Consultant general, hepatobiliary pancreatic and liver transplant surgeon Dr Johann Faizal Khan warns that non-alcoholic fatty liver disease, as well as metabolic associated fatty liver disease (MAFLD), are fast becoming a silent epidemic, significantly elevating the risk of liver cancer among Malaysians.
MAFLD is basically fatty liver disease coupled with obesity and metabolic syndrome.
“Most people don’t realise they have fatty liver disease until they undergo an ultrasound assessment during a routine health screening or for other medical conditions that warrant an ultrasound,” he told Bernama recently.
“Left undetected, it can advance to more severe stages like cirrhosis – when the liver gets badly damaged over time and turns into scar tissue – which poses significant risk for developing liver cancer.”
Johann explained that fatty liver disease develops when excess fat accumulates in the liver. Over time, this leads to inflammation, cell damage, haphazard repair and scarring. At the end of the spectrum, there is a significant risk of developing liver cancer.
Research has shown that individuals with fatty liver disease face an increased risk of liver fibrosis, which eventually leads to cirrhosis and cancer. By the time symptoms such as jaundice, abdominal pain and weight loss appear, the cancer may be in its advanced stage.
While chronic viral hepatitis B and C infection remain significant causes of liver cancer globally, undiagnosed or untreated cases continue to drive cancer rates in Malaysia.
Liver cancer falls into two categories. Primary cancer originates in the liver owing to risk factors such as fatty liver disease, cirrhosis or hepatitis, while secondary cancer occurs when it spreads from other organs, such as the colon, lungs or pancreas, to the liver.
Johann stressed that early detection through regular health screenings, including liver function tests, MRI scans, blood tests, tissue sampling and ultrasound scans, is crucial.
“Medical advancements have improved treatment options. There is surgery, targeted therapy, chemotherapy and immunotherapy to improve patient outcomes,” he noted.
However, once liver cancer reaches an advanced stage, treatment options become limited. This underscores the importance of early intervention and proactive healthcare measures, he added.
Still, it’s not all doom and gloom: fatty liver in its early stages is reversible. By exercising and taking care of your diet, the condition can actually be reversed in as early as six weeks to a couple of months.
As Malaysia grapples with an increasing burden of liver-related diseases, Johann urges the public to take charge of their health through regular checkups, adhering to a balanced diet, and engaging in an active lifestyle.
Being young and overweight, especially below age 40, and having risk factors like a family history of heart disease, diabetes or high cholesterol are all the red flags for the development of cancer – and not just in the liver.
As such, Johann urges at-risk individuals to adopt a healthier lifestyle by increasing their intake of fruits, vegetables, whole grains and lean proteins, while cutting back on processed foods and sugary drinks.
Even moderate activities such as brisk walking or cycling can significantly lower the risk of fatty liver disease and its complications, he concluded.