Sunday December 12, 2010
This post is on Healthwise
Stand and de-liver
TO a large extent, liver cancer is a silent disease. And when signs and symptoms appear, it may be too late for doctors to offer any form of curative treatment for the cancer.That means, when you show up at your doctor’s office with symptoms like a bloated abdomen, jaundice, drastic weight loss, and a feeling of heaviness in your upper abdomen, even though there may be treatments to get the cancer under control, your chances of a cure might be limited.
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| Since its relocation to Hospital Selayang in 1999, the hepatobiliary unit has evolved into a national tertiary referral centre specialised in the management of critically ill patients with acute and chronic liver diseases. |
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| Mr R. Krishnan ... Patients still come late to us. |
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| Datuk Mr Harjit Singh ... Most of the time, primary liver cancer occurs in people with some underlying liver disease |
Unfortunately, in Malaysia, this is the norm rather than the exception.
“Patients still come late to us,” says Mr R. Krishnan, head of hepatobiliary surgery at Hospital Selayang. The unit, which is now the national tertiary referral centre for liver diseases, receives about 150 patients with liver cancer every year.
“Right now, for the bulk of our patients, there is little we could offer,” says Mr Krishnan. It’s only in less than 25% of cases that we could offer some sort of treatment for their cancer,” he notes.
However, hope is not lost. Liver cancer might be a silent disease, but its risk factors and causes are rather well documented. The trick is to minimise your risk factors, monitor your liver regularly if you have any of the conditions that may lead to liver cancer, and follow the timeless health advice: live a healthy lifestyle.
Know the causes and risk factors
While more recent data is yet to be published, going by the numbers provided in the National Cancer Registry in 2006, liver cancer was then already ranked the sixth most common cancer among Malaysians. It was the fifth most common cancer among males and ninth most common cancer among females in Peninsular Malaysia.
There are two types of liver cancer. Cancers of the liver caused by malignant changes in liver cells are called primary liver cancers (hepatocellular carcinoma). Cancers in the liver that are caused by the spread and retention of cancer cells from elsewhere are called secondary liver cancers.
“Most of the time, (primary) liver cancer occurs in people with some underlying liver problem,” says Ministry of Health national head of surgical services Datuk Mr Harjit Singh, who is also former head of hepatobiliary surgery at Hospital Selayang.
A lot of them have hepatitis B or C infections, alcoholic liver disease, fatty liver, or any kind of liver disease that can lead to cirrhosis (the formation of scar tissue in the liver). However, the problem is that most people take these things for granted.
“They don’t go for any form of check-ups or screening tests,” says Mr Harjit. “By the time they present with pain or symptoms, the disease is already (at) an advanced (stage).”
According to a consensus paper on the management of hepatocellular carcinoma (primary liver cancer) in Asia that Mr Harjit co-authored, the risk factors for developing liver cancer in Asia include heavy exposure to aflatoxin (toxins produced by a type of fungus), algal hepatotoxins (liver toxins) in contaminated water, betel nut chewing, diabetes mellitus, and alcohol abuse leading to liver cirrhosis.
However, the main known cause for liver cancer in Asia is chronic hepatitis B virus infection. “In Malaysia, it is hepatitis B. But (liver cancer due to) hepatitis C is picking up,” says Mr Krishnan.
That said, these remain as risk factors. There is no guarantee that you will develop liver cancer if you have these conditions. Nevertheless, you have a greater chance of developing it compared to those who don’t.
Care, monitor, and don’t work it too hard
So, how do you prevent liver cancer? You can start by taking steps to prevent or minimise the risk factors and have your liver checked if you have any underlying liver disease.
Getting yourself immunised against hepatitis B is a start. Malaysians who are born after 1989 would have already been immunised as a child under the National Immunisation Schedule, but those born before that will have to obtain their immunisation from their local healthcare providers. There is still no vaccine for hepatitis C.
As both viruses are transmitted through the exposure to infectious blood or body fluids, avoiding and managing situations that may lead to its transmission – like unprotected sex, needle sharing, and transmission from mother to child during delivery – can help prevent one from getting infected.
That is why even for procedures that involve needles like tattoo drawings, body piercings, and even acupuncture, it is important to make sure that the needles used are disposable ones meant for single use, Mr Harjit explains.
Pregnant mothers with hepatitis B can also be given appropriate treatment to prevent the child from being infected as well.
On top of that, those with a family history of liver disease or liver cancer should also get themselves screened regularly through medical checkups.
People who have underlying liver disease must, essentially, follow up with their family physician or their regular GP and get their screening tests done at least every six months, says Mr Harjit.
Even people who are healthy should at least get themselves tested for diseases such as hepatitis B and C, especially when they have reached the age of 30.
“We have almost 2.5 million hepatitis B carriers in this country. A significant proportion of them are at a risk of developing chronic liver disease,” Mr Harjit adds.
A healthy diet and regular exercise also plays a role in preventing liver cancer as well. At the very least, it could minimise one of the risk factors – fatty liver – that is usually associated with excessive consumption of alcohol and the metabolic syndrome (brought about by unhealthy diets and physical inactivity). This will, in turn, minimise your risk of developing liver cancer.
Work with your regular doctors
As the hepatobiliary unit in Hospital Selayang is a tertiary care centre, the patients they receive are mostly referrals from primary care doctors. But both Mr Krishnan and Datuk Mr Harjit emphasises that you don’t have to go to a liver specialist for a normal checkup.
“Ideally, the message is that people should be seen by their primary care doctors,” says Mr Harjit. “If their doctors find any liver problems, like liver masses or tumours, they can refer the patients to us,” he adds.
Source:
http://www.thestar.com.my/lifestyle/health/2010/12/12/stand-and-deliver/
http://thestar.com.my/health/story.asp?file=/2010/12/12/health/7599479&sec=health
Article added on 16 October 2014:
Hospital Selayang hepatobiliary unit
Published: Sunday December 12, 2010 MYT 12:00:00 AMUpdated: Friday November 8, 2013 MYT 4:16:29 PM
DEDICATED liver services in Malaysia started only in 1992, and was pioneered by Health Ministry director-general Tan Sri Dr Mohd Ismail Merican in Hospital Kuala Lumpur to meet the demands of patients who suffer from complications of liver diseases.
In 1999, this service was relocated to Hospital Selayang, which has since evolved into the national tertiary referral centre specialised in the management of critically ill patients with acute and chronic liver diseases.
In year 2000, the then head of the Hospital Selayang hepatobilary surgery Datuk Mr Harjit Singh commenced the liver transplant service in the unit. Since then, there have been 45 liver transplants done in the centre, with an overall survival rate of 72%.
“A lot of our patients do not know where to go,” says Dr Ismail, who is also currently the head of the hepatology unit in the centre. “There were attempts to do liver transplantation in private centres, but we felt that liver transplantation should be offered to patients in a public facility ... as it is very specialised and very resource intensive,” he adds. The unit is currently the only centre in Malaysia that performs liver transplants.
Besides offering services for complex liver diseases at the Hospital Selayang hepatobilary unit, the Ministry of Health, together with the Malaysian Liver Foundation, also organises biennial Liver Updates to inform local doctors about the latest findings and technology in liver treatment and diagnostics.
The 9th Liver Update, which will be held next year on July 13 to 17 at the Sunway Lagoon Resort hotel, will feature live surgery workshops and talks by international speakers and is open to all healthcare professionals who are interested in liver care.
As the hepatobiliary unit receives more and more patients, it is the unit’s hope to eventually have a liver centre of its own. “Hopefully, with a dedicated liver centre, we will be able to retain our specialists and ask some of them who have left to come back,” says Dr Ismail. A dedicated liver centre could also help the unit meet the increasing demands of liver services in the country, he adds.
http://www.thestar.com.my/Lifestyle/Health/2010/12/12/Hospital-Selayang-hepatobiliary-unit/Article added on 9 December 2016:
Kudos to Selayang Hospital for superb service
Tuesday, 3 March 2015
OUR father, Mohamed Mokhtar Ahmad Bajunid, was diagnosed with liver and thyroid cancer in December last year.
We can hardly forget that day when the doctors broke the news. We, the children, pooled our resources and tried to offer the best support we could monetarily, physically and emotionally.
We immediately thought of a private hospital or at least a semi-government one where we believed our dad would receive the best treatment.
When we were told to take our father to Selayang Hospital, we were apprehensive in the beginning.
We’ve read many news reports about misdiagnosis and low standard of service and care in government facilities.
We were clearly prejudiced on the onset. We proceeded to the hospital with caution and were ready to jump ship at any time and shoot off to other perceived “better” hospitals.
Little did we know this arduous journey would lift the veil of misconception that had been drummed into us for a long time.
It began with a meeting with Dr T. Haritharan, the hepatobiliary specialist and surgeon. He sat with dad and took his time explaining then answering questions, not forgetting to repeat where needed.
His patience and understanding were exemplary. We shamelessly voiced our concerns about the hospital and asked if dad could be referred elsewhere to which he answered with an affirmative.
Yet, he went on to explain that most specialists they may refer us to were also trained at Selayang Hospital by the very doctors currently practising there.
He assured dad he was in good hands and there was no need to look elsewhere. They would also bring in a specialist, Dr Sarinah Basro, from Putrajaya Hospital to oversee his thyroid cancer.
All this were expressed without any display of drama or ego. It was laid out to us calmly, precisely and in simple terms.
We went home and did our research and found out repeatedly that Selayang Hospital was touted as the best facility for liver and abdominal cancer. We decided to forge ahead based on all the positive reviews. It was no exaggeration.
From the moment dad checked in, through his surgery to his last day in the hospital, he received gracious attention from the nurses, attentive care from the doctors and timely and professional treatment from the specialists.
Even in my father’s most depressed state, an emotion many will face in these type of situations, the doctors, notably Dr Haritharan, treated him – the person – not just the illness.
These doctors are highly respected by their peers and set a strong example for others to follow.
We commend them for their outstanding achievements and exemplary service. Others should emulate their commendable dedicated service.
Our mother, Sirima Binthep, never left his side and was equally treated with kindness and respect by the hospital staff, from the security personnel right up to the doctors.
They seemed to know a little smile and kindly spoken words would go a long way to ease the burdened soul.
Today, with God’s grace, our father has been declared cancer free, just a little more than a month after his surgery.
Though we can finally breathe a sigh of relief, our thoughts and prayers are with those still battling this horrendous disease.
We would also like to thank the entire staff of Selayang Hospital. Thank you Dr Haritharan, Dr Yang Khuan Fatt, Dr Tee Chee Sian, Datuk Dr Harjit Singh, Dr R. Krishnan, Dr Suryati Mokhtar, Dr Lim Kin Foong and the nurses of ward 9B, and Putrajaya Hospital’s Dr Sarinah.
Whatever the future brings, to you we owe our eternal gratitude.
AZHAR SYARAWI
SARINA MOKHTAR
SUVANI MOKHTAR
AZLAN SYARAWI
(Children of Mohamed Mokhtar Ahmad Bajunid)
http://www.thestar.com.my/opinion/letters/2015/03/03/kudos-to-selayang-hospital-for-superb-service/Others articles:
- Liver Cancer
- Liver Cancer and Coffee
- Fat livers
- Fatty liver may be the next major health woe
- De-liver me from illness
- Selayang Hospital - Liver Cancer Treatment, KL
- Survival Difference between Surgery and Non-Surgery for the Treatment of Hepatocellular Carcinoma Patients at Liver Centre, Malaysia
- Treating liver cancer
- Kidney & Liver Cancer - Treatment options
- Rogue stem cells in liver cancer
- Stem Cell treatment for Liver Cancer
Also:
http://healthticket.blogspot.my/2016/03/foreign-patients-turn-to-india-in.html
Added on 09 December 2016:
http://epjjmedimagingselayang.blogspot.my/p/imaging-department.html
Added on 31 December 2016:
Added on 09 December 2016:
Radiology Department Selayang Hospital
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General radiography (Computed Radiography & Direct Digital System)International Perspective Selayang Hospital: A Paperless and Filmless ...
link.springer.com/chapter/10.1007%2F978-1-4757-4041-7_11
by H Rosnah - 2004 - Related articles
Selayang Hospital has set a milestone in Malaysian history for being the first hospital in the country to create a “paperless and filmless” environment for its ...Added on 31 December 2016:
