The 5-year survival rate of liver cancer is only 12.1%, why does life enter the countdown as soon as the liver hurts?

At present, the 5-year survival rate of liver cancer in mainland China is only 12.1%, and liver cancer is still in the current situation of "high incidence and low survival", so early detection and early treatment are the key.

As one of the top five cancers in terms of incidence, liver cancer can be said to be almost painless in the early stage, or even asymptomatic, and often when the pain is felt, the cancer is at an advanced stage and cannot be cured at all. This "silent" characteristic also makes the mortality rate of liver cancer extremely high, with the current survival rate of only 12% [1]. Even Steve Jobs, the founder of Apple, who has excellent health care conditions, could not escape this invisible killer, and he died of liver cancer at the age of 56.

For this invisible killer, many doctors and friends have concluded: liver cancer can often be cured when there is no pain, and once there is pain, I am afraid it cannot be cured. Why is liver cancer so not noticed by anyone in the early stages? Today, let's talk about liver cancer with all of you.

▍Why is liver cancer so difficult to detect?

An important feature of liver cancer is that it is not painful in the early stage, but it will only be painful in the late stage. Why is this so?

Unlike other organs in the body, our liver does not have any pain nerves. So when liver cancer is very small, it grows in the liver, and we don't feel any pain. The early manifestations of liver cancer are often featureless and non-directive, such as weight loss and fatigue. If you do not pass a professional medical examination, it is difficult for us to perceive the early stage of liver cancer.

However, when the liver cancer gradually grows and the diameter grows to more than 10 cm, the liver capsule is enlarged due to the increase in the size of the liver, and the liver capsule has pain nerves. When the area of liver cancer becomes larger and larger, the liver capsule will be stretched out little by little, and the tension on the surface will increase. Just like a balloon, the qi in it is filled little by little, and our pain will become more and more intense, and at this time, it will be an incurable advanced liver cancer.

▍How can I detect liver cancer at an early stage?

When liver cancer is very small, there is no feeling, so how can we detect liver cancer at an early stage?

This requires regular check-ups for high-risk groups. At present, the most effective and cost-effective way to screen for early liver cancer is to have a combination of liver ultrasound and alpha-fetoprotein testing every six months. The smallest diameter of liver cancer that can be detected by this test is about one centimeter, and the detection rate is 60-70%. Abnormal results of either ultrasound or hepatitis A protein should be performed with contrast-enhanced CT or enhanced magnetic resonance imaging (MRI), which is the most accurate detection of early-stage liver cancer [2].

▍To prevent liver cancer, six groups of people need to pay attention!

Liver cancer has an insidious onset and is often found to be at an advanced stage. Therefore, "early detection and early treatment" is the first principle. For high-risk groups of liver cancer, it is necessary to be vigilant and conduct regular screening. People who are easily targeted by liver cancer often have the following six characteristics, let's take a look at them together.

1. Hepatitis B patients

Hepatitis B can lead to liver cancer by two main mechanisms:

First of all, the hepatitis B virus can be integrated into the genome of liver cells, and if the virus happens to integrate into the key sites that activate oncogenes or block tumor suppressor genes, liver cancer can occur.

Second, repeated episodes of hepatitis B can lead to fibrosis of the liver, which eventually progresses to cirrhosis. In the cirrhosis stage, hepatocytes grow disorderly and are prone to malignant transformation, resulting in liver cancer [3].

2. Likes drinkers

Research data have shown that men who consume more than 40 grams of alcohol per day (20 grams for women) have a risk of ALD after 5 years. The end result of ALD is often cirrhosis and liver cancer [4].

According to the alcohol conversion formula, 40 grams of alcohol is about two taels of liquor or two bottles of beer, which is not very large. Therefore, abstaining from alcohol is a very necessary means of liver maintenance, and it is best to do it without drinking!

3. Those who eat moldy food

When food becomes moldy, aflatoxin, a highly toxic liver carcinogen, is produced. Epidemiological studies of liver cancer in mainland China showed that the level of aflatoxin contamination in the diet was closely related to the incidence of primary liver cancer. In 1993, aflatoxins were classified as Class 1 carcinogens by the World Health Organization. Therefore, it is recommended to throw away the food after it has become moldy, and never do anything to continue eating it after removing the moldy part.

4. There is liver cancer in the family

Although liver cancer is not a genetic disease, there is a certain familial cluster. For example, mothers with hepatitis B often pass the virus to their children when they give birth.

Familial clustering refers to a relatively high incidence or prevalence of a particular disease in a family. Familial clustering occurs when there are multiple members of the same family who have the same disease and the prevalence exceeds the level expected in the normal population.

5. Obese people

Fatty liver caused by obesity is the most common liver disease in China, with an incidence of up to 20-30%. The cause of fatty liver disease is simple: eating too well and exercising too little. The accumulation of fat in the body will not only make the belly and thighs thicker and poorer, but also cause deep damage to our liver. At present, there is no specific treatment for fatty liver, and we can only rely on weight loss!

6. Patients with gallstones

Patients with long-term gallstones, especially intrahepatic bile duct stones, are prone to cholestasis and biliary obstruction, which increases the accumulation of bilirubin in the liver, which in turn leads to cholestatic cirrhosis and long-term chronic inflammation, leading to an increased risk of liver cancer.

▍Summary

Liver cancer is a malignant tumor caused by a variety of factors (e.g., hepatitis B, alcoholism, obesity); The onset is insidious and not easy to detect. High-risk groups should be screened for liver ultrasound and alpha-fetoprotein every six months for early detection and early treatment.

bibliography

1. 中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗规范（2019年版）[J].临床肝胆病杂志,2020,36(2)：277-292.2.JORGE A. MARRERO, LAURA M. KULIK, CLAUDE B. SIRLIN, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology, 2018, 68 (2) : 723-750.3.中国抗癌协会肝癌专业委员会.中国肝癌多学科综合治疗专家共识[J].临床肝胆病杂志,2021,37(2)：278-285.4.中华医学会检验医学分会分子诊断学组. 肝细胞癌生物标志物检测及应用专家共识[J].国际检验医学杂志, 2020,41(24)：2945-2948.

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