What's worthy of our attention is that approximately 250,000 people worldwide die from this disease, Chinese occupying nearly two-thirds. It's cancer of the liver--the silent killer which causes people to turn pale simply by hearing it mentioned.

The liver is the largest, heaviest, warmest, and most durable and complicated of our body's internal organs. Professor Sung Jui-lou of National Taiwan University Hospital describes the liver as the body's chemical factory responsible for manufacturing more than 1,000 kinds of enzymes making the body's internal metabolism work smoothly. The liver also produces coagulants, and stores a minimal amount of irons, copper, and many other kinds of minerals. More importantly, it also simultaneously acts as an internal filter and poison neutralizer and gets rid of waste material.

When the heart poses a problem an artificial heart may be used to replace it; when the lungs cease to function normally, man-made lungs may be used instead. But when the liver, a highly sophisticated "factory," breaks down, there's nothing that can take its place. This is also the reason why liver ailments especially render the medical world powerless.

What worries people most is that cancer of the liver and cirrhosis of the liver are not clearly detectable in their early stages, and after diagnosis the possibility of recovery is bleak. Only after the patient experiences swelling in the upper-right portion of his abdomen, poor appetite, a loss in weight, and depression does he usually go for a checkup only to find that it's too late; all medicines fail to affect a cure. Patients whose liver cancer is in the advanced stage may live as short as three to six months, and there's only a fifty percent chance that patients with cirrhosis of the liver may survive for five years.

Why is there such a high rate of liver cancer in Chinese people? Although the reason it leads to cancer is not clearly understood, the medical world holds the common view that hepatitis B is undoubtedly a major culprit. In areas where there is a high spread of contamination there is also a similar increase in cancer of the liver. On Taiwan, 85 to 90 percent of liver cancer patients are carriers of hepatitis B. The percentage in children who suffer from cancer of the liver and are also carriers of hepatitis B is as high as 100 percent. Pathological analysis has discovered that the cells of cancered livers always have a condition where the DNA (found in the cell nuclei and genes and associated with the transmission of genetic information) of hepatitis B virus is present. This is strong evidence that cancer of the liver is the aftereffect of hepatitis B.

For the most part, cirrhosis of the liver in Europe and the U.S. is attributed to alcoholism, but on Taiwan, with the exception of small towns and villages in mountainous areas, excessive drinking is not serious. In view of the fact that more than eighty percent of liver cirrhosis patients are carriers of hepatitis B, cancer of the liver and cirrhosis of the liver are closely related.

From the above we can see the dangers of hepatitis B. Regrettably, hepatitis B is considered a large threat to public health in areas around the world where Chinese people live, whether on Taiwan, Mainland China, Hong Kong, or Southeast Asia.

Although about fifteen percent of liver cancer patients don't have cirrhosis of the liver, generally speaking, chronic hepatitis B, cirrhosis of the liver, and cancer of the liver are the three standard steps Chinese people pass through during their liver ailment. On account of this, Professor Chen Ting-hsin of National Taiwan University Hospital emphasizes, "Knowing that you are a carrier of hepatitis B is the first step in protecting yourself."

Of course, the rate of carriers who suffer from cancer of the liver is 200 times higher than non-carriers. However, though the virus may be the culprit, it's not the only factor. Other factors, including smoking, abuse of medicines, food additives, aflatoxins, a history of liver cancer in the family, glandular excretion, and even emotion and pressure, all play a role and lead to cancer of the liver.

Smoking and drinking decrease the body's immune system, preventing the digestive system from absorbing nutrients, and increase the work load of the liver to filter out poisons. On Taiwan there are many occasions where men drink and talk over business and endure great amounts of pressure. Moreover, it has been proven that testicle ketone in male hormones causes cancer. So, although the number of male and female carriers of hepatitis B is close in number, the number of males who suffer from cancer of the liver is eight times greater than females, and cirrhosis in males occurs four to five times more frequently. It's no wonder why Hsiao Kuang-jen, a biochemistry researcher at Veterans General Hospital, defines the high-risk group of liver cancer as "hepatitis B carriers, males above forty, especially those who have suffered from chronic hepatitis or those whose liver can't function normally."

Cancer of the liver is a great threat to Chinese people. Through the hard work of the R.O.C.'s medical field over the years, its medical achievements occupy a first-rate standard in these aspects, whether in working to prevent hepatitis B or in carrying out clinical treatment or basic research on liver ailments. This standard is so high that even many Chinese in the U.S. and Japan return to the R.O.C. for treatment. However, this kind of fame is not what the medical field desires. How to mobilize the entire nation to eliminate the public enemy of hepatitis B and then to lower the rate at which liver cancer occurs to match that in the advanced nations is the major task at present.

A Comparison of Changing Trends in Age-Adjusted Mortality Rates in Cancer of the Liver

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CANCER OF THE LIVER RATE PER 100,000

A Comparison of the Age-Adjusted Mortality Rate of Liver Cancer Throughout the World (1979-1981) [Picture]

A Comparison of Death Rates Between Chinese People and Locals Due to Cancer of the Liver (1982-84) [Picture]

[Picture Caption]

If the next generation of Chinese people is to get out from under the overshadowing cloud of liver cancer, all newborns should be vaccinated. Eradicating hepatitis B is the most important goal at present.

Hepatitis B and cancer of the liver are noticeably high in areas where there is a high concentration of Chinese people. What are the factors which cause this? Up until now there aren't any clear-cut answers to offer.(photo by Arthur Cheng)

Alcohol may be enticing, but knowing its harmful effect on the liver, you should cut down on your intake. (photo by Arthur Cheng)

Chungming Chang, Professor and Director of the Graduate Institute of Microbiology and Immunology at National Yang-Ming Medical College, is working with others abroad and has successfully recreated the hepatitis B virus which has been most helpful in basic research. (photo courtesy of Chungming Chang)

This instrument can automatically detect and record test results; it's been useful as the Veterans General Hospital screens large numbers of people for cancer of the liver.

Aflatoxin is one of the causes which lead to cancer of the liver. Eating soybeans, pickles, peanuts, and gluten will increase your risks. (photo by Wei C. Wang)

Hepatitis B and cancer of the liver are noticeably high in areas where there is a high concentration of Chinese people. What are the factors which cause this? Up until now there aren't any clear-cut answers to offer.（photo by Arthur Cheng）

Alcohol may be enticing, but knowing its harmful effect on the liver, you should cut down on your intake. （photo by Arthur Cheng）

Chungming Chang, Professor and Director of the Graduate Institute of Microbiology and Immunology at National Yang-Ming Medical College, is working with others abroad and has successfully recreated the hepatitis B virus which has been most helpful in basic research. （photo courtesy of Chungming Chang）

This instrument can automatically detect and record test results; it's been useful as the Veterans General Hospital screens large numbers of people for cancer of the liver.

Aflatoxin is one of the causes which lead to cancer of the liver. Eating soybeans, pickles, peanuts, and gluten will increase your risks. （photo by Wei C. Wang）