23. Do HBV carriers need monitoring?
So what should every hepatitis B carrier need
to do for monitoring? What I recommend is you screen for liver damage
every six months with a simple ALT or SGPT. You need to screen for
liver cancer. If your doctor won’t ask for it, you ask him
for it. And if he doesn’t do it, switch, go and see another doctor.
You need an AFP blood test every six months, an ultrasound of the
liver once a year. And if you have family history, we
recommend twice a year screening with ultrasound, for those who have
family history of liver cancer and if you have cirrhosis. Because once you have a family history of
liver cancer and cirrhosis, your risk of developing cancer is much
higher than if you don’t have a positive family history of cirrhosis.
If the ultrasound is not satisfactory,
(some people when you do an ultrasound it is difficult to interpret
because you might have a fatty liver or a very fibrotic liver), the
ultrasound will look like a piece of swiss cheese. You don’t know which hole has cancer. Then
in those cases you need to do a triphasic CT scan of the abdomen. You
cannot just do one test alone because you can miss the cancer. AFP
will only pick up about forty to fifty percent of the liver cancers.
22. How does early detection play a role in liver cancer survival?
24. Can regular screening lead to early detection?