In 7/2024, Mrs. Ngoc underwent an examination at Tam Anh General Hospital, TP HCM. Tests revealed a high alpha-fetoprotein (AFP) level of 435,3 ng/mL, indicative of hepatocellular carcinoma (HCC). An abdominal magnetic resonance imaging (MRI) scan detected a tumor measuring 15x22 mm in her right liver. Doctor Huynh Van Trung, Deputy Head of the Department of Gastroenterology, Endoscopy and Gastrointestinal Endoscopic Surgery Center, diagnosed Mrs. Ngoc with early-stage cancer, with no extrahepatic metastasis or portal vein thrombosis.

Doctor Trung explained that metabolic-associated fatty liver disease (non-alcoholic) is an increasingly common condition. It often affects individuals with: obesity, type 2 diabetes, dyslipidemia, and insulin resistance. Excessive fat accumulation in the liver leads to fatty acid oxidation, which generates free radicals. These free radicals damage DNA, initiating chronic inflammation and liver fibrosis. For those with obesity and diabetes, insulin resistance accelerates the growth of malignant cells. This can result in liver cancer even without prior cirrhosis, as observed in Mrs. Ngoc.

Doctor Trung examining Mrs. Ngoc during a follow-up visit. *Photo: Tam Anh General Hospital*

Mrs. Ngoc received minimally invasive transarterial chemoembolization (TACE). This method effectively destroys tumors while preserving healthy liver tissue and function. Guided by a digital subtraction angiography (DSA) system, doctors accessed the artery feeding the tumor. They then injected embolizing agents combined with chemotherapy drugs, cutting off the tumor's blood supply.

Following the intervention, Mrs. Ngoc recovered well, eating and living normally.

Following liver cancer treatment, doctors advised Mrs. Ngoc to strictly manage underlying health issues such as: blood pressure, blood sugar, and blood lipids. They also recommended maintaining physical activity to reduce her weight by 5-10%, particularly abdominal fat. Doctors emphasized that while the treated tumor might be stable, uncontrolled fatty liver and metabolic disorders still pose a risk for new tumors in other parts of the liver. Her follow-up health check in 2/2026 showed no unusual signs.

The Ministry of Health estimates that nearly 30 million Vietnamese people have fatty liver disease, and 30-35% of these are at risk of developing cirrhosis. To prevent and slow disease progression, it is recommended to maintain a body mass index (BMI) between 18,5-22,9. Additionally, individuals should limit: alcohol, refined carbohydrates, animal fats, and fructose. Increasing intake of green vegetables and beneficial fats, like omega-3 found in fatty fish, olive oil, and nuts, is advised. Engaging in at least 30 minutes of moderate physical activity daily also improves metabolism and reduces liver fat.

Bao Tram

*Patient's name has been changed*