Cai Tou died of liver cancer. Was it too late to seek medical treatment for abdominal pain and bleeding? Doctors explain the difficult truth about advanced liver cancer
Liver cancer ranks second as the cause of cancer death. Is the symptom of abdominal pain and bleeding already in the advanced stage?
Well-known artist Cai Tou was treated for liver cancer last year, and it was recently reported that he passed away from advanced liver cancer. According to statistics from the Taiwan Ministry of Health and Welfare, liver cancer has been the main cause of cancer death in Taiwan for many years, ranking second among the top ten causes of cancer death in 2020. Dr. Wang Wenlun, director of the Department of Digestive Endoscopy at E-Da Hospital, reminded that in the past, Taiwanese people had a high proportion of hepatitis B and hepatitis C carriers. In addition, early-stage liver cancer has no obvious symptoms. High-risk groups should pay attention to regular follow-up examinations.
The liver itself has no nerves, so most liver cancers are found in advanced stages? Dr. Wang Wenlun pointed out that only when liver tumors grow to a certain extent will they invade surrounding organs or nerves on the surface of the liver and cause compressive symptoms, such as right upper quadrant pain. Or abdominal pain may occur due to tumor rupture.
Dr. Wang Wenlun explained that “chronic hepatitis, cirrhosis, and liver cancer” are called the trilogy of liver cancer. Although some liver cancer patients have small tumors, they have complications caused by cirrhosis, resulting in insufficient liver metabolism and synthesis, and they will be unable to Jaundice occurs due to the metabolism of jaundice toxins, or the inability to synthesize sufficient albumin and coagulation factors, leading to severe ascites, abdominal bleeding, and even peritonitis and sepsis.
In addition, the enlargement of liver tumors will affect the patient’s appetite, and the tumors will also absorb nutrients supplied to normal cells, causing the patient to develop “cachexia”, where the body becomes abnormally thin and cannot swallow food, which is also one of the manifestations of liver cancer.
What are the treatments for liver cancer? Can vascular embolism be controlled in the long term?
Dr. Wang Wenlun reminded that when liver cancer is discovered only with clinical manifestations, the tumor is usually already very large or has invaded the bile duct and other parts, which is considered advanced liver cancer. The treatment effect of advanced liver cancer is not very satisfactory. Usually only targeted therapy, high-dose chemotherapy and the latest immune drugs are available in stages 3 and 4. Although it can increase immunity against tumors and prolong survival time, there is still no cure so far.
“Early diagnosis is very important. If liver cancer is discovered at a late stage, it is usually too late and the treatment effect is not good!” Dr. Wang Wenlun said that liver cancer has been among the top ten causes of cancer death for many years. In the past, Taiwanese people with hepatitis B virus were nearly 15%, and hepatitis C also accounts for 4%. Known as a “national disease”, the high prevalence rate of viral hepatitis greatly increases the risk of subsequent progression to cirrhosis and liver cancer.
Dr. Wang Wenlun explained that if liver cancer tumors do not exceed 3 and are less than 3 centimeters, or if a single tumor is less than 5 centimeters, it is usually under good control. The radical approach is surgical resection or electrocautery of liver tumors. When there are too many tumors or they are scattered in both lobes of the liver, and surgery or electrocautery is impossible, vascular embolization will be chosen to block the hepatic artery that the tumor relies on to absorb nutrients, causing the tumor to lose nutrients and become necrotic.
However, the effectiveness of embolization treatment is not 100%. Dr. Wang Wenlun explained that there may be sporadic cancer cells around the liver tumor that obtain nutrients from the small branches of the hepatic artery, leading to local recurrence of liver cancer. Vascular embolization can control the progression of liver cancer, but it usually requires multiple treatments or even more than 10 times. Or embolization combined with electrocautery treatment can help achieve better tumor control.
What are the risk factors for liver cancer? Seek medical attention immediately if you have 4 major symptoms
“Taiwanese people’s awareness of disease has improved, especially among the younger generation!” Dr. Wang Wenlun said that people under the age of 50 are more aware of the dangers of hepatitis B, hepatitis C carriers and liver cancer, and generally have regular blood tests and Ultrasound tracking makes it possible to find very early liver cancer and treat it early.
On the contrary, people over the age of 60 and 70 do not regularly seek medical treatment and have no awareness of hepatitis B and hepatitis C. When they are tested when there are obvious symptoms, it is usually late-stage liver cancer.
Dr. Wang Wenlun reminded that in addition to hepatitis B and hepatitis C, alcoholic hepatitis, long-term medication use, and exposure to aflatoxin are all risk factors for liver cancer. Liver cancer does not only occur in older people. There have been patients who were found to have hepatitis B carriers as children, cirrhosis of the liver in their 20s, liver cancer in their 30s, and recurrence in other parts of the liver after surgical resection.
Dr. Wang Wenlun explained that liver cirrhosis means that the entire liver is damaged by hepatitis B and hepatitis C, and there may be precancerous lesions or tumors everywhere in the liver. Therefore, after liver cancer patients have their right liver removed, a second cancer is likely to develop in the left liver. Even if patients are diagnosed early, they still need to be followed closely after treatment.
Dr. Wang Wenlun reminded that those who are hepatitis B or hepatitis C carriers must follow up regularly and undergo ultrasound examinations every six months. Patients with liver cirrhosis should be checked once every 3 months. When symptoms such as loss of appetite, weight loss, jaundice, and gastrointestinal bleeding occur, you must seek medical advice as soon as possible.
Further reading:
