Malaysia Faces Silent Liver Cancer Crisis, 74 Pct Of Cases Detected At Stage Four

KUALA LUMPUR, July 25 (Bernama) -- With hepatitis B still endemic in Malaysia and over 21.3 per cent of the population classified as obese, both key causes of metabolic dysfunction-associated fatty liver disease (MAFLD) are making more Malaysians at risk of getting liver cancer.

Yet, many cases go undetected until the disease is in its late stages.

Consultant General, Hepatobiliary Pancreatic and Liver Surgeon at Sunway Medical Centre Velocity (SMCV) Dr Johann Faizal Khan shared that one of the biggest barriers to improving liver cancer outcomes is the lack 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,” he said in a statement today.

Dr Johann noted that 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.

According to the Ministry of Health, liver cancer, especially hepatocellular carcinoma (HCC), remains one of the leading causes of premature death in Malaysia, is the eighth most common cancer in Malaysia, yet it has the second-lowest five-year survival rate among major cancers at just 12.8 per cent.

Alarmingly, 74 per cent of cases are diagnosed at the most advanced stage (stage four), where treatment options are limited and outcomes are significantly poorer.

 “The absence of early symptoms should not be mistaken for an assurance of good health. Many individuals who do not drink alcohol or engage in what are typically considered ‘high-risk’ behaviours assume that they are not at risk.

“In reality, liver cancer can develop silently, without any warning signs,” said Dr Johann, stressing the importance of regular health screenings regardless of perceived health status, as early detection remains the most effective way to improve outcomes.

While late detection remains a challenge, there is a range of innovative treatment options available to give renewed hope to 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 them is NanoKnife surgery, which uses electrical pulses to 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.

The treatment method may also serve as a bridging treatment for patients awaiting liver transplantation 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,” Dr Johann explained.

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, Dr Johann emphasised that they are not competing methods as treatments are guided by a personalised approach, with an emphasis on tailoring care to each patient and adopting precision medicine whenever possible.

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,” Dr Johann said.

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, the statement said.

-- BERNAMA

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