Coughing is the body's natural response to removing foreign objects, such as germs, viruses, dust, or irritating substances, from the respiratory tract. Even so, coughing also often indicates the presence of certain health problems, ranging from ARI, allergies, asthma, to lung cancer.
The throat and lungs normally produce little mucus or phlegm. This mucus is usually expelled through coughing and sneezing. Coughing that occurs occasionally and quickly subsides is generally still relatively normal, because it helps move phlegm which functions to keep the respiratory tract moist.
However, a cough that lasts for several weeks or even months should be watched out for because it could be a symptom of an illness that needs to be treated.
Handling for coughs needs to be done immediately, especially if the cough is accompanied by other symptoms, such as fever, shortness of breath, and phlegm that is greenish yellow or mixed with blood.
Please note that coughing can also be one of the symptoms of COVID-19. If you or your child has a cough, especially if accompanied by fever, headache, or loss of smell, immediately check with your doctor to confirm these conditions.
so you can be directed to the nearest COVID-19 test:
Antibody Rapid Test
Antigen Swab (Rapid Test Antigen)
PCR
Cough Symptoms and Causes
Coughs are generally accompanied by other symptoms, such as a runny or stuffy nose, sore throat, wheezing, shortness of breath, and heartburn. Based on the duration of occurrence, cough can last less than 3 weeks to more than 8 weeks.
Coughs can be caused by infections in the upper respiratory tract or lower respiratory tract. Coughs can also result from allergies or long-term illnesses, such as asthma, COPD, and chronic bronchitis.
Cough Treatment and Prevention
Apart from taking cough medicine, there are independent efforts that can be made to relieve coughing. Some of these ways are by getting enough rest, drinking lots of water, and consuming honey.
If the cough is caused by a bacterial infection, then consult a doctor regarding the use of antibiotics. Also consult a doctor if coughing is suspected due to stomach acid or gastroesophageal reflux disease (GERD).
The way to prevent coughing is to stop smoking, wash your hands frequently, not make contact with people who are sick, use a mask when you are sick, and eat a complete and balanced nutritious diet.
In addition, getting flu and pneumonia vaccinations can prevent respiratory infections that can cause coughing.
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Liver cancer can not always be prevented. However, the following ways can be done to reduce the risk of developing liver cancer:
Get hepatitis B vaccination
Avoid consuming alcoholic beverages
Do not smoke
Use standard personal protective equipment when working in an environment with a risk of exposure to chemicals
Have healthy and safe sexual intercourse
Avoid using NAPZA
Maintain ideal body weight
Wash hands with soap and water regularly
Wash vegetables and fruits thoroughly before processing them
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Liver cancer can cause complications in the form of a cancerous lump pressing on other organs, increased levels of hormones produced by cancer, and liver failure. Some of these complications are:
Spread of cancer to other organs, especially the bones and lungs
Bleeding, such as nosebleeds or gums that bleed easily
Bile duct blockage
Inflammation of the lining of the abdominal cavity (peritonitis) due to ascites
Portal hypertension, namely increased pressure in the arteries of the liver
Rupture of esophageal varices
Hepatorenal syndrome, which is kidney disease due to damage to the liver
Hepatic encephalopathy, which is brain disease resulting from damage to the liver
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Liver cancer treatment depends on the stage of the cancer, the patient's age, and the patient's overall condition. Some of the methods commonly used are:
Operation
Surgery is performed if there is only one cancer in the liver, liver function is still good, and the cancer has not spread to other organs. One type of surgery to treat liver cancer is the removal of the cancerous part of the liver.
Another surgical option is liver transplantation, which involves removing the patient's entire liver and replacing it with a donor's liver. Liver transplant is done if the location of the cancer is in a position that is difficult to remove.
Ablation
Ablation is an action to destroy the cancer without having to remove it. This method is used for small cancers, or for patients who cannot undergo surgical removal or liver transplantation.
There are several types of ablation, namely:
Radiofrequency ablation (RFA), which uses high-energy sound waves
Microwave ablation (MWA), using electromagnetic waves
Cryoablation or cryotherapy, using liquid nitrogen
Ethanol ablation or percutaneous ethanol injection (PEI), by injecting ethanol directly into the tumor to destroy cancer cells
Embolization
Embolization is an injection of drugs to block or reduce blood flow to cancer cells in the liver. This procedure is performed on cancers that are more than 5 cm in size with good liver function.
Chemotherapy
Chemotherapy is the administration of drugs to kill cancer cells. This procedure is used for liver cancer that cannot be removed surgically, and for liver cancer that cannot be treated with ablation, embolization, or targeted therapy.
Chemotherapy drugs can be given as a single drug or in combination. Common types of drugs used include:
Capecitabine
Cisplatin
Gemcitabine
Doxorubicin
Chemoembolization
Chemoembolization or trans arterial chemoembolisation (TACE) is a therapy that combines embolization with chemotherapy. TACE is done by injecting drugs into the cancer area and blocking blood flow to cancer cells in the liver.
Chemoembolization is performed in patients who cannot undergo surgical procedures and in patients who are waiting for a liver donor. Chemoembolization may also be performed to shrink the tumor so that it can be removed surgically.
Target therapy
Target therapy is the administration of drugs in tablet form that specifically target proteins in cancer cells so that cancer growth is inhibited. This therapy can be done in advanced liver cancer. However, not all liver cancers can respond well to this therapy.
Drugs commonly used in targeted therapy are protein kinase inhibitors, such as sorafenib and regorafenib; and monoclonal antibodies, such as bevacizumab and ramucirumab.
Immunotherapy
Immunotherapy is the administration of drugs that stimulate the immune system to kill cancer cells. This method is usually used in advanced liver cancer.
Types of drugs used in immunotherapy include:
Atezolizumab
Ipilimumab
Nivolumab
Pembrolizumab
Radiotherapy
Radiotherapy or radiation therapy aims to kill cancer cells using high-energy radiation. One type of radiotherapy to treat liver cancer is external radiotherapy, namely by directing a beam of radiation to the patient's body.
Another method of radiotherapy is stereotactic body radiotherapy. This procedure is performed by shooting radiation beams into tumor cells in a focused manner so that they do not hit the surrounding healthy tissue.
Radioembolization
Radioembolization is done by inserting small balls called microspheres into the blood vessels that supply blood to the liver.
The microsphere containing the radiotherapy substance will then enter into the small blood vessels around and inside the cancer. The radiation released by the microsphere will destroy liver cancer cells.
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To diagnose liver cancer, the doctor will ask about the patient's symptoms and medical history. The doctor will also ask whether the patient has a habit of smoking or consuming alcoholic beverages.
After that, the doctor will carry out a complete physical examination, including feeling and pressing the right side of the patient's abdomen to detect whether there is an enlarged liver.
If the patient is suspected of having liver cancer, the doctor will carry out supporting examinations to confirm the diagnosis, including:
Blood tests, to check liver function, measure alpha-fetoprotein levels, and find out the patient's overall health condition
Scanning with ultrasound, CT scan, or MRI, to determine the location of the cancer in the liver and detect the spread of cancer to other organs
Liver biopsy, to find out the specific type of liver cancer by examining a sample of liver tissue
Laparoscopy, to examine the condition in the stomach with a camera tube if the previous examination was not enough to determine the diagnosis
Liver Cancer Stage
Based on the results of the examination above, the doctor will determine the stage of liver cancer the patient is suffering from. This determination will also determine the right type of treatment for the patient.
The following are the stages of liver cancer:
Stage 0
Stage 0 or early stage indicates that there is 1 tumor measuring less than 2 cm in the liver. At this stage, usually the liver can still function normally.
Stage A
Stage A indicates that in the patient's liver there is 1 tumor with a size that can vary or there are 2-3 tumors with a size of less than 3 cm. Liver function is still fairly normal or only experiencing mild-moderate disturbances and the patient does not feel sick.
Stage B
In stage B, there are several large tumors in the liver. Even so, liver function has not been disturbed. It can also be disturbed with mild-moderate degrees, but the patient's condition is generally good.
Stage C
Cancer has spread to blood vessels, lymph nodes, or other organs. The patient's physical condition begins to decline, while liver function may still be good or even experience mild-moderate disturbances.
Stage D
Stage D indicates that the cancer has spread to other organs, such as the bones and lungs. At this stage, the liver is already badly damaged and the patient's condition has deteriorated.
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Generally, symptoms of liver cancer will only appear when the cancer has entered an advanced stage. However, in some cases, symptoms may appear earlier.
Some complaints to watch out for because they can be signs and symptoms of liver cancer are:
Loss of appetite
Easily full even if you only eat a little
Nausea and vomiting
Vomiting blood
Bloated
Weight loss drastically
The body gets tired and weak
Itchy rash
Accumulation of fluid in the abdomen (ascites), which is characterized by an enlarged or swollen abdomen
Yellowing of the skin and whites of the eyes
Dark urine
Stools are gray or white like putty
The body bruises and bleeds easily
Pain in the upper right abdomen or near the right shoulder blade
Other symptoms of liver cancer that can appear, such as:
Enlarged breasts in men (gynecomastia)
Small testicles
Weak muscles
Redness of the skin, including the face
When to See a Doctor
Check with your doctor if you notice any of the above symptoms, especially if the symptoms are interfering with your daily activities.
For groups of people who are at risk of developing liver cancer, do liver cancer screening every 6-12 months. Liver cancer screening can be done with an abdominal ultrasound and blood tests to measure the levels of a protein in the blood called alpha-fetoprotein (AFP).
Liver cancer screening aims to detect the disease as early as possible. That way, treatment can be done immediately so that the patient's chances of recovery are also higher.
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Causes of Cancer
Liver cancer occurs when cells in the liver undergo changes (mutations) so that these cells grow abnormally and form tumors.
It is not yet known what causes the liver cells to mutate. However, several conditions can support the occurrence of these mutations. That is, people with these conditions will be more at risk of developing liver cancer:
Prolonged hepatitis B or hepatitis C infection
Cirrhosis or scar tissue that forms in the liver
Fatty liver disease
Excessive consumption of alcoholic beverages
Smoking habit
Overweight or obesity
Liver diseases inherited from parents, such as hemochromatosis and Wilson's disease
Weak immune system, for example as a result of suffering from HIV/AIDS or having recently undergone an organ transplant
Have had gallstones or had gallbladder removal surgery (cholecystectomy)
Long-term (chronic) heartworm infection
Certain conditions, such as diabetes or lupus
Exposure to aflatoxins, which are toxins from molds that grow on beans, wheat, soybeans, corn or rice that are not stored properly
Exposure to chemicals, such as arsenic, vinyl chloride, and trichlorethylene
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