We diagnosed a 14 cm liver cancer in a normal liver in a 23 year old yesterday. Does not drink, does not smoke, no metabolic diseases, goes to the gym, is very fit.
He had zero symptoms. He had sustained a knee ligament injury during a football play and was planned for surgery. As a routine, because the patient said he had "gas trouble" from time to time, the anaesthetist asked for an abdominal screening and found a large mass in the liver and advised him to meet us.
The whole family and his friends are shattered. But not to worry about that part, because, he has a healthy liver because of which he can undergo a surgery known as extended-right-hepatectomy where the whole tumour along with some healthy liver tissue will be removed and the rest of the liver will grow back to full adult size in 4 weeks.
The reason for such massive liver cancers happening in young men and women is something known as OBI - or occult hepatitis B virus infection. OBI means the hepatitis B virus (HBV) is hiding.
This is a tricky situation.
And you must all know about it.
Occult Hepatitis B (HBV) infection (OBI) means someone has the hepatitis B virus in their liver (and sometimes in their blood), but a standard blood test doesn't detect a specific protein called HBsAg, which is usually a sign of active HBV infection. Even though the infection is hidden, a person with OBI can still transmit the virus to others through blood transfusions or organ transplants.
So HBsAg (the test to detect hepatitis B) is non-reactive (or negative), but virus DNA will be inside the liver and sometimes in low levels in the blood.
How to diagnose this?
Taking a bit of liver and running high‑powered DNA tests is the gold standard. But liver biopsies are invasive, not routine, and the test itself isn’t standardized worldwide.
So when you are checking for your hepatitis B status with HBsAg, switch to the latest highly sensitive kits and almost half of the previous “negatives” can flip to positive (off‑the‑shelf HBsAg kits detect down to 0.05 IU/mL only, so use the latest 0.005 IU/mL kit)
Modern kits also use multiple antibody probes to catch “S‑escape” mutant hepatitis B viruses that dodge older tests.
Apart from HBsAg, also look for anti-HBc (or antibody to hepatitis B viruses' core protein). If this is positive, it means one has to dig deeper and look into DNA levels also.
You can prevent hepatitis B and related terrifying complications including liver cancer by taking the vaccine. It is safe, effective and highly beneficial.
HBsAg - non reactive persons should check for anti-HBs (which is the antibody to surface protein of the virus, which shows protection). If anti-HBs is also negative (<10), then go for full 3 dose vaccine. If anti-HBs is >10 but <100 then take a booster dose only. In case the anti-HBc (like we discussed above) is also positive, then check DNA levels using high-sensitive PCR test to look for hidden hepatitis B virus infection.
For this young man, we will probe for hepatitis B virus inside his liver tissue and the cancer tissue once we remove it from him.
PS: picture for representation only. Not the patient's.
Drink more water if you want a healthier mouth.
Water rinses away food particles and neutralizes acids that can damage your enamel and cause cavities on your teeth.
So, instead of ‘washing down’ your food with a bottle of soda, drink water instead. It’s simple and cheap.👍🏾
@garyalsmith "26 minutes of action in a season-long loan spell". So much for a spell. Hope he's able to use whatever he learned to push his career further.
9.87s!!🔥
Abdul-Rasheed Saminu (USF) 🇬🇭 has just run a blazing 9.87s to win the men's 100m at the Florida Relays!
The wind was just over the legal limit at 2.2m/s.
Neo Mosebi (FSU) 🇿🇦 was 2nd in 10.03s.
@DAZNBoxing It's becoming sad watching Joyce's slide. Perhaps extra credit to Hrgovic though, given he was a late replacement. Entertaining fight? Maybe.. but the Juggernaut is barely crushing anything lately
@G__Chain I remember watching this live in Ghana. Ike was tough, but that last round rally by Oscar derailed his efforts. An all-time classic. In an interview many years later, Oscar said Ike's punches "were like bricks". Prime de la Hoya was a beast.