Liver cancer, the fourth most common cancer in Malaysia, is rapidly becoming a major public health concern. Recent statistics from the Global Cancer Observatory report that the disease is also the fourth leading cause of cancer-related deaths, with approximately 1,700 new cases reported in the country annually.
Health experts have raised alarms over the rising incidence of fatty liver disease, which is increasingly being linked to liver cancer. Non-Alcoholic Fatty Liver Disease (NAFLD) and its more recently identified counterpart, Metabolic Associated Fatty Liver Disease (MAFLD), are becoming silent epidemics, significantly contributing to the country’s liver cancer burden.
Dr. Johann Faizal Khan, Consultant Hepatobiliary, Pancreatic, and Liver Transplant Surgeon at Sunway Medical Centre Velocity (SMCV), explained that many Malaysians are unaware of their condition until it reaches more severe stages. He emphasized that NAFLD often goes undiagnosed, only being detected during routine medical imaging, such as ultrasound exams.
“If left unchecked, fatty liver disease can progress to cirrhosis, where the liver is severely damaged and replaced by scar tissue, greatly increasing the risk of developing liver cancer,” Dr. Johann said in an interview with Bernama.
While obesity and metabolic syndrome are key risk factors for MAFLD, which is now considered a significant epidemic, Dr. Johann warned that individuals with normal body weight are also susceptible. He noted that about a quarter of people with NAFLD fall into the “lean” category and are also at risk of developing type 2 diabetes.
Fatty liver disease occurs when excess fat accumulates in the liver, leading to inflammation and liver cell damage. Over time, this can cause fibrosis, which may eventually progress to cirrhosis and, in some cases, liver cancer. Symptoms of advanced liver cancer, such as jaundice, abdominal pain, and unexplained weight loss, typically appear when the disease is in its later stages, making early detection critical.
While chronic hepatitis B and C infections remain major contributors to liver cancer globally, Dr. Johann stressed that undiagnosed or untreated fatty liver disease is a significant driver of liver cancer rates in Malaysia. Liver cancer can be classified as either primary, originating in the liver, or secondary, when cancer spreads to the liver from other organs such as the colon or lungs.
Dr. Johann urged Malaysians to prioritize regular health screenings, including liver function tests, ultrasounds, and blood work, to identify fatty liver disease before it reaches a critical stage. He emphasized that early detection is crucial for improving survival outcomes.
“Treatment options for liver cancer have improved significantly, including surgery, chemotherapy, targeted therapy, and immunotherapy. However, once the cancer reaches an advanced stage, treatment becomes limited,” he said.
Encouragingly, Dr. Johann highlighted that fatty liver disease is reversible in its early stages. With proper dietary adjustments and regular exercise, the condition can be significantly improved within a matter of weeks or months.
As Malaysia faces an increasing burden of liver-related diseases, Dr. Johann urged the public to adopt healthier lifestyles to reduce the risk of fatty liver disease and liver cancer. He recommended a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, while minimizing the consumption of processed foods and sugary drinks.
Dr. Johann also advised that even moderate physical activity, such as walking or cycling, can significantly reduce the risk of developing fatty liver disease and its complications.
“Preventive healthcare is the key to tackling fatty liver disease and reducing the risk of liver cancer. By making healthier lifestyle choices and seeking regular medical check-ups, individuals can make a significant impact on their long-term health,” he concluded.
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