Dr Mohan and dr Hoo both stressed that liver disease must not be taken lightly as it could lead to cancer. — Azlina Abdullah/The Star
The liver is a quiet workhorse, and quite resilient to boot.
It detoxifies, metabolises, synthesises and stores nutrients. But when it falls “sick”, it often does so silently.
By the time symptoms appear, the damage may already be severe.
Sunway Medical Centre Damansara consultant hepatobiliary and general surgeon Dr Mohanasundram Pillai and consultant physician and gastroenterologist and hepatologist Dr Hoo Chai Zhen warn that liver disease must not be taken lightly.
Some conditions can even pave the way to one of Malaysia’s deadliest cancers: liver cancer.
Dr Hoo notes that many liver disorders do not lead to early signs and symptoms.
“It’s usually quite late in the disease that signs and symptoms appear – for example, yellowing of the skin and whites of the eyes (jaundice), and abdominal distension. These indicate that the liver has already been significantly compromised,” she says.
The physician reminds us that we should never ignore the above signs, and other symptoms such as dark urine, pale stools and sudden weight loss. These may signal serious liver trouble.
“However, liver disease can be detected early with simple tests such as blood tests, ultrasounds and hepatitis screening. When this happens, liver disease can often be managed before complications develop,” adds Dr Mohan.
Both doctors say the most common liver disorders include: > Fatty liver disease: According to Dr Hoo, the current term for this is metabolic dysfunction-associated steatotic liver disease (MASLD).
This condition is increasingly tied to diet, and is commonly seen in individuals with obesity and type 2 diabetes.
“It develops over the years, and people may feel fine but already have liver damage. It’s very common – about one in three are affected in the general population. It is even more common among those living with diabetes.” > Hepatitis B and C: Viral infections that scar the liver over time. > Alcohol-related liver disease: Usually due to long-term drinking, although for some, any alcohol may be dangerous. > Cirrhosis: Permanent scarring that sets the stage for cancer.
How disease becomes cancer
Most liver cancers usually grow as a result of long-standing disease.
“Liver disorders can lead to inflammation, and scarring develops over time. When this happens, the risk of cancer shoots up,” says Dr Hoo.
According to Dr Mohan, risk factors for liver cancer include those with liver cirrhosis, Hepatitis B or Hepatitis C, family history of liver cancer, smoking and alcohol consumption.
Prevention remains the strongest defence against any disease.
Dr Mohan advises that a healthy lifestyle increases our chances of maintaining good health in the long term.
“Stop smoking and alcohol if you indulge. Get vaccinated against Hepatitis B. Screen early if you’re at risk of liver disease. Keep weight in check with diet and exercise.”
If liver cancer is spotted earlier, surgery offers hope. “Options include removing the tumour, or in selected cases, a liver transplant. Not every patient qualifies.
“Eligibility depends on factors such as the tumour’s size and number, as well as overall liver function.
“Other considerations are also taken into account before surgery is possible.
“And in non-cancerous liver diseases, surgical intervention only takes place when the patient is symptomatic or the disease has affected liver function,” informs Dr Mohan.
With technological innovations advancing at a brisk pace, surgical outcomes are improving further.
For example, minimally invasive and robotic techniques now result in less scarring, reduced pain, faster recovery and fewer complications.
Treatment rarely rests with one doctor. “Managing liver disease requires teamwork,” says Dr Hoo.
“Physicians, surgeons, oncologists, radiologists and dietitians all play a role.
“This coordinated approach is increasingly seen as the standard of care.”
Addressing misconceptions
The liver may work quietly, but the disease shouldn’t be ignored.
“Listen to the silent signs,” urges both doctors.
“Many believe that if there’s no pain, there’s no problem. That’s a misconception, especially when it comes to the liver.
“In addition, not drinking alcohol doesn’t mean you’ll never develop liver disease. Other risk factors are at play, including diet,” warns Dr Hoo.
Both doctors also warn about the common misconception that you can cleanse or support your liver with supplements.
“Many people take supplements to protect liver health, but some of these may harm rather than help. To be safe, seek professional medical advice first.”
Your liver works tirelessly in silence, but disease can strike quietly until it’s too late.
“Pay attention to the silent signs and take charge of your health,” both doctors urge.
