A tragic case reveals that relying solely on blood work for liver health may lead to a fatal oversight—one that cost a 38-year-old doctor his life.
In a recent episode of Taiwan’s health program 57 Healthy Classmates, medical experts shared the heartbreaking story of Dr. Liao Yongxiang, a physician at National Taiwan University Hospital who was also a hepatitis B carrier. Despite undergoing regular blood tests that consistently showed normal liver enzyme levels, Dr. Liao was diagnosed with terminal liver cancer—a 10-centimeter tumor had silently taken root. He fought the disease for seven years before passing away. His case has ignited a crucial conversation about the limitations of routine liver function screening.
The Missing Step That Proved Fatal
Dr. Liao did everything right on paper: he tracked his liver enzymes, known as ALT and AST, through regular blood draws. The results came back normal every time. But according to intensive care specialist Dr. Huang Xuan, who appeared on the program, normal enzyme levels do not rule out cancer or cirrhosis.
“When the liver is in acute or chronic inflammation flare-ups, or when it has reached end-stage failure, enzyme levels often do not rise,” Dr. Huang explained. The critical oversight? Dr. Liao never had an abdominal ultrasound.
Without imaging, small tumors can remain invisible until they grow large enough to cause symptoms—or until it’s too late.
Why Blood Tests Alone Are Not Enough
Liver enzymes reflect inflammation and cell damage but cannot detect masses. A tumor can develop without disrupting enzyme production. This is especially dangerous for high-risk groups like hepatitis B carriers, who face a significantly elevated risk of hepatocellular carcinoma.
Gastroenterologist Dr. Xiao Dunren added that the liver sits protected by the rib cage in the upper right abdomen, making it impossible to feel during a physical exam when healthy. He recounted a patient who visited multiple clinics complaining of abdominal pain. Only when Dr. Xiao palpated the abdomen did he discover a liver enlarged to the midline—rock hard. An ultrasound later revealed 10-centimeter tumors on both lobes.
Recognizing the Warning Signs
Early liver cancer often presents no symptoms, but as the disease progresses, patients may experience:
- Unexplained weight loss
- Abdominal pain or swelling
- Jaundice (yellowing of skin or eyes)
- Fatigue and weakness
- Loss of appetite
Doctors also warn of three skin conditions that can signal liver trouble:
- Persistent itching without a rash
- Spider angiomas (small, spider-like blood vessels on the skin)
- Yellowish bumps (xanthelasma) around the eyes
Habits That Damage the Liver
The liver is remarkably resilient—it can regenerate even after losing one-third of its mass. However, its peak performance lasts about 60 years. By age 65, liver volume shrinks by 30% and blood flow drops by 35%. Common habits that accelerate damage include:
- Excessive alcohol consumption
- Poor diet high in processed foods and sugars
- Smoking
- Chronic stress and lack of sleep
Actionable Takeaways for Readers
- If you have hepatitis B or C, a family history of liver cancer, or are over 40, do not rely solely on blood tests.
- Ask your doctor for a liver ultrasound at least once a year if you’re in a high-risk group.
- Healthy liver diet: Incorporate leafy greens, coffee (in moderation), and avoid aflatoxins from moldy grains or nuts.
The tragedy of Dr. Liao underscores a vital lesson: screening for liver cancer requires a combined approach—blood work plus imaging. As medical experts continue to advocate for broader use of abdominal ultrasounds, the hope is that fewer families will face the same devastating outcome.
For more on liver health and cancer prevention, explore related articles on proper food storage and recognizing early symptoms.