Each year, on October 20, the Korean Liver Society was founded.
The cause of liver cancer is clear, but there are no symptoms, so it is difficult to detect
The development of immuno-tumor drugs increases the possibility of a complete cure
“Early diagnosis and active treatment are important”
[아시아경제 김영원 기자] Every year, October 20 is the “Liver Day” established by the Korean Liver Society. Since the liver is called the “silent organ”, there are no symptoms even if there is severe damage, so an active examination is required for early diagnosis. In particular, of all liver diseases, “liver cancer” has the highest physical, economic and social burden. Liver cancer was fatal in the 4050 generation with active social and economic activities. According to the “Statistics of Causes of Death in 2021” published by the National Statistical Office, liver cancer ranks first among the causes of cancer death among people aged 40 to 50.
Liver disease terminus ‘liver cancer’ … Risk of developing chronic epilepsy ↑
Compared to other cancers, liver cancer is characterized by a distinct incidence in patients with chronic liver disease. It is known that the risk of developing liver cancer is 20 times higher if infected with the hepatitis virus. Liver cirrhosis, in which cells harden due to chronic inflammation and cause fibrotic changes in the liver, accompanies approximately 80% of all liver cancer patients and the incidence of liver cancer among patients with cirrhosis it is about 1-5% per year.
The main symptoms of liver disease include fatigue, loss of appetite, and jaundice, but most of them are asymptomatic. When liver cancer occurs in patients with cirrhosis, symptoms of jaundice or ascites may suddenly appear. Symptoms of liver cancer include pain or lump in the right upper abdomen, abdominal distention, weight loss, severe fatigue, and indigestion. However, most of these symptoms appear after the cancer has advanced.
In some cases, cancer is discovered during a health check when there are no ambiguous symptoms or conditions. For this reason, experts say regular checkups are important, especially for high-risk groups, so early screening is important. Heo Jeong, professor of gastroenterology at Pusan National University Hospital, said: “Hepatitis B virus is the cause in 72% of liver cancer patients and hepatitis C virus and alcohol are in many. cases the causes of liver cancer “. by the nature of the process, early diagnosis in high-risk groups is very important, as many people experience symptoms only after the disease has progressed and visit the hospital late ”.
Curative Treatment in Early Stage Liver Cancer … Chance of complete cure with recent advances in treatment ↑
For liver cancer, the treatment policy is determined by fully considering the degree of cancer progression, liver function, and systemic conditions. If liver function or systemic conditions are not very bad, curative treatment such as liver resection, liver transplant, radiofrequency ablation, or ethanol injection is performed.
Liver resection is preferentially considered when tumor resection is possible and liver function is sufficient. Liver transplantation is a treatment that can provide a good prognosis for early stage liver cancer where there is usually only one tumor and it is less than 5 cm, or when there are three or fewer (each less than 3 cm). cm) and the cancer has not invaded the blood vessels and has not metastasized outside the liver. . However, even with curative treatment, liver cancer can recur in about half of patients.
Non-curative therapy is used to treat liver cancer that is highly advanced, such as multiple tumors or vascular invasive tumors. About half of liver cancer patients have multiple tumors, vascular invasion tumors, or impaired liver function. For this reason, surgery is difficult to prioritize and the most commonly used treatment is carotid artery chemoembolization (TACE). It is a method of blocking blood vessels by administering anticancer drugs to the arteries that supply oxygen and nutrients to liver tumors.
Chemotherapy may be considered if metastases are present in other parts of the body, such as lymph node, lung, or bone metastases, or if several treatments do not work. For about 10 years, “targeted anticancer drugs” have been used for the chemotherapy of hepatocellular carcinoma. Unlike previous cytotoxic anticancer drugs, targeted anticancer drugs rarely attack normal cells and work to prevent proliferation by inhibiting the activity of biomaterials that occur during cancer formation. However, there was a disadvantage that the chemotherapy response rate, i.e. the treatment options and effects, were limited.
Recently, “anticancer drugs” have been developed and used that improve the response rate and survival rate of chemotherapy and use the body’s immune system to kill cancer cells. Immunotherapy is a treatment that stimulates the body’s immune system to make immune cells better attack cancer cells, rather than attack the cancer itself. The main global guidelines in the United States and Europe and the “Guidelines for the treatment of hepatocellular carcinoma 2022”, which were revised in June, are designed to prioritize combination therapy of immunotherapy (Tecentriq- Avastin) as the first treatment for patients with unresectable liver cancer.
Tecentriq-Avastin combination therapy reduced the risk of death by approximately 40% compared to conventional therapies in global clinical trials and showed the longest median overall survival (19.2 months) among the approved treatments in Korea so far. In particular, in about 8% of the patients who participated in the study, a “complete remission” was observed in which all tumors have disappeared, so recovery can also be expected in metastatic hepatocellular carcinoma.
Since May, national health insurance benefits have been applied to Tecentriq-Avastin combination therapy for liver cancer. Previously, Tecentriq’s health insurance coverage only applied to secondary non-small cell lung cancer, urothelial cancer and small cell lung cancer. As a result, the annual cost of drugs, which was approximately 66 million won before the application of health insurance, has been reduced to the current level of 3.3 million won, greatly reducing the burden of treatment costs. .
Professor Huh said: “Metastatic hepatocellular carcinoma in the past was a very desperate cancer due to its low survival rate, but the latest combined immunotherapy therapy has emerged that can also be cured in advanced hepatocellular carcinoma and the landscape of treatment is changing, “said Professor Huh. Eh. Since a good prognosis can only be expected when the patient is in good condition, regular checkups and consistent, active treatment are important for the prevention and treatment of liver cancer and various liver diseases. “
Journalist Kim Young won [email protected]
