1. Who should go for a regular checkup once every three to six months?

(a) Male hepatitis B carriers above forty

(b) People who suffer from cirrhosis of the liver

(c) People with a family history of liver cancer and whose liver does not function properly

2. Checkup Methods:

(a) Assay of Alpha-Fetoprotein Concentration: The one drawback of this test is that its sensitivity is not very high. The level of α-type fetoprotein in one-third of patients with cancer of the liver will not rise, so this form of testing must be accompanied by an ultrasound examination.

(b) Ultrasound Examination: This method of testing is rather painless and fast, carrying with it a high degree of accuracy. It has a ninety percent efficiency rate in detecting small-type tumors measuring less than three centimeters, but it's rather difficult to detect those which are less than one centimeter.

(c) Computerized Tomography: If it is already determined that the liver contains a tumor, this accurate method may be used in order to determine whether the tumor is benign or malignant and where it's located so that a proper method of treatment can be chosen.

(d) Liver Biopsy: Although the above methods are advanced they merely employ instruments on the exterior of the body to examine the patient's condition. Sometimes tumors are very tricky and not detected easily. Under these conditions a test should be performed in which, after the skin has been anesthetized, a needle is inserted into the tumor of the liver to extract a small sample to determine whether the cells of the tumor are cancerous or not. This method can omit a needless operation in those with benign tumors.

Although a liver biopsy may sound quite frightening, Director Chen Ting-hsin says that with a good anesthetic an experienced doctor can lessen the pain and keep loss of blood to a minimal. This is much better than having an unnecessary operation.

3. Treatment Methods:

(a) Operation: An operation, considered the best method, can remove almost all cancer if the cancer cells have not yet spread over a wide area.

(b) Transcatheter Arterial Embolization: In a normal liver three-fourths of the blood is supplied by portal veins and one-forth by the hepatic artery. However, blood for tissue in the cancered liver depends entirely upon the hepatic artery. This method utilizes a stopper (like the gel of a sponge) to obstruct the hepatic artery so that blood will not flow in. In this way the cancerous tissue's food supply will be cut off and thus starve to death; damage done to normal cells is not significant.

(c) Partial Treatment: Cancer-resisting drugs or pure alcohol is injected directly into the portion of the liver which has cancer and the cancer cells shrivel up and die.

(d) Immunization: This method is only in the experimental stage in the medical field around the world but has become a hot new topic as a method of possible treatment. The medical profession has yet to come up with an effective prescription to destroy the virus, but as long as the "landiord's" (the carrier's) resistance could be strengthened then the illness may not occur. In normal people, when the virus makes its invasion, the immune system automatically produces interferon-preventing reproduction of nucleic acids of the virus. Based on this principle, if you stimulate the production of interferon in the body it could increase the body's defense capabilities and lower the possibility of illness.

Atvogen, an interferon inducer invented by Tsao An-pang of the Academia Sinica, is safer and more effective than other available medicines. Atvogen may offer new hope for such incurable diseases as cancer and AIDS.