18/08/2025

MONDAY | AUG 18, 2025

26

HEALTH

Malaysia’s silent liver cancer crisis W ITH hepatitis B still endemic in Malaysia and over 21.3% of the population classified as o 74% of cases classified as stage IV, bringing attention to urgent need for greater awareness, earlier intervention

not competing methods. Neither is considered better than the other. They each play a role and work together to achieve the best outcome for patients. Treatments are guided by a personalised approach, with an emphasis on tailoring care to each patient and adopting precision medicine whenever possible. Follow-up care after surgery Even after successful treatment, patients with underlying conditions such as chronic viral hepatitis, liver fibrosis or cirrhosis, remain at lifelong risk. While treatment can halt progression, continued surveillance is critical to detect recurrence early. Equally important is the patient’s role in maintaining liver health. Follow-up care goes beyond medical appointments, with patients strongly advised to adopt healthier lifestyle habits, including consuming a balanced diet, avoiding alcohol and smoking, and unregulated traditional medicine, all of which play a critical role in supporting long-term liver health and recovery. Empowering patients with the knowledge and tools to take charge of their liver health will be just as critical as medical treatment in shaping long-term outcomes. The evolution of liver cancer treatment, from open surgery to minimally invasive techniques and targeted ablation therapies, marks a significant step forward in patient care. These advancements not only expand curative options for previously inoperable cases but also prioritise safety, recovery and quality of life. As expertise deepens and access to cutting-edge treatments grows across Malaysia, patients now stand a better chance at long-term survival, especially when medical innovation is paired with continued surveillance and proactive lifestyle changes. This article is contributed by Sunway Medical Centre Velocity consultant general, hepatobiliary pancreatic and liver surgeon Dr Johann Faizal Khan.

obese, both key causes of metabolic dysfunction-associated fatty liver disease are making more Malaysians at risk of getting liver cancer. Yet, many cases go undetected until the disease is in its late stages. One of the biggest barriers to improving liver cancer outcomes lies in the absence of effective public screening programmes. While high-risk individuals such as those with liver cirrhosis (long-term liver damage that causes scarring and poor liver function) and chronic viral hepatitis are screened, patients who appear relatively healthy may not even realise they have either of these diseases. This issue is not unique to Malaysia, but reflects a global trend, with healthcare institutions now dealing with the long-term effects of undiagnosed or untreated chronic liver conditions. particularly hepatocellular carcinoma, remains one of the leading causes of premature death in Malaysia. It is the eighth-most common cancer in the country, yet it has the second-lowest five-year survival rate among major cancers at just 12.8%, according to the Health Ministry. Alarmingly, 74% of liver cancer cases in Malaysia are classified as Stage IV, where treatment options are limited and outcomes are significantly poorer. However, the absence of early symptoms should not be mistaken as an assurance of good health. Many individuals who do not drink alcohol or engage with what are typically considered as “high-risk” behaviours assume that they are not at risk. In reality, liver cancer can develop silently, without any warning signs. Regular health screenings should be conducted, regardless of one’s perceived health status, as early detection remains the most effective way to improve outcomes. Understanding liver cancer Liver cancer,

Liver cancer is the eighth-most common cancer in Malaysia.

Treatment options to address liver cancer While the outlook may seem daunting, there are a range of effective treatment options available even for patients with more advanced cases. Minimally invasive procedures, such as ablation therapies offer a viable alternative to open surgery by reducing surgical trauma, blood loss and recovery time. Among these is the NanoKnife surgery, which uses electrical pulses to target and break down cancer cells

without damaging the surrounding healthy tissue. This technique is particularly beneficial for patients with compromised liver function or tumours near vital structures. This treatment method may also serve as a bridging treatment for patients awaiting liver transplant or as an option in cases of recurrence, where repeated surgery may risk damaging healthy liver tissue. However, not all tumours are suitable for minimally invasive approaches. Larger tumours or those

requiring complex reconstructions may still necessitate traditional open surgery, especially when complete resection is the goal. In such cases, a partial hepatectomy may be performed to surgically remove the cancerous portion of the liver, allowing the liver to regenerate post surgery. For patients with more extensive liver damage, a liver transplant may be required, involving the replacement of the entire diseased liver with a healthy donor organ. While each approach carries its own set of risks, they are

HoSZA team performs first-ever successful choriocarcinoma surgery

Using AI tools can ‘deskill’ health workers, study finds USING artificial intelligence (AI) regularly can potentially “deskill” health workers, a new study suggests, reported PA Media/dpa. Academics said the finding is “concerning” given the rapid uptake of AI across healthcare. The new study looked at health workers who perform a test to look for early signs of bowel cancer. colonoscopies without AI by analysing work conducted in Poland. The research team analysed 1,442 colonoscopies conducted by experienced health workers before and after AI systems were rolled out at certain centres in 2021. the impact of AI on health professionals’ skills across different medical fields. We need to find out which factors may cause or contribute to problems when healthcare professionals and AI systems do not work well together, and to develop ways to fix or improve these interactions.” In a linked editorial, Omer Ahmad, a consultant gastroenterologist and

better chance of a quicker recovery and reduced risk of complications. The patient can return to normal life with improved quality of living, even in complex and challenging cancer cases,” he said in a Facebook post recently. He said this success is proof that public hospitals in Malaysia are capable of offering world-class, high-tech treatments through skilled and highly competent specialists for the well-being and health of Malaysians. Choriocarcinoma is a cancer that occurs when placental cells grow abnormally in the uterus. It can develop after a miscarriage or termination of pregnancy. – Bernama

THE gynae-oncology team of the Obstetrics and Gynaecology Department at Sultan Zainal Abidin Hospital, Terengganu, has achieved its maiden success in performing a “total laparoscopic hysterectomy with bilateral salpingo oophorectomy” on a patient diagnosed with choriocarcinoma. Health Minister Datuk Seri Dr Dzulkefly Ahmad said the complex surgery was led by gynae-oncology specialist Dr Alik Riasadesa Zakaria, together with O&G Department head Dr Ramli Ibrahim, and supported by the Anaesthesiology and Intensive Care Department, the medical team and nurses. “With minimally invasive surgical techniques, the patient now has a

Writing in the journal Lancet Gastroenterology and Hepatology , researchers reported that the rate of detection of polyps was 6% lower after the introduction of AI in standard and non-AI-assisted colonoscopies. “To our knowledge, this is the first study to suggest a negative impact of regular AI use on healthcare professionals’ ability to complete a patient-relevant task in medicine of any kind,“ said one of the study authors, Dr Marcin Romanczyk, Academy of Silesia in Poland. “Our results are concerning, given that the adoption of AI in medicine is rapidly spreading. We urgently need more research into

Endoscopists perform a test called a colonoscopy to look for precancerous growths in the bowel known as adenomas. This means these pre-cancerous growths can be detected and removed, preventing them from becoming bowel cancer. Advances in AI technology have led to the development of computer-assisted polyp detection systems, which have been found to help these health workers spot more adenomas. Researchers wanted to assess whether continuous use of AI led to a dip in performance when endoscopists perform

interventional endoscopist and clinical research fellow at University College London, wrote: “These findings temper the current enthusiasm for rapid adoption of AI-based technologies such as CADe and highlight the importance of carefully considering possible unintended clinical consequences. “The study provides the first real-world clinical evidence for the phenomenon of deskilling, potentially affecting patient-related outcomes.” – Bernama-PA Media/dpa