than this, and hepatitis B or C virus carriers are the highest risk group. Recently, there are quite a few patients with fatty liver or alcoholic liver cancer, so it is not safe. In particular, cirrhosis patients are recommended to be examined once every 2 to 3 months.
Radiofrequency ablation, hepatic arterial chemoembolization, liver resection, liver transplant, etc. Treatment selection according to the condition
When liver cancer is diagnosed, the treatment method is determined according to the stage of liver cancer. It can be largely divided into surgical resection and non-surgical treatment such as radiofrequency ablation or hepatic arterial chemoembolization. Through diagnosis, the progress of the cancer is identified, and the optimal treatment method is found for the patient following making a comprehensive judgment such as the size and location of the cancer lump and the state of liver function. Surgery is performed by surgeons, and non-surgical treatments are performed by internal medicine.
A typical non-surgical treatment is radiofrequency ablation. It is a sure way to treat early cancer. However, it is not recommended when the location of the cancer is attached to blood vessels, because heat is taken away by blood vessels and does not deliver enough heat to necroze cancer tissue.
Hepatic arterial chemoembolization is performed in patients with advanced cancer who are not eligible for surgery. The goal is not to cure cancer, but to block oxygen and nutrients necessary for cancer to grow, and to cause cancer to die. Search for arteries that supply nutrients to the liver, administer anticancer drugs, and block blood flow with substances that block blood vessels. Although it has the advantage of selectively killing cancer and minimizing damage to normal liver tissue, there are many recurrences of cancer, so a follow-up examination must be performed following the procedure, and reoperation is performed whenever it recurs.
Surgery can be considered in the early stages of liver cancer, when the tumor is confined to the liver or has invaded only to the periphery of the liver, and the decision is made following comprehensively reviewing the patient’s health and liver function. Surgical resection is a good way to reliably remove liver cancer, but it is difficult to perform if liver function is poor. For example, even in the early stages of liver cancer, liver transplantation is the only alternative if liver function is impaired due to liver cirrhosis.
Liver transplantation is known as the most ideal treatment for early-stage liver cancer as well as for cases where liver cirrhosis has become severe and medical treatment is no longer possible. In particular, living donor liver transplantation, in which a portion of a healthy human liver is transplanted into a patient, is possible as soon as a donor appears without a complicated process. However, living donor liver transplantation is limited in advanced liver cancer, so early detection is very important in the case of liver cancer.
Most liver cancer surgeries are performed laparoscopically. Five holes the size of a knuckle (5 to 12 mm) are made in the abdomen, and a light source, camera, and surgical tools are inserted to remove the liver, including the tumor. The laparoscopic hepatic resection operation time is similar to that of open surgery, but the pain felt by the patient is reduced and the recovery is faster. With laparoscopy, recovery is fast enough to walk and eat within a day or two following surgery. Patients who open their stomach complain of pain for 3 to 5 days, and the hospitalization period is long. In addition, open surgery leaves a large scar of regarding 30 cm, and it may be added during the healing process.
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Life management following liver cancer surgery
You just have to maintain a normal life. Some people feel a little tired because of the followingeffects of surgery, but it is better not to overdo it while living a normal life. You should avoid strenuous exercise, but you can walk or do light physical activity. You should also eat well.
Some people consume too much health food because their stamina has fallen due to surgery. Excessive calories can cause fatty liver, so it is desirable to maintain an appropriate weight. It is recommended to avoid too high-fat or high-carbohydrate meals, and to exercise steadily. In addition, you should not strain your liver by taking unverified herbs or herbs.
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