Chapter 183 - 167: Diagnosed with Early-Stage Liver Cancer Just Like That?

Chapter 183: Chapter 167: Diagnosed with Early-Stage Liver Cancer Just Like That?

Soon, it was lunchtime.

Cao Dongge saw that there was only one follow-up appointment left for the morning. Just then, Dr. Cao received a phone call.

Besides his clinic hours, Cao Dongge spent most of his time in the operating room. He was the subordinate Director Shen Xiaofei trusted most, as well as his go-to assistant.

Seeing the call was from Director Shen Xiaofei, Dr. Cao answered immediately.

He glanced at the time; there was just one follow-up patient left.

"Dr. Wu, could you keep an eye on things for a moment? I need to take a call. When the patient for follow-up number 23 arrives, you can take a look at her test results first. Don’t say too much, just tell her to wait for a call from me. I’ll be quick."

Physician Cao took his phone and stepped behind the curtain in the consultation room to take the call.

A few moments later, a woman in her thirties walked in.

Sheng Ping was thirty-two years old and worked as a manager in an engineering company’s project department. She had previously eaten a meal with some construction workers on-site. The cafeteria was a repurposed shipping container, and the sanitary conditions were quite poor.

She had been too busy that day. Sheng Ping had just come from the site after being chewed out by the client. With more things to arrange in the afternoon, she decided not to leave. She made do with a meal on-site, where the bowls and chopsticks were for public use. As luck would have it, she was unlucky.

The set of utensils Sheng Ping grabbed hadn’t been washed thoroughly.

After that meal, Sheng Ping was infected with the hepatitis B virus. She didn’t notice at first, only discovering the problem nine months later during a routine physical.

But by then, it was too late. It had already developed into chronic hepatitis B. She was taking medication to control it, but her liver function was progressively worsening.

Sheng Ping had regular check-ups, but for a condition like chronic hepatitis B, without any specific signs of malignancy, the treatment was just routine medication.

This time, besides coming for her hepatitis B follow-up, Sheng Ping had also been to the emergency department.

She’d had another stroke of bad luck on a construction site. While inspecting a structure, there was an accident. A large aluminum plate fell from above like a giant guillotine, slicing open the back of her hand and damaging a tendon.

So, in addition to her routine hepatitis B check-up at the Hepatobiliary Surgery Department, she also needed to be admitted for a minor surgery on her left hand.

Sheng Ping felt that things had been rough lately. The construction industry was in a slump, collecting project payments was difficult, and now she had to deal with this. Her mood had been terrible, and her physical condition wasn’t great either.

She planned to use this surgery as a good excuse to get some rest.

Carrying the test results from the Hepatobiliary Surgery Department and the Hand Surgery Department, Sheng Ping walked into the consultation room.

Seeing the young Wu Ting, Sheng Ping frowned.

"Um... where is Dr. Cao?"

Sheng Ping had seen Wu Ting before, standing to the side and listening to Dr. Cao’s diagnoses, so she knew he was just a junior doctor observing the consultations.

"Dr. Cao is taking a call inside. It will just be a few minutes, he’ll be quick. How about this, you give me your test results first, and I’ll take a look. Just wait a moment, and Physician Cao will see you when he’s done."

Sheng Ping had finished her business here and still needed to go to the Hand Surgery Department to handle her admission, so she wasn’t in a rush.

Using her one good hand, she placed the whole stack of papers on the desk.

Wu Ting began to look them over. In the Hepatobiliary Surgery Department, the patient had undergone a routine liver biochemistry panel, mainly checking her serum alanine aminotransferase, aspartate aminotransferase, bilirubin, and albumin.

Thanks to the textbooks and literature recommended by Director Fu, Wu Ting was quite knowledgeable about hepatitis B.

A quick glance revealed that the patient’s liver had sustained some damage; her hepatocellular injury markers were more than twice the normal value.

Of course, based on a routine examination, all one could see was liver damage caused by hepatitis B, and that her hepatitis was not in good shape. Nothing else stood out.

Normally, Wu Ting would have just waited for Physician Cao to return before making any recommendations.

However, the patient also had a tendon injury, and in this area, Wu Ting was at the Grandmaster Level.

So, he picked up those results and started examining them.

Sheng Ping noticed and said, a little sheepishly:

"Doctor, those are from the Hand Surgery Department. My hand is injured, and I need an operation... Those aren’t for hepatobiliary surgery..."

Wu Ting smiled faintly. "I know. I used to be in emergency surgery, and I’ve done quite a few tendon suture operations..."

When it came to his area of expertise, Wu Ting was naturally calm and composed. Hearing him say this, regardless of whether it was true or if the young doctor was just showing off, Sheng Ping decided to listen to another doctor’s opinion.

Wu Ting looked at the results and then offered his thoughts.

He also proposed a few treatment options.

Listening to Wu Ting’s analysis, Sheng Ping was clearly surprised.

"Yes, yes. That’s exactly what the director of hand surgery said. The surgical plan and precautions he mentioned are identical to what you just said."

Sheng Ping was taken aback. This young doctor had come up with the exact same plan as the hand surgery expert just by looking at a few papers.

That hand surgery expert was the chief director of his department, a famous professor in Jin Province, and she’d had a hard time getting an appointment with him.

After finishing, Wu Ting also noticed Sheng Ping’s four-item coagulation test results.

Generally, patients undergo a comprehensive examination before surgery, and this coagulation panel was mandatory.

After all, if a patient’s coagulation function was abnormal, surgery could not be performed.

Looking at Sheng Ping’s coagulation results, Wu Ting noticed something was off.

The coagulation markers were sufficient for her to undergo surgery, but several of the indicators coincided with the P3 Chronic Hepatitis B-related Primary Liver Cancer Early Diagnosis Skill he was developing.

An ordinary doctor certainly wouldn’t pay attention to these things.

But Wu Ting was different. Seeing these indicators, he quickly reached a very grim conclusion.

If he ruled out other potential causes for the patient’s abnormal coagulation and combined it with her chronic hepatitis B and significant liver cell damage, he could almost certainly conclude that the patient had early-stage hepatitis B-related primary liver cancer!

Of course, this diagnostic technique was just for reference; the patient’s condition could be due to other reasons.

However, anyone who did have early-stage hepatitis B-related primary liver cancer would definitely present with these coagulation markers.

Just then, Physician Cao finished his call and walked over.

But before Physician Cao could even look at the reports, Wu Ting looked at Sheng Ping with a grave expression and told her in a heavy tone:

"Ms. Sheng, based on your liver biochemistry panel and these pre-operative coagulation markers, I suspect you may have the early symptoms of hepatitis B-related primary liver cancer."

"Of course, this is not a good situation, but in a way, it’s also a good thing. If we can truly diagnose it now and perform an early surgical resection, there’s a high probability of a full recovery. However, if we miss this early diagnosis..."

"Chronic hepatitis B-related primary liver cancer progresses very rapidly. Once you miss this window and it enters the middle or late stages, the prognosis becomes very grim..."

To ensure the patient took this seriously, Wu Ting intentionally adopted this posture.

Dr. Cao, standing to the side, was a bit puzzled. He casually took Sheng Ping’s test reports, but a glance showed nothing more than ordinary chronic hepatitis B, just that her liver function had taken a bit of a hit recently. The standard procedure would be to increase her antiviral medication.

It was not yet at the point where traditional checks like liver cancer screenings and various imaging studies were necessary.

And, according to the patient’s regular check-up schedule, she could still wait a while.

As for the other coagulation test from the Hand Surgery Department being used to judge liver cancer... he’d never heard of such a thing, had he?

Physician Cao’s knowledge of early diagnosis for hepatitis B-related liver cancer was solid. The currently available methods were basically ultrasound, CT, MRI, and so on, but such screenings were not recommended unless absolutely necessary.

Based on the current test results, Dr. Cao would never have thought to order a further screening for hepatitis B-related primary liver cancer.

However, now that Wu Ting had so earnestly explained it to the patient, it wouldn’t be right for Physician Cao to contradict him.

Physician Cao knew a bit about Wu Ting; he likely wouldn’t speak without reason.

Besides, for a patient with chronic hepatitis B, suggesting a screening for primary liver cancer was justifiable.

Of course, this was just a recommendation; the final decision was up to the patient.

Physician Cao decided to see how the patient would react. If she was resistant, he would just go with the flow, write a prescription, and suggest she add the screening to her next regular check-up.

Sheng Ping normally wouldn’t have trusted the judgment of a young doctor. Besides, she had looked up her own liver biochemistry markers on Baidu before. It was just chronic hepatitis B.

But, just moments ago, based on a few papers, Wu Ting had proposed the exact same surgical plan as a renowned hand surgery expert from the province, especially regarding the details of the tendon repair, which were identical to what the expert had said.

Therefore, Sheng Ping was inclined to trust Wu Ting. After all, if it could be diagnosed early, it would be a blessing in disguise.

Lately, Sheng Ping had read up on the situations of many hepatitis B patients. Most of them ran into trouble because they missed the optimal window for diagnosis.

"Doctor, what should I do then? What tests do I need?"

Wu Ting thought for a moment.

"How about this: this afternoon, go directly to the Hepatic Tumor Surgery department and find Director Fu. I’ll contact him in a bit and have him arrange for someone to give you a detailed ultrasound screening, as well as an enhanced CT and an MRI!"

"And get a serum alpha-fetoprotein test..."

Wu Ting considered it. Given the patient’s current condition, the clues were only visible through his highly sensitive P3 Chronic Hepatitis B-related Primary Liver Cancer Early Diagnosis Skill.

A single conventional method would have a hard time detecting it. Only with a combination of several tests, plus a serum alpha-fetoprotein test, he believed that a professional of Director Fu’s caliber would be able to identify this early-stage hepatitis B-related primary liver cancer!

Listening to Wu Ting’s thorough and detailed arrangements, Physician Cao, standing by his side, was impressed and a little mystified.

’Could he really diagnose early-stage primary liver cancer just from a routine liver panel and coagulation factors?’

Physician Cao was well aware that this kind of early diagnosis was extremely difficult, and very few physicians could spot it at the first opportunity.

Of course, the most important thing was that current traditional diagnostic methods had very low sensitivity. By the time one suspected early-stage liver cancer and thought to get it checked and confirmed, it was usually already in the middle or late stages.

Many early-stage liver cancers were discovered due to other, coincidental factors.

Therefore, if Wu Ting could refine such a simple new screening method, it would cause a huge sensation.

Physician Cao’s expression remained unchanged, but inside, his mind was reeling. He, too, was eager to see the results from Director Fu’s department that afternoon.

’This Dr. Wu... he’s truly full of surprises.’