Case history: liver cancer

Hanson Yip was an energetic young man with a heart for helping others. But while studying for a university degree in social work, the 26-year-old Yip (whose full has been withheld for reasons of patient confidentiality) started feeling twinges of pain in his upper abdomen.

Initially he tried to ignore it, but the pain persisted for weeks. Uneasy, he went to his family doctor, who found that he had an enlarged liver, which was highly unusual for a man of his age. He was referred to a specialist, where a CT (computed tomography) scan showed he had a tumour the size of an orange lodged in his liver. Blood tests showed that Yip's levels for a cancer marker called alpha-fetoprotein (AFP) was off the charts. Normal levels should hover around 10 ng/ml (nanograms per millilitre), but Yip's reading was 120,000 ng/ml.

The CT scan and blood test indicated he had a very aggressive primary liver cancer, also known as hepatoma or hepatocellular carcinoma (HCC). A PET (positron emission tomography) scan to measure metabolic activity confirmed that the tumour in the left lobe of his liver was malignant.

The diagnosis was shocking. Although Yip tested positive for hepatitis B, which carries a risk for liver cancer, it was unusual for the disease to strike someone so young. Furthermore, there was no history of liver cancer in his family.

Liver cancer is the third biggest killer among cancers in Hong Kong. Its obscure symptoms thwart early detection of the disease.

Yip's best hope for a cure at the time was surgery and he was operated on at Hong Kong Sanatorium and Hospital in September 2011.