Is liver cancer preventable and treatable? Who are the high-risk groups for liver cancer?

Prevention of liver cancer starts with "early"

Researchers have confirmed that liver cancer is closely related to hepatitis B, C and D viruses that are transmitted through blood, while hepatitis A that is transmitted through food has nothing to do with liver cancer.

According to statistics, about 70-80% of liver cancer patients are related to hepatitis B, about 15-20% are related to hepatitis C and D, and another 5% of liver cancer patients may be related to alcoholism, parasitic infection, and long-term use of contraceptives.

As people's eating habits improve, the incidence of liver cancer caused by eating moldy food (containing aflatoxin) and drinking contaminated water is decreasing. It can be seen that the prevention of liver cancer should focus on the word "early", that is, to prevent hepatitis.

First, we must understand the transmission route and block the infection route

Mother-to-child transmission:

It is generally believed that about one-third (about 30 million) of hepatitis B surface antigen carriers are transmitted from mother to child. Due to early infection, more than 90% develop chronic infection. Studies have shown that the risk of chronic infection in children under 6 years old is about 30%, while only 5% of those infected in adults become chronic. Mothers who are positive for both HbsAg (hepatitis B surface antigen) and HbeAg (hepatitis B e antigen) are particularly contagious.

Blood transmission and medical transmission

Hepatitis B virus mainly exists in the patient's blood, so blood transmission is also an important route, such as blood transfusion or use of blood products, hemodialysis, accidental puncture by needles or scalpels, sharing razors and toothbrushes, tattoos, tooth fillings, etc.

Sexual transmission

The semen of male hepatitis B surface antigen carriers is contagious. Condoms must be used during sexual intercourse.

Other ways

The virus can also be transmitted through damaged oral mucosa and insect bites. There are still few patients with hepatitis C and D in my country, and they are also transmitted through the blood route, mainly through blood transfusion.

Reminder: Liver disease patients should have frequent checkups in spring

Second, inject hepatitis B vaccine and anti-hepatitis B immunoglobulin

It is impossible to avoid contact with hepatitis virus in daily life. Fortunately, a safe and effective hepatitis B vaccine is now available, with a success rate of over 97% in inducing protective antibodies after injection. my country has now promoted the vaccination program for infants and children, and it is expected that the incidence of liver cancer will drop significantly in 20 years.

For pregnant women who are positive for both HbsAg and HBeAg, a monthly injection of high-titer hepatitis B immunoglobulin can neutralize the hepatitis B virus in the pregnant woman and reduce the chance of intrauterine infection of the fetus. Newborns can be effectively protected by a combination of hepatitis B vaccine and anti-hepatitis B immunoglobulin injection after birth.

Third, we must seriously treat hepatitis

At present, the main drugs for hepatitis virus are interferon and lamivudine. It should be reminded that the use of drugs to control the replication of hepatitis virus requires very professional knowledge and experience, so it is absolutely not advisable to use them casually based on hearsay, otherwise it will only do more harm than good and aggravate the symptoms. Of course, interferon and lamivudine cannot completely eliminate hepatitis virus infection, and some patients will eventually develop cirrhosis. For patients with cirrhosis, the only effective means of treating and preventing liver cancer is liver transplantation.

Fourth, develop good living habits

More and more scholars believe that malignant tumors are related to bad living habits. For those who have already suffered from hepatitis, regular life, not overwork, not drinking, not taking drugs indiscriminately, and taking drugs that control or reduce viral replication can reduce liver lesions and thus reduce the risk of liver cancer.

So what are the causes of liver cancer?

The American Institute for Cancer Research (AICR) has organized experts from around the world to put forward 13 recommendations, which are summarized as follows:

1. Eat a variety of foods, including a variety of plant foods, such as grains, beans, and potatoes. Irregular eating can cause malnutrition and lack of some trace elements and vitamins, which can reduce the body's immunity and cell stability, and thus easily induce cancer.

2. Eat more vegetables and fruits, 400-800 grams a day. Fresh vegetables contain two special ingredients, phenol and quinone. Quinone can dilute carcinogens and excrete them from the body in liquid form, while phenol can prevent the metabolism and development of cancer cells. The combination of the two can better fight cancer.

3. Eat appropriate amounts of fish, poultry, eggs, and lean meat regularly, and eat less fat and animal oil.

4. Eat low-fat and low-salt foods, with the salt intake not exceeding 6 grams per person per day.

5. Balance food intake and physical activity to maintain a suitable weight.

6. Do not smoke and drink in moderation. The daily intake of beer should not exceed 500ml, the daily intake of wine should not exceed 250ml, and the daily intake of strong liquor should not exceed 30ml.

7. Process and store food safely.

8. Healthy lifestyle

The World Health Organization has proposed a 16-word mantra for health: an optimistic attitude, adequate sleep, moderate exercise, and balanced nutrition. Improving dietary nutrition, participating in physical activities, and maintaining a healthy weight are expected to reduce the incidence of cancer by 30%-40%, and quitting smoking can reduce it to 60%-70%.

9. Smile often

Experts have found that after a cancer patient laughs, the level of natural active substances in the body that kill cancer cells will be greatly increased.

10. Get quality sleep

The climax of human cell division is after falling asleep at night. If the sleep is not good, it is difficult for the human body to control the cells from mutating and becoming cancer cells during the division process.

11. Avoid exposure to the sun

The medical community has confirmed that excessive exposure to ultraviolet rays is related to the occurrence of skin cancer and melanoma.

12. Chew thoroughly

Saliva is the first line of defense against carcinogens in food. Some people collect saliva, process various carcinogens with saliva, and then apply them to bacteria. The results show that bacterial mutations are reduced. Saliva can fully exert its effect as long as it comes into contact with food for 30 seconds.

13. Take vitamin supplements appropriately

Scientific research shows that people with high levels of vitamin E in their bodies have a lower risk of cancer. Vitamin E can prevent the initial growth of cancer cells. As an antioxidant, vitamin E can adsorb to the surface of damaged cells and stimulate them to "commit suicide." At the same time, it can also enhance the body's immunity and prevent cancer cells from invading blood vessels, thereby cutting off the tumor's access to nutrition.

Who are the high-risk groups?

It is generally believed that:

35-59 years old;

Hepatitis B patients (chronic hepatitis or hepatitis B antigen positive, especially those who have developed cirrhosis);

Those with a family history of liver cancer (parents, brothers or sisters in the family have liver cancer);

Chronic alcoholics are a high-risk group.

According to a six-year follow-up study conducted by Zhongshan Hospital on 18,816 people at high risk of liver cancer in Shanghai, the results showed that the incidence rate of these high-risk people was 11 times higher than the city's average level.

How to detect early

After years of efforts by medical workers and researchers, liver cancer has changed from an incurable disease to a curable disease. However, most of the long-term survivors are early-stage liver cancer patients.

There are no characteristic signs in the early stage of liver cancer, which are mostly manifested as dull pain in the liver area, poor appetite, abdominal distension, fatigue, etc., which are similar to the symptoms of most digestive tract diseases. So, how can we detect it early?

Practice has shown that regular physical examinations for people who are prone to liver cancer are an effective measure for early detection. Experts recommend that liver function, alpha-fetoprotein and B-ultrasound should be checked every six months (preferably every three months).

Liver cancer should be treated rationally

Once you are diagnosed with liver cancer, you still have a chance of long-term survival as long as you actively and reasonably treat it. The five-year survival rate of early liver cancer patients treated by the Liver Tumor Department of Zhongshan Hospital has reached 60%. So far, 368 surgical patients have survived for more than 5 years, 112 have survived for more than 10 years, and one has survived for as long as 38 years, which is at the international leading level.

The existing treatment methods mainly include: surgical resection, interventional therapy, anhydrous alcohol injection, cryotherapy, radiotherapy, microwave coagulation, radiofrequency therapy, chemotherapy, guided therapy, gene therapy, etc. Surgical resection is currently recognized internationally as the most effective method for treating liver cancer, but clinically only 15% of liver cancer patients can be directly resected, and 85% of patients still need to choose other treatment methods.

For those who cannot undergo surgery, there are two main treatment methods: one is hepatic artery catheterization and drug infusion pump placement. The other method is interventional therapy. In addition, a variety of local treatment measures such as radiotherapy, radiofrequency therapy, and cryotherapy provide patients who cannot undergo direct surgery with a variety of options. By combining a variety of non-surgical treatment methods, liver cancer that cannot be directly removed can be reduced in size and then surgically removed. The treatment effect is similar to that of early liver cancer.

Postoperative treatment is extremely important

Liver cancer has multiple origin characteristics. It is difficult to find some tiny lesions in the liver before surgery. Since the patient's body resistance decreases after surgery, these small lesions will develop rapidly. Therefore, postoperative treatment is extremely important. Some scholars have reported that the five-year survival rate of liver cancer after surgery with intravascular interventional treatment can be 40% higher than that of no treatment.

After surgical resection, regular alpha-fetoprotein + B-ultrasound examinations should be performed. If alpha-fetoprotein cannot be reduced to normal, residual lesions in the liver should be considered. If they can be located, local treatment or even surgical resection can be performed. If the diagnosis cannot be confirmed, interventional treatment can be performed, and a CT scan can be performed 3-4 weeks after the interventional treatment to detect residual lesions and take corresponding measures. If alpha-fetoprotein drops to normal after surgery, or is normal before surgery, some patients may also need interventional treatment about one month after surgery depending on their condition. It is estimated that the chance of recurrence can be reduced by about 1/3. Unless extrahepatic metastatic lesions that cannot be treated locally are found, systemic chemotherapy is generally not considered. Long-term use of biological agents such as interferon after surgery may help reduce the long-term recurrence rate.

Liver transplantation—a glimmer of hope

With the improvement of the success rate of liver transplantation, liver transplantation has become an important means of treating liver cancer. At the same time, because cirrhosis can easily turn into liver cancer, liver transplantation has become the first choice for patients with end-stage cirrhosis to prevent liver cancer. Domestic liver transplantation has made great progress in recent years, and the cumulative number of cases has increased. For small liver cancer combined with severe cirrhosis, liver transplantation is the only way to improve the quality of life and obtain cure. Attempts to perform liver transplantation for large liver cancer have been carried out in China, and from the current clinical efficacy, there is hope. The results of practice show that for some early liver cancer patients with liver decompensation, liver transplantation can indeed prolong life and improve tumor-free survival rate, exploring new ways for the treatment of liver cancer. However, problems such as postoperative hepatitis recurrence, tumor recurrence and metastasis, and rejection reactions need to be further studied in basic and clinical aspects.