300 liver cancer long-term survival hearts warm winter! Experts remind: early prevention and early treatment are the key

In just a few days, the South + client "394 Liver Cancer Long-term Survival Voices" public welfare collection activity supported by Merck Sharp & Dohme China received 300 good wishes from everyone, making this winter of cold and frost prevention and new crown extra warm!

Behind the 300 voices, there are actually several sets of amazing data: according to the latest global cancer burden data, there were 410,000 new cases of liver cancer in China in 2020, ranking fourth among all malignant tumors, and 391,000 deaths, second only to lung cancer.

From 2012 to 2015, the five-year survival rate for liver cancer was only 12.
1%.

As experts say, early prevention and treatment are the key to improving the
survival rate of liver cancer patients.
To this end, we must understand how liver cancer occurs from the source, so that it can be detected as soon as possible, diagnosed as soon as possible, and treated
as soon as possible.

1.
How does liver cancer occur?

The occurrence of liver cancer is the result of
the combined action of many factors inside and outside.
Internal factors refer to family history and genetic factors of liver cancer; External causes mainly include viruses, alcohol, drugs, autoimmune attacks, etc
.

In fact, as one of the important digestive organs, the liver can be called the metabolic factory
of the human body.
It is "busy" and undertakes the synthesis, transformation and decomposition of a variety of nutrients, especially proteins, fats, sugars, vitamins, etc.
; Participate in the metabolism of hormones in the body, the decomposition and detoxification of alcohol, drugs and metabolic wastes; It can also secrete bile, which helps digestion
.

But it is also a "dull" organ - in fact, there are no obvious symptoms in the early stages of liver cancer, and it is often overlooked
.
70% of liver cancer patients in China are in the middle and advanced stages
as soon as they are diagnosed.

Second, what are the characteristics of liver cancer in China?

As Professor Wang Xuehao, academician of the Chinese Academy of Engineering, said, China is a country with a high incidence of liver cancer, accounting for nearly half
of the world's new cases every year.
On the other hand, China is also a big country
with liver disease.
Due to the large population of liver diseases such as viral hepatitis and fatty liver, the number of people who develop liver cancer is also large
.
People with chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection, excessive alcohol consumption, nonalcoholic steatohepatitis, cirrhosis of the liver caused by other causes, and a family history of liver cancer, especially men aged > 40 years, are at high risk of
liver cancer.

As Professor Zheng Shusen, academician of the Chinese Academy of Engineering, mentioned: Chinese liver cancer is mostly caused by hepatitis B virus infection, and after hepatitis B virus infection in the human body, from liver fibrosis, cirrhosis to liver cancer trilogy, is a very clear cause.

Therefore, reducing the rate of hepatitis B infection is key
.

However, at present, due to the hidden onset of liver cancer, 70%-80% of patients are diagnosed in a locally advanced stage or distant metastasis, which means that the incidence of early liver cancer in China is less than 30%.

This means that many liver cancer patients need to be warned
before they are diagnosed.
Only by finding more liver cancer patients through screening and monitoring of high-risk groups can more patients provide early treatment and enable patients to achieve long-term survival
.

3.
How to improve the survival rate of advanced liver cancer?

High morbidity, high mortality and low survival rate constrain thousands of liver cancer patients, but they also inspire scientists and clinical experts in the field of liver cancer to continuously explore medical development, develop innovative therapies, and promote the update
of diagnosis and treatment models.

Academician Fan Jia, academician of the Chinese Academy of Sciences, called for multi-dimensional discussions
from the early diagnosis, early treatment, whole-process management, and multidisciplinary cooperation of liver cancer in order to achieve the goal of "increasing the overall five-year survival rate of cancer by 15%" proposed by the Healthy China 2030 Health Program.

Academician Fan is also the first big coffee expert to participate in this public welfare call and share his voice, he said: "Liver cancer treatment methods are constantly developing, and the liver cancer team of Zhongshan Hospital has been actively exploring and making unremitting efforts
to prolong the lives of liver cancer patients.
We firmly believe that the future of liver cancer treatment in China will be at the forefront of the world, and our liver cancer patients can get better treatment and achieve longer and better survival
.
”

With the continuous strengthening of hepatitis prevention and treatment capacity and the continuous development of liver cancer system treatment, targeted therapy and immunotherapy drugs are widely used in the field of liver cancer treatment, and the efficacy is remarkable, especially PD-1 monoclonal antibody-led immunotherapy is expected to improve the five-year survival rate
of patients with intermediate and advanced liver cancer.
It is worth noting that in October 2022, the National Medical Products Administration (NMPA) of China approved the PD-1 inhibitor pembrolizumab for the treatment of patients with hepatocellular carcinoma (HCC)
who had previously received chemotherapy for related drugs based on the results of KEYNOTE-394 clinical research 。 It is worth noting that due to the different characteristics of liver cancer in China and the West, the KEYNOTE-394 clinical study is "tailor-made" for Chinese patients in terms of protocol design, statistical methods, enrollment criteria, etc.
, and its approval not only helps liver cancer patients to achieve "long survival", but also scientifically proves the exact efficacy and clinical application potential of immunotherapy monotherapy in the treatment of advanced hepatocellular carcinoma
.

Third, during the peak period of new crown infection, what should liver cancer patients do?

The peak of new coronavirus infection is still continuing, liver cancer patients due to their age, complications and other factors, immunity is relatively low, should pay more attention to protection to reduce the risk of
infection.
According to the expert group of Zhongshan Hospital affiliated to Fudan University "Expert Guidance on the Whole Process Management of Liver Cancer Patients During the Novel Coronavirus Pneumonia Epidemic":

1.
Under the premise of effective protection against the new coronavirus, ensure the timely treatment of anti-tumor treatment and related emergencies as much as possible

2.
Scientifically adjust the treatment mode of liver cancer under the new crown pneumonia epidemic

3.
For patients with new coronavirus infection, priority is given to controlling infection, while ensuring anti-tumor treatment to the greatest extent

If a liver cancer patient is positive for the new coronavirus, he can fully inform the tumor history, medication history, allergy history, etc.
through Internet consultation or offline medical treatment, and the doctor will conduct a multidisciplinary and individualized discussion with the patient, and then judge how to use the symptomatic drug more appropriately
.

Fourth, individual prevention first, jointly fight liver cancer

In the face of liver cancer, and even more cancer, there may be no way to prevent it from happening
.
However, the World Health Organization also notes that "30% to 50% of cancers today can be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies"
.
For the public, we should pay more attention to primary prevention, stay away from carcinogenic factors, reduce the rate of hepatitis B virus infection, reduce the incidence of liver cancer, and live a healthy and healthy life
.

Primary prevention: prevention of causes

1.
Do a good job in hepatitis B preventive vaccination

2.
Cut off the transmission route of the virus: including blood transmission, mother-to-child transmission, sexual transmission, cutting off the transmission route can effectively deal with hepatitis and avoid the development of liver cancer

3.
Avoid exposure to carcinogenic factors: such as not eating moldy food, such food usually contains a large amount of class I carcinogen aflatoxin

4.
Change bad lifestyle to avoid liver function damage: such as smoking, alcoholism, etc.
to a certain extent increase the risk of liver cancer

Secondary prevention: early detection, early diagnosis, early treatment

1.
Stay away from relevant risk factors: including viral infection, personal bad behavior and lifestyle, environmental pollution, etc

2.
Regular screening for hepatitis and liver cancer

Tertiary prevention: comprehensive treatment of liver cancer

1.
Treatment of anti-hepatitis B or hepatitis C and other causes

2.
Take comprehensive treatment measures that can reduce the recurrence of liver cancer, reduce the mortality rate and improve the survival rate

3.
Regular monitoring of liver cancer recurrence and metastasis: liver function, alpha-fetoprotein, hepatitis virus quantification and abnormal prothrombin examination every three months; B-ultrasound or CT or magnetic resonance examination every six months

At last! 394 voices for long-term survival of liver cancer are continuously solicited, I hope you can join us, share your voice, and bring strength to the group fighting liver cancer with love, support, understanding, and blessing, and firmly go on!

Resources:

1， IARC, China Fact Sheet (2020).

2， Zeng, Hongmei et al.
“Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries.
” The Lancet.
Global health

vol.
6,5 (2018): e555-e567.

3, Han Yanan, Qin Sheng, Zhang Xiaolin, et al.
DNA mismatch repair and susceptibility to primary liver cancer: a meta-analysis[J].
Chinese Journal of Cancer Prevention and Treatment, 2019, 26(21):6.

4, Expert Group of National Multi-center Prospective Liver Cancer Very Early Warning Screening Project, Expert Consensus on Early Screening Strategy for Liver Cancer in China, Chinese Journal of Hepatology.

5, Healthy China Action (2019-2030).

6, XIA Yongxiang, ZHANG Feng, LI Xiangcheng, et al.
Analysis of 10966 exceptions for primary liver cancer.
Chinese Journal of Surgery, 2021,59(1): 6-17.

7, YANG Xinrong, SUN Huichuan, XU Yang, et al.
Whole process management strategy of liver cancer patients during the novel coronavirus pneumonia epidemic.
Chinese Journal of Digestive Surgery, 2020, 19(3): E010.

8, Liver Cancer Professional Committee of Chinese Anti-Cancer Association.
Chinese Guidelines for Integrated Diagnosis and Treatment of Cancer (CACA)-Liver Cancer Section.
Electronic Journal of Comprehensive Oncology Therapy, 2022, 8(3): 31-63