Wednesday, January 25, 2023 Commissioner of Public Health The Senate, under the leadership of the President Dr. Chet Siratharanon, held a weekly meeting on Wednesday, this Wednesday meeting about the 5 cancers that cause the most Thai deaths. As an advisor to the Senate Public Health Commission, I regret having to travel to attend the opening ceremony of the Gastrointestinal Endoscopy Center. and the Center for Endoscopy and Respiratory Surgery at Surin Hospital, but I listened online until the last minute that I had to turn off my phone. when on the machine but listened to you Director of the Cancer Institute The Ministry of Public Health provides information that the 5 cancers that cause the most deaths among Thai people are liver and bile duct cancer, lung, breast, cervical and colon cancer, etc. Therefore, I took the opportunity to give my opinions to the meeting in terms of disease prevention. Unfortunately, I didn’t listen to the end. And that didn’t have the opportunity to comment more than that.
However, I would like to bring the story of cancer in these 5 organs to talk to readers about the causes and prevention methods. So that you can put this knowledge into practice by having proper behavior from now on. Really, I want to see this knowledge. related to health promotion disease prevention, etc. Teach in schools across the country. People across the country will acquire important knowledge from a young age.
Today I would like to talk about cancer of the liver and bile ducts in the liver first. because it is the number 1 cause of death from cancer in Thailand
Liver cancer is easily diagnosed. It is a cancer of the liver (hepatoma) which has a different cause than bile duct cancer in the liver. Cancer of the bile duct in the liver in Thailand mainly comes from eating raw fish, koi, fish, pla som. from freshwater fish In foreign countries, the cause of bile duct cancer is not the same as in Thailand, etc.
liver cancer (hepatocellular carcinoma or hepatoma) has four main causes: one from obesity, two three from excessive alcohol use, three from the hepatitis B virus (HBV), and four from the hepatitis C virus (HCV).
Today I would like to talk about HBV and HCV first, but before going here, I would like to briefly say, in a simple, fist-pushing way, that is, cancer caused by alcohol consumption and obesity. That comes from all our own behavior that has been done for a long time. Later on, I’ll talk about these 2 things, but today, let’s talk about HBV, HCV first.
HBV and HCV are transmitted from the blood and blood products (semen, vaginal fluid, lymph fluid, etc.) of an infected person. The transmission method is from mother to child at birth. from having sex with an infected person without using a condom the use of sterile needles, for example in the case of people who inject drugs together Dirty needle tattoo, ear piercing, body piercing with dirty needles, 2019 World Health Organization. informing that there are 296 million HBV-infected persons with 1.5 million new infections per year, 820,000 deaths per year, and 58 million HCV-infected persons with 1.5 million new infections per year, 290,000 deaths per year ( Year 2019)
The infection and method of infection of HBV and HCV are the same but differ in the amount. If a mother is infected with HBV at birth, 90% of them are transmitted to her baby. But not more than 10% of the children can be transmitted to the child. Sexual intercourse with a person with B is more likely to be transmitted than C. Nowadays, C infections often come from using dirty syringes. In some countries, needles are also used. reused syringes which if cleaning is not good enough can spread infection
But the advantage is that even mothers who are infected with HBV and can infect up to 90% of their children, but Thailand since 1992 has been vaccinated against the virus. HBV but must be injected within the first 24 hours after birth and should be injected with 3 doses The World Health Organization says that a booster dose after the 3rd dose is not necessary.
And fortunately, HCV, although there is no vaccine to prevent it. But mothers with HCV can infect their children no more than 10% and another advantage of HCV is that there are currently oral medications that can treat the disease. HCV can be cured up to 95% with only 3-6 months of treatment.
As for HBV, the treatment is not as good as the treatment for HCV, which is about 40-50% curable, but it can still slow down liver disease. Reduce the chance of cirrhosis. or liver cancer It is hoped that if all people of the world are vaccinated against HBV, HBV will gradually disappear from the world.
WHO aims to eradicate viral hepatitis from the world by 2030. The definition of limitation is to reduce the infection rate by 90%, reduce the mortality rate by 65%.
For this reason, the WHO has set World Hepatitis Day on July 28 of every year. To campaign for people to go get a blood test to see if they have HBV, HCV or not, and if so, they need to see a doctor to determine if they need treatment. (Not everyone meets the criteria for treatment.)
I am of the opinion that nowadays we do not need to have liver cancer at all. If we have the knowledge, discipline and can access the services of the Thai public health system for everyone, such as free HBV, HCV testing for everyone, I would like NHSO. Social Security, Comptroller General’s Department, etc. If people are still not given the right to screen for HBV, HCV, please consider doing so. And would like to campaign for HBV vaccination in all newborns within the first 24 hours after birth, including consulting a specialist doctor whether If the mother has HBV, in some cases, apart from the HBV vaccination, do I need to give other medicines such as Immunoglobulin (HBIG) and/or medicines that the mother or baby should be able to get at birth, etc.
Dr Pinit Kullawanich
