A 38-year-old physician, a hepatitis B carrier, diligently monitored his liver function through regular blood tests—and every result came back normal. Yet, he was diagnosed with terminal liver cancer, harbouring a 10-centimeter tumour. The fatal oversight? He never underwent an abdominal ultrasound. This tragic case, shared on a Taiwanese health programme, underscores a critical gap in routine liver screening that can mean the difference between early detection and death.
The doctor, identified as Liao Yongxiang, a physician at National Taiwan University Hospital, followed standard protocol for hepatitis B carriers. He had his alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels checked regularly. These numbers, often called “liver function indices,” were consistently within the normal range. But as intensive care specialist Dr. Huang Xuan explained on the show, a normal liver index does not rule out liver cancer or cirrhosis. In acute hepatitis flares or after the liver has reached end-stage failure, enzyme levels can actually decline. The result: a massive tumour that had grown silently for years, discovered only when it was too late to treat.
Liao fought the disease for seven years before succumbing—a battle that could have been avoided with a simple, non-invasive scan.
Why Blood Tests Alone Are Not Enough
Liver cancer is notoriously stealthy. The organ, located in the upper right abdomen and shielded by the rib cage, shows no early symptoms. Gastroenterologist Dr. Xiao Dunren described a patient who visited multiple clinics complaining of abdominal pain with no diagnosis. When Dr. Xiao examined him, the liver had swollen to the midline and was palpable—hard and irregular. Scans revealed bilateral 10-centimetre tumours. Surgery was the only option.
The key takeaway from these cases: blood tests measure liver enzyme activity, not tumour presence. Only imaging—specifically abdominal ultrasound—can detect masses, cysts, or lesions. For high-risk groups—hepatitis B or C carriers, those with fatty liver disease, or a family history of liver cancer—annual ultrasound is essential.
Skin Changes: Unexpected Warning Signs
Doctors also highlight three dermatological clues that may signal liver cancer:
- Jaundice (yellowing of skin and eyes)
- Spider angiomas (small, spider-like blood vessels on the skin)
- Pruritus (persistent, unexplained itching)
These symptoms occur when the liver fails to filter toxins or metabolise bilirubin properly. Anyone noticing such changes, especially with risk factors, should seek immediate evaluation.
Habits That Harm the Liver
The liver possesses remarkable regenerative capacity—it can regrow after losing two-thirds of its mass. However, its functional lifespan is about 60 years. After age 65, liver volume shrinks by roughly 30% compared to age 40, and blood flow decreases by 35%. Common behaviours that accelerate damage include:
- Excessive alcohol consumption – directly toxic to liver cells.
- Unhealthy diet high in processed foods, sugar, and saturated fats – leads to non-alcoholic fatty liver disease.
- Prolonged use of certain medications or supplements – especially paracetamol and herbal remedies with unknown hepatotoxicity.
- Chronic viral hepatitis – the leading cause of liver cancer in Asia.
A Call to Action
The medical community urges that for anyone with hepatitis B or C, or a family history of liver cancer, annual abdominal ultrasound is not optional—it is life-saving. Blood tests alone create a false sense of security. The tragedy of Dr. Liao Yongxiang is a stark reminder: what you don’t check can still kill you.
If you or a loved one falls into a high-risk category, speak to your doctor today about scheduling an ultrasound. Early detection of liver cancer can increase the five-year survival rate to over 70%, compared to less than 10% when diagnosed at a late stage. Don’t let a normal blood test be your only shield.