– February 2 is the day of liver cancer. It was established in 2017 by the Korean Liver Cancer Society with the meaning of diagnosing liver cancer at an early stage and receiving appropriate treatment by regularly receiving two tests a year and two tests. The two tests are liver ultrasound and serum alpha-fetoprotein test (blood test). If liver cancer is diagnosed early, a cure can be expected through liver resection and liver transplantation. However, about 70% of domestic patients are found in a state where liver cancer has already progressed considerably. This is because the liver does not send a danger signal even if 70-80% of the liver is attacked by viruses, alcohol, fat, and drugs. Young-cheol Yoon, a professor of hepatobiliary surgery at the Catholic University’s Incheon St. Mary’s Hospital, said, “There are many cases where the liver, which is called the silent organ, is found after the disease progresses without our knowledge and becomes untouchable.” Patients with hepatitis C virus or alcoholic cirrhosis need special attention as they can worsen liver cancer.”
◆ Liver cancer 5-year survival rate is fatal with 37%
The number of new liver cancer patients (National Cancer Registration Statistical System) in 2018, which was announced in December 2020, was 1,5736, the 6th largest among all cancers. However, the average 5-year survival rate for men and women for liver cancer is 37%, which is fatal. Liver cancer is detected late, and accordingly, the mortality rate is serious. Cancers with a 5-year survival rate lower than that of liver cancer are lung cancer 32.4%, pancreatic cancer 12.6%, and gallbladder/biliary tract cancers 28.8%.
The major risk factors for liver cancer are hepatitis B virus (72%), hepatitis C virus (12%), and alcohol (9%). In addition, drugs, obesity, and autoimmunity can also be the cause. In particular, it is known that infection with hepatitis B virus increases the risk of liver cancer by about 100 times and the number of people infected with hepatitis C virus by 10 times. In addition, the longer the duration of hepatitis, the greater the risk of developing liver cancer. In particular, the presence or absence of cirrhosis has a great influence on the incidence of liver cancer. In 80% of patients with liver cancer, cirrhosis is preceded by cirrhosis, and the incidence of liver cancer is increased by more than 1000 times in people with cirrhosis.
Professor Yoon said, “The most common cause of liver cancer is the hepatitis B virus. In addition, the hepatitis C virus, hepatitis caused by excessive alcohol use, and severe fatty liver can be the cause.”
◆ When diagnosing liver cancer, hurry to’liver transplant’
Symptoms of liver cancer are almost absent in the early stages and then appear gradually. When symptoms become apparent, most cases have already progressed. Even if the liver level is very high due to hepatitis, even if the liver becomes small due to liver cirrhosis, even if the liver is large due to liver cancer, most of them have no symptoms at all. However, if the size of liver cancer increases and the lymph nodes or blood vessels are invaded, abdominal pain or discomfort, severe fatigue and weakness, deterioration of liver function, jaundice and ascites may occur.
The degree of liver cancer progression is divided into four stages depending on the size of the tumor and whether the tumor has invaded blood vessels or metastasized to other organs. If it is judged that the patient’s liver function and health condition can be thoroughly examined and treatment can be entered, liver resection in which a part of the liver with cancer is removed or liver transplantation in which the entire liver of the patient is removed and a healthy liver is transplanted are performed.
In addition, there are various treatments such as high-frequency heat treatment and ethanol injection. It is performed when the size of liver cancer is less than 3 cm. If the size of the cancer is small, the treatment results are comparable to liver resection. When liver cancer is so advanced that liver resection, liver transplantation, or high-frequency heat treatment cannot be applied, carotid artery chemoembolization, radiation therapy, chemotherapy, etc. Implement.
However, by all means, the most obvious treatment for liver cancer is a liver transplant, which turns a diseased liver into a healthy liver. This is because cancer itself can be completely removed and all diseased livers that can cause liver cancer in the future can be removed. Compared to other treatments, in addition to the 5-year survival rate, the 10-year and 20-year survival rates are also overwhelmingly high.
There are two types of liver transplantation. △First, a’pre-brain-dead liver transplant’ that transfers and attaches the whole brain-dead liver. If brain death donation is activated, liver transplantation can be avoided. However, since brain death donation is not activated in Korea, more biotransplantation is inevitable. In vivo liver transplantation is of the utmost importance to minimize complications in liver donors. Because donors are healthy people, not patients. Recently, laparoscopic surgery, in which only a few holes are drilled in the stomach, is applied to relieve the burden of surgery on liver donors who provide a healthy liver.
Professor Yoon said, “Our country has a very good regular check-up system for patients with liver disease, so if you pay little attention, you can detect cancer early. Because most of the liver cancer occurs in patients with liver disease, Liver cancer is absolutely not a scary disease if they receive regular checkups hard,” he said.
◆ Free regular checkup for high-risk liver cancer
To prevent liver cancer, it is important to prevent hepatitis B or C, which causes cirrhosis. Hepatitis B can be prevented through vaccination. For hepatitis C, which does not have a vaccine yet, be careful of infections through blood or secretions, such as using a single needle, avoiding inappropriate sexual contact, and tattooing or piercing. Never use a group of nail clippers or razors. In addition, in order to prevent alcoholic cirrhosis, you should refrain from drinking excessively, and if you have alcoholic liver disease, you should abstain from drinking.
In Korea, high-risk liver cancer patients over the age of 40 can receive a test provided by the National Health Insurance Service every 6 months. The high-risk group for liver cancer is cirrhosis, hepatitis B virus antigen positive, hepatitis C virus antibody positive, and chronic liver disease caused by hepatitis B or C virus. The screening fee may be free or a 10% copay. You can check it by accessing the Health Insurance Corporation homepage and inquiring about the subjects for examination.
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