Dr Matin Mellor Abdullah

Fasting in the holy month of Ramadan is an important pillar of Islam that encourages prayer, self-discipline, and spiritual reflection. While all Muslims who are mukallaf (have reached puberty and are of sound mind) are required to fast from sunrise to sunset, exemptions are made for several categories, including those who are ill, receiving treatment, or recovering from serious illness, injury, or surgery.

“While those who are ill or receiving treatment for a serious illness are exempt, many faithful feel the spiritual need to do so.” – Dr Mellor”

In spite of this, the desire to participate in this spiritual journey is strong and many cancer patients still wish to proceed with fasting. The question is, should they?

Dr Mellor advises a pragmatic approach that treads a cautious line between practicality, safety and spirituality.

“Many patients I see are open with me about their intention to fast. While I can advise them on medical matters, there are no official guidelines available hence I also advise them to speak to their ustaz so they can have clarity and peace of mind about their spiritual obligations,” he said.

When it comes to their health, these are things every cancer patient should consider if they wish to fast this Ramadan.

1. Every cancer patient is on a different point in their treatment journey.

“For patients who have already undergone treatment or are in maintenance, there should be no impediment to fasting. However, those who are currently undergoing investigations may find it challenging due to the required tests, and those in the midst of receiving therapy may need to make adjustments to their medication schedule,” explained Dr Mellor.

Furthermore, Dr Mellor said those who are receiving curative treatment may wish to forgo fasting and adhere to their planned treatment schedule to maximize their chance of cure, while patients receiving palliative treatment may temporarily defer treatment and resume after Ramadan.

However, each patient must be evaluated on a case-by-case basis, he stresses, with due consideration for the patient’s health and wellbeing.

2. There are different types of treatment, and every cancer patient tolerates treatment differently.

Patients with cancer may be receiving radiotherapy, chemotherapy, or targeted therapy, and each of them are associated with a different range of side effects, with some patients being more affected than others.

To cite an example, Dr Mellor said, “Chemotherapy remains the mainstay of cancer treatment, and it is common for patients to feel unwell for a few days or even up to a week. Side effects can include loss of appetite, feeling weak, developing mouth ulcers, and gastrointestinal discomfort like diarrhoea or gastritis. Sometimes, the side effects are so severe that medications are necessary to control the nausea or diarrhoea. Because of these factors, the individual ability to tolerate both treatment and fasting differs from patient to patient.”

3. Treatment schedules can be adjusted, with medical supervision.

“If you wish to fast while on treatment, be sure to discuss this with your doctor first so we can advise you on adjusting medication schedules and address any concerns,” said Dr Mellor.

Treatment options vary according to the type of cancer, its location and stage, he explained.

– Oral medication. These may include oral chemotherapy and medications to manage nausea and pain, which are usually taken twice daily and can be timed for sahur and iftar.
– Hormone therapy. These are usually taken once daily and patients who are already familiar with the side effects may adjust the timing so that nausea medications may be taken if needed. Among patients who have received several cycles of treatment, familiarity with its side effects may make it possible to plan their fasting accordingly.
– Radiotherapy and nuclear medicine procedures. These are administered at the hospital and may be scheduled accordingly, based on availability and your doctor’s advice.

4. Prioritise your wellbeing.

“Many patients try to fast with good intentions but are unable to complete it, which can be disappointing. I would advise patients to refrain from fasting if they are recovering from surgery or who are nutrient-deficient as the body may not be able to tolerate fasting under such circumstances,” said Dr Mellor.

For those fasting, he advises being careful to get sufficient hydration and to eat a balanced diet that is rich in fruits, vegetables and protein so they get the nutrition they need.

At the end of the day, said Dr Mellor, “It is a deeply personal decision, and I remind all my patients that it is also important to recognise their body’s limits – there is no medication for tiredness and sometimes, your body just needs rest and recovery so reflect deeply on your decision, speak to your doctor, listen to your body and act accordingly.”

Dr Marfu’ah Nik Eezamuddeen and Ms Kuah Rui Ning of Subang Jaya Medical Centre

Resource persons: Dr Marfu’ah Nik Eezamuddeen, Consultant Clinical Oncologist and Ms Kuah Rui Ning, Registered Counsellor, Subang Jaya Medical Centre

For many, a cancer diagnosis still feels like an immediate loss of control, that is, a future defined by hospital corridors, aggressive treatments and lives put on hold. But cancer care today is undergoing a profound transformation. As science deepens its understanding of the disease, treatment is no longer driven by a one-size-fits-all approach. Instead, it is becoming more precise, more personal and increasingly focused on helping patients live well, not just survive.

While cancer may share the same name, no two patients experience it in the same way. Each person’s biology is different, as are their lives, circumstances, and the hopes, fears and priorities that shape their journey. Combining medical innovation with emotional and psychological support is helping many patients live longer and better with cancer.

Every patient is unique

“When I sit across a patient, I am not just seeing a diagnosis. I am seeing a life, a family and a future they are afraid of losing,” says Dr Marfu’ah. Over the past decade, cancer treatment has undergone a major transformation. Previously, treatment decisions were largely based on where the cancer started, such as the breast or lung, and followed standard protocols.

Today, doctors look much deeper. Through molecular pathology testing, specialists can study the unique biology and behavior of each cancer. This allows treatment to be tailored according to the individual cancer profile rather than relying solely on conventional approaches.

“Two patients may both have breast or lung cancer, yet their cancers and their lives can be very different,” she explains. “Personalized care recognizes that difference.”

In Malaysia, increased access to molecular testing has significantly changed how cancer care is delivered. These tests help oncologists make earlier and more precise treatment decisions, often identifying therapies that are more effective and better tolerated.

For patients, this brings clarity at a time that can feel overwhelming.“Instead of uncertainty, patients are able to understand why a certain treatment is recommended for them,” Dr Marfu’ah says. “That understanding gives them confidence and a greater sense of control.”

“United by Unique” journeys

Malaysia’s SJMC observed World Cancer Day on 4 February with the theme “United by Unique,” reminding the public that while cancer may appear similar on scans or reports, no two journeys are ever the same. Being “United by Unique” means recognizing that science and compassion must go hand in hand. It means treating the disease while never losing sight of the person behind it. Today, with advances in personalized medicine and a growing focus on emotional support, cancer care is no longer solely about survival. It is about helping patients live with meaning, dignity, and hope.

Advances in cancer treatment

Many Malaysians still associate cancer treatment with harsh chemotherapy and severe side effects. While chemotherapy and radiotherapy remain essential tools, newer options have changedhow patients experience treatment.

Advances such as immunotherapy and oral targeted therapy allow treatment to target cancer cells more precisely. In some cases, these therapies are better tolerated and allow patients to continue with daily routines.

“Cancer treatment today is often far more manageable than people expect,” says Dr Marfu’ah.“Many patients are still able to work, care for their families and maintain their independence during treatment, “ she adds.

These developments have been particularly meaningful in cancers such as lung and breast cancer, where survival outcomes have improved significantly. “I have seen patients live years longer than what was previously expected,” she shares. “But what matters most is not just how long they live, but how they live.”

She recalls young mothers watching their children grow up and individuals continuing their careers while undergoing treatment. “This shift reminds us that cancer care is no longer only about extending life. It is also about preserving purpose, identity and meaning.”

Personalized care that honors every patient’s life

While medical tests guide clinical decisions, personalized care goes far beyond laboratory results.

“A patient’s background, lifestyle, beliefs and family responsibilities matter deeply,” Dr Marfu’ah explains. “Some prioritize longevity, while others prioritize independence or being present for their children.”

Listening to these priorities allows treatment plans to reflect what matters most to each patient.

“My role is not just to treat cancer,” she says. “It is to help patients walk through treatment with clarity, dignity and as little fear as possible.”

This approach becomes especially important when patients are coping with fear after diagnosis.

“Fear is a natural response,” she adds. “I often tell patients that it is normal to feel afraid. We will take this one step at a time, together.”

By explaining treatment plans clearly and outlining available support, many patients begin to realize that a cancer diagnosis does not automatically mean the end of their life or identity.

“Modern cancer care is a partnership between the medical team, the patient and their loved ones, ”she says.

An emotional journey

While medical advances play a vital role, cancer affects far more than the body alone. The emotional journey can be just as complex and challenging.

From the counselling perspective, Kuah Rui Ning sees cancer as a deeply personal experience that unfolds in stages. “At diagnosis, it often feels like a sudden storm,” she says. “There is shock, disbelief, fear and vulnerability. Many patients feel their world has paused.”

As treatment begins, the emotional landscape shifts. “I often describe it as a marathon,” she explains. “There is anxiety and determination at the start, but as side effects build, patients reach what I call the long middle.”

Fatigue, emotional exhaustion and loss of motivation are common during this phase. Yet she also witnesses moments of unexpected strength. “Many patients realize they are stronger than they believed. They discover strength they never knew they had.”

Survivorship, she adds, can be equally complex. “While there is relief and hope, there can also befear of recurrence and anxiety about trusting the body again. Learning to rebuild a sense of normal takes courage.”

Across every stage, one need remains constant. “Patients want to be heard,” she says. “They want to know their feelings are valid.”

Helping patients express feelings into words

From a counselling perspective, understanding how a patient is coping emotionally is an important part of care. Kuah explains that she often uses simple assessment tools such as a distress thermometer, which allows patients to rate their emotional or physical distress on a scale.

“For many patients, feelings like fear or anxiety can be difficult to describe,” she says. “This tool helps make those emotions more concrete and opens a conversation about what is truly weighing on them.”

Apart from verbal conversations, she also incorporates expressive arts therapy for selected patients. Through drawing, colors or creative expression, patients are able to communicate emotions that may feel overwhelming or difficult to articulate.

“The process creates a safe and supportive space for reflection,” she explains. “It allows patients to express their experiences in a gentler way and often helps them reconnect with themselves during a very uncertain time.”

Caring for the whole person

People-centered cancer care extends far beyond medical treatment. It is about supporting emotional, mental and social wellbeing alongside physical health.

“To me, it is not just treating a disease,” Kuah says, adding “It is caring for the whole person.”

Families and caregivers play an equally important role. Counselling helps strengthen these support systems by offering education, emotional support and guidance in communication.

Research indicates that emotionally supported caregivers demonstrate improved coping abilities, greater confidence in their caregiving role, reduced anxiety, and enhanced marital and family relationships. Such interventions help caregivers feel more prepared and less distressed, which in turn is likely to lead to more positive outcomes for patients.

Sustaining quality of life while living with cancer

Medical and psychological care are deeply connected. Emotional support has been shown to influence treatment tolerance, motivation and overall wellbeing.

“When patients feel supported, we often see improvements in rest, appetite and confidence, ”Kuah shares. “These factors affect how the body copes with treatment.”

In challenging cases, such as patients undergoing intensive therapy for nasopharyngeal cancer, psychological care can help individuals persevere through difficult side effects. “When patients understand their emotions and learn coping strategies, they move through treatment not as passive recipients, but as resilient individuals.”

Image credit: OSU/Parinaz Ghanbari

Scientists at Oregon State University (OSU) have developed a new nanomaterial that selectively destroys cancer cells by triggering a dual chemical attack inside tumors while sparing healthy tissue.

The study, published in Advanced Functional Materials, describes a novel approach to chemodynamic therapy, an emerging cancer treatment that takes advantage of the unique chemical conditions found in malignant tumors. Cancer cells tend to exist in a more acidic environment and contain higher levels of hydrogen peroxide than normal cells, creating an opportunity for targeted chemical reactions.

The OSU research team, led by Oleh and Olena Taratula and Chao Wang from the College of Pharmacy, designed an iron-based metal-organic framework nanoagent capable of producing two different types of reactive oxygen species inside cancer cells. These highly reactive molecules damage vital cellular components such as proteins, lipids, and DNA, leading to cell death through oxidative stress.

Previous chemodynamic therapies were limited because they typically produced only one type of reactive oxygen species and often lacked the catalytic strength needed for sustained tumor destruction. As a result, earlier studies frequently achieved only partial tumor reduction.

In laboratory tests, the new nanoagent proved highly toxic to multiple cancer cell lines while causing minimal harm to noncancerous cells. In mouse models implanted with human breast cancer cells, the treatment accumulated in tumors, eliminated the cancer completely, and prevented recurrence without detectable side effects.

The researchers plan to test the therapy across additional cancer types, including aggressive pancreatic cancer, before advancing toward human trials.

Source: OSU

Malaysia faces a significant and escalating cancer burden. The lifetime risk has risen to one in eight, projecting that one person in every eight may be diagnosed with cancer by the age of 75.

This increase is mirrored in the overall caseload, which has more than doubled between 2006 (21,773 cases) and 2025 (56,932 cases). Crucially, the latest reports indicate that the majority of cases are still caught too late, with 65.1% now detected at Stage 3 or 4 (an increase from 63.7% previously).

The first step in treating cancer is often the most critical. When a patient is suspected of having blood cancer, doctors must determine the exact type and severity of the disease. The difference between one subtype and another can completely change the course of treatment. A correct diagnosis at the start ensures the patient receives the most effective therapy, while a wrong or delayed diagnosis could cost valuable time.

“Getting it right the first time is crucial,” emphasized Dr Tan Sen Mui, Consultant Hematologist at Subang Jaya Medical Centre (SJMC). “The tools we have today allow us to see deeper into the disease than ever before, so we can choose treatments that are best suited for each individual.”

While traditional methods like blood tests and microscopic examination remain important, modern technology offers far greater precision. In earlier decades, doctors relied mainly on these basic checks; today, they are complemented by sophisticated molecular tools.

For instance, techniques can now identify whether cancer cells are of B-cell or T-cell origin. More critically, cytogenetic testing and next-generation sequencing (NGS) allow doctors to detect specific gene mutations and chromosomal abnormalities, which not only confirm the malignancy type but also provide critical prognostic information and target treatment.

Imaging modalities such as PET-CT and MRI scans as well as specific tumor markers further refine by enabling precise identification of disease subtypes such as diffuse large B-cell lymphoma, mantle cell lymphoma, or FLT3-mutated acute myeloid leukemia.

This level of diagnostic precision ensures that patients receive more accurate risk stratification and individualized management plans.

Precision medicine in action
Dr Tan shared the case of a 29-year-old man who first came in simply complaining of lower back pain. Although his initial blood work looked nearly normal, it hinted at an underlying issue. A follow-up blood smear revealed the presence of abnormal, immature cells, leading to a bone marrow biopsy that strongly suggested Acute Myeloid Leukaemia (AML).

Since traditional genetic tests did not reveal any major chromosomal clues, she turned to next-generation sequencing (NGS). This step confirmed the AML diagnosis but also identified a key genetic flaw, the FLT3-ITD mutation. This vital information did more than just finalize the diagnosis; it provided clear, personalized targets for his treatment.

At a leading tertiary hospital with a comprehensive one-stop cancer center like SJMC, NGS testing is supported by a team of pathologists and laboratory specialists who work closely with hematologists, oncologists, surgeons and other cancer specialists in multidisciplinary tumor boards.

This team-based approach ensures every patient benefits from comprehensive, state-of-the-art diagnostics and a tailored management plan. Most importantly, it provides timely access to accurate diagnosis and precision medicine that specifically targets cancer mutations, leading to better outcomes and fewer side effects.

A lifeline for children with cancer
Dr Chan Lee Lee, Consultant Pediatrician & Pediatric Hematologist–Oncologist at SJMC, stressed that these advances are transforming outcomes for children as well. “Technologies like NGS have enabled us to diagnose childhood cancers with greater accuracy and intervene much earlier,” she said.

Cancer remains a formidable challenge, but with the innovations, it is no longer the hopeless fight it once was. “Today, childhood cancer is highly treatable, and with the right care, many children go on to live full and healthy lives,” shared Dr Chan. “In the late 1960s, children diagnosed with acute lymphoblastic leukemia (ALL) had survival rates below 20% within five years of diagnosis. By the 1990s, survival rates had risen above 80% and today, cure rates for ALL have reached more than 90%.”

“With treatment options available at high cure rates, early and accurate intervention is crucial and can make all the difference. Parents are encouraged to seek timely medical care and ensure their children receive the full support they need. Every child’s case is unique, which is why treatment plans are carefully tailored to their individual needs.

Depending on the diagnosis, this may include a combination of chemotherapy, surgery, radiation therapy, or transplantation,” she added.

Related: Reclaiming the voice: Let’s talk about holistic care in head, neck cancer

Future of cancer care
Cancer care is moving from a “one-size-fits-all” approach to a highly personalized, precision-based model designed specifically for each patient’s unique disease. Though chemotherapy continues to be used, there has been a remarkable shift towards targeted and immune-based therapies.

“The rise of targeted therapy, immunotherapy, CAR T-cell therapy, and stem cell transplantation offers targeted alternatives with less toxicity. These innovations bring real hope to patients and families, and their success depends on an accurate diagnosis from the very start,” Dr Tan said.

Looking ahead, innovations such as AI-assisted diagnostics, digital pathology, and broader access to genetic testing are expected to further transform cancer care in Malaysia.

Related: New medical innovations addressing Malaysia’s rising cancer rates

Breakthroughs in medicine and early, accurate detection are transforming cancer care, ensuring the right treatment at the right time, and paving the way for more patients to not only survive but truly thrive.

As Dr Chan put it, “With accurate, timely diagnosis, we are giving patients not just treatment, but the best chance at life.”

Resource person: Dr Ben Yap Beng Khiong, Consultant Clinical Oncologist at OncoCare Cancer Centre Malaysia

Cancer’s impact to identity, dignity

For patients, a diagnosis of head and neck cancer goes beyond medical treatment. It affects daily activities many take for granted, such as speaking, eating, swallowing, and breathing. Losing the ability to enjoy meals, converse with loved ones, or participate socially can lead to withdrawal, isolation, and difficulty continuing to work.

The effects can be profound. Many patients feel they have lost part of their identity, especially if they can no longer speak clearly or enjoy food as before. This often results in embarrassment, social withdrawal, depression, and strained family relationships, though many families rally to provide vital support.

These emotional burdens show the importance of holistic care beyond tumor removal. Cancer treatment is not only about survival but also about supporting patients through their journey, helping them rediscover their sense of self and reclaim the simple joys that give life meaning.

A multidisciplinary approach is essential, involving oncologists, speech therapists, dietitians, physiotherapists, and psychologists. Small milestones—such as sharing a meal with family or speaking clearly again—play a major role in restoring confidence, self-worth, and well-being.

Emotional and social support are equally critical. Families, peer groups, and survivor communities offer encouragement that can greatly influence recovery. From experience, patients with strong support networks recover more positively, as they feel less alone.

In Malaysia, head and neck cancers make up around 6% of all newly diagnosed cases and 8% of cancer-related deaths. Among men, nasopharyngeal cancer, which develops behind the nose and above the soft palate, is the fifth [1] most common, with over 1,600 cases reported in 2022. Although less common in women (1.5% of all female cancers), the impact of these cancers extends far beyond statistics.

Cancer care goes far beyond removing or controlling the tumor. The real goal, apart from curing the disease, is restoring the patient’s dignity and improving quality of life, ensuring they can communicate effectively, consume food, and regain confidence in themselves.

Nasopharyngeal cancer most common in Malaysia

Head and neck cancer refers to cancers that begin in the mouth, throat, voice box, nose, sinuses, or salivary glands. In Malaysia, nasopharyngeal cancer is the most common, followed by cancers of the oral cavity, larynx, and oropharynx (back of the throat, tonsils, and base of the tongue).

Nasopharyngeal cancer occurs far more often in Malaysia and neighboring countries than in the West, where it is relatively rare. Risk factors include Epstein-Barr virus (EBV) infection, family history, diets high in preserved foods such as salted fish, and lifestyle habits such as smoking, alcohol use, and betel quid chewing. Human papillomavirus (HPV) infection is also linked to cancers of the oral cavity and oropharynx.

HPV-related head and neck cancers are increasingly recognized, especially among younger, non-smoking individuals. Symptoms may include a persistent sore throat, ear pain, difficulty swallowing, hoarseness, or a neck lump (swollen lymph node).

Overcoming stigma and misconceptions

Despite medical advances, stigma surrounding head and neck cancers remains a major challenge. Some patients delay seeking treatment out of fear of being judged or because they believe their diagnosis offers little hope. Others worry that treatment will inevitably lead to severe disfigurement or permanent loss of vital functions such as speaking and swallowing.

In reality, modern therapies—including precision radiotherapy, chemo-immunotherapy, and organ-preserving surgical techniques—have advanced significantly, allowing many patients to maintain their appearance, voice, and ability to eat close to normal. Still, these fears often hold people back from seeking help, and when treatment is delayed, its effectiveness may be reduced.

Humanizing cancer helps break stigma and encourages more people to seek screening and treatment. Early detection saves lives and preserves dignity.

New treatments from precision radiotherapy to immunotherapy

In recent years, significant technological advances have improved treatment for head and neck cancers.

Techniques such as intensity-modulated radiotherapy (IMRT) allow tumors to be targeted with precision while sparing healthy tissues such as the salivary glands and hearing structures, reducing side effects like dry mouth and hearing loss. In advanced cases, newer systemic therapies, including targeted drugs and immunotherapy, have enhanced both survival rates and quality of life.

These advances not only give patients hope but also help preserve vital functions—such as speaking and eating—allowing them to live more comfortably, which is essential for recovery and dignity.

HPV-associated head and neck cancers generally have a better prognosis and respond well to treatment; therefore, aggressive and disfiguring surgery should be avoided whenever possible.

From fear to advocacy

One patient with advanced tongue cancer under Dr Ben Yap’s care overcame initial fear and hopelessness through strong family support and a combination of therapies, ultimately achieving a remarkable recovery. The patient underwent chemo-immunotherapy prior to surgery and radiotherapy. Only a small portion of the tongue was resected, allowing most of its function to be preserved. “Not only did he recover, but he eventually returned to work,” Dr Ben Yap recounts. “His story will inspire many others to come forward earlier for screening and treatment, ” Dr Yap recounted.

Awareness, early detection save lives

The lessons from survivors carry a vital message: cancer is not the end of the story. With timely diagnosis, advanced treatment, and holistic care, patients can reclaim their lives.

Younger adults are urged to receive the HPV vaccine, which greatly reduces the risk of HPV-associated head and neck cancers. Quitting smoking also remains crucial, as it is a major risk factor for non-HPV-related cancers.

As Malaysia fights cancer, open dialogue and community education encourage earlier treatment and foster a society that supports patients with dignity and understanding.

Reference:
[1] https://gco.iarc.who.int/media/globocan/factsheets/populations/458-malaysia-fact-sheet.pdf

Editor’s note:The opinions expressed in contributed articles are those of the authors and do not necessarily reflect the views of HCA

A report by the Japanese Society of Gastroenterological Surgery, presented to the health ministry, projects that the number of gastrointestinal surgeons will fall by 40% by 2040, dropping from around 15,200 today to 9,200. Demand, however, is expected to require nearly 14,400 specialists, leaving a gap of more than 5,000.

The Ministry of Health, Labor and Welfare (MHLW) expert group echoed this warning, projecting that the number of physicians under 65 eligible for society membership will fall from 15,200 in 2025 to 9,200 in 2040, a 39% drop. Even with fewer surgeries needed, this will translate into a shortage of about 5,200 doctors.

The crisis is fueled by ebbing interest among young physicians. Gastrointestinal surgery, which treats cancers of the stomach, colon, and other parts of the digestive tract, is considered one of the most demanding fields. Between 2012 and 2022, the number of surgical gastroenterologists fell 10% to about 19,000, with the decline reaching 15% among doctors under 40. Long, complex operations and frequent emergency procedures during nights and holidays have driven many away.

Meanwhile, cancer cases will continue to rise in the near term. New diagnoses are projected to climb 3%, from 1,025,000 today to a peak of 1,055,000 in 2040, before gradually declining along with the overall population.

The impact is said to vary by region. Smaller cities and depopulating areas are already seeing a reduction in patients, with Akita Prefecture expected to experience over 10% fall by 2040. In contrast, 16 urban prefectures will record increases, with Tokyo and Okinawa forecast to see growth of more than 10%.

Cancer treatment in Japan rests on three main pillars: surgery, radiotherapy, and drug-based therapies such as chemotherapy. While radiotherapy and drug treatments are expected to grow, surgical procedures will decline by 5%, from 465,000 in 2025 to 440,000 in 2040. This reflects fewer cases among the working-age population, who are more likely to undergo surgery.

Health ministry officials warn that Japan’s current cancer care model is unsustainable without major restructuring. A draft report released in July cautioned that even existing surgical treatments “may no longer be sustainable” if reforms are delayed.

To address the problem, the ministry is urging prefectural governments to consider consolidating facilities, staff, and costly equipment. Options include merging hospitals, centralizing services such as radiation therapy, and reallocating resources based on projected patient numbers.

Demographic shifts will reshape demand for treatment. By 2040, cancer cases among patients aged 85 and older are expected to rise in nearly all regions, apart from a few remote rural areas. This will increase demand for radiation therapy by 24% drug therapy by 15%, while surgery dwindles.

Radiation therapy specialists are projected to meet demand through 2040, but maintaining expensive equipment in depopulating areas may prove unsustainable. For drug-based therapies, no clear shortage or surplus of doctors has been identified. However, because these treatments require ongoing, scheduled care, the report recommends expanding telemedicine to ensure access in underserved regions.

The finalized report will soon be distributed to prefectural governments. Regional councils comprising local authorities, hospitals, cancer care providers, and patient groups will then determine how best to respond. The ministry stressed that clear and ongoing communication with the public will be critical in managing expectations and preserving trust as the system adapts.

Japan’s cancer care system is thus caught between rising patient needs and a waning workforce. Without urgent reforms, experts warn, even treatments that are standard today may no longer be guaranteed in the decades ahead.

Sources: Nippon/Asahi Shimbun

The project was led by SMART’s Antimicrobial Resistance research group in collaboration with Nanyang Technological University, the University of Florida, the University at Albany, Lodz University of Technology, and MIT.

Current methods to study RNA modifications are slow, expensive, and involve hazardous chemicals. To overcome these limits, the SMART team designed an automated system that uses robotics to prepare and analyze samples safely and efficiently. The system can profile thousands of tRNA modifications in a fraction of the time, reducing costs and risks while increasing research capacity.

In their study, published in Nucleic Acids Research, the researchers used the tool to analyze more than 5,700 genetically modified strains of Pseudomonas aeruginosa, a bacterium that causes pneumonia, urinary tract infections, and wound infections. By processing over 200,000 data points, the system revealed previously unknown RNA-modifying enzymes and mapped gene networks that control how bacteria adapt to stress. One discovery showed that the enzyme MiaB, which modifies tRNA, is highly sensitive to iron, sulfur, and low oxygen levels.

The team explained that this large-scale profiling provides a clearer view of the epitranscriptome, the collection of all RNA modifications in cells. It allows scientists to validate theories, discover new biology, and identify molecular targets for drugs and diagnostics. Professor Peter Dedon of MIT noted that the tool represents a major advance in decoding RNA’s role in disease and could speed up the development of targeted therapies against cancer and resistant infections.

The system also has applications in industry. Pharmaceutical and biotech companies can use it for drug discovery, biomarker screening, and evaluating how treatments affect RNA modifications. Dr. Jingjing Sun, first author of the paper, said the tool makes large-scale epitranscriptomic analysis practical for the first time, opening the door to new diagnostics and therapeutic targets.

SMART plans to expand the tool’s use to human cells and tissues, with the aim of translating the technology into clinical research. This would accelerate the search for biomarkers and personalized treatments for cancer and infectious diseases. The work is supported by Singapore’s National Research Foundation through the CREATE program.

This initiative strengthens the public-private partnership, ensuring underserved communities receive high-quality radiotherapy and radiosurgery at no cost.

Health Minister Datuk Seri Dr Dzulkefly Ahmad highlighted the significance of the agreement, stating, “This collaboration is a concrete step toward closing the access gap for underserved and lower-income groups. It also reflects Malaysia’s broader commitment to Universal Health Coverage, where cancer care is not treated as a privilege but as a right.”

The expanded program now includes eight IHH hospitals, with the newly added Island Hospital in Penang equipped with Gamma Knife and LINAC technologies.

These advanced tools enable precise treatment, particularly for tumours in sensitive areas.

Since its launch in 2022, the partnership has already benefited 1,000 cancer patients nationwide.

The latest MoU aims to further reduce barriers to treatment, especially for those diagnosed at late stages.

Dzulkefly noted that over 60 per cent of Malaysia’s cancer cases are detected late, complicating treatment and reducing effectiveness.

The initiative aligns with the National Strategic Plan for Cancer Control, focusing on early detection, effective treatment, and palliative care.

The MoU covers various cancers, including brain tumours, lung, breast, and colorectal cancers.

Source – Bernama

Within India, Kerala shows the highest rate at 4.5%, followed by Karnataka and Maharashtra, but even these numbers remain critically low. Delhi reports the lowest rate—under 1%. Health experts attribute this widespread neglect to a mix of misinformation, stigma, and a lack of infrastructure.

Dr. Ashish Gupta, Chief of Medical Oncology at Amerix Cancer Hospital, pointed out that many women avoid screenings due to fear, social pressures, and misconceptions about the procedure. He noted that late-stage diagnosis is often the result, drastically reducing survival chances. In rural regions, the problem worsens as access to diagnostic facilities is limited, and traveling for care can be costly and time-consuming. Misunderstandings around mammography—such as fears about pain or radiation—also discourage participation.

To address these barriers, experts are urging immediate action. They recommend national awareness campaigns to highlight the benefits of early detection, along with the rollout of mobile screening units in remote and underserved areas. Public health programs that offer free mammograms could further reduce financial obstacles.

Dr. Gupta explained the importance of combining education with accessible services, suggesting that community involvement—through local leaders, nonprofits, and social influencers—can help break the cultural resistance surrounding cancer screening.

Dr. Shubham Garg, head of surgical oncology at Dharamshila Narayana Superspeciality Hospital, advocated for introducing breast health education in schools. Teaching young girls how to perform self-exams, he said, could encourage proactive health habits later in life. He also recommended that workplaces include routine cancer screenings in their wellness programs to support early detection among working women.

Dr. Gupta agreed that corporate health check-ups could play a significant role in boosting screening rates.

Dr. Rahul Bhargava of Fortis Memorial Research Institute opined that spreading awareness is the first and most critical step. He called for urgent, nationwide initiatives to prioritize women’s health and prevent avoidable deaths from a disease that is highly treatable when caught early.

This scenario raises concerns that patients may not receive timely treatment, thereby increasing mortality rates.

Utusan Malaysia reported that, based on Health Ministry data, there are only 175 oncologists across the country.

Meanwhile, the recorded number of cancer patients s of 2020 stands at 48,639, meaning the ratio is at of one doctor for 277 patients.

The National Cancer Institute predicts that the number of cancer patients will double by 2040 from the 48,639 cases recorded in 2020.

This indicates that one in every 10 people in Malaysia will receive a cancer diagnosis in their lifetime.

In terms of treatment centres, Malaysia has only nine such facilities under the Health Ministry, including the cancer institute in Putrajaya, Kuala Lumpur Hospital, Penang Hospital, and the Sabah Women and Children’s Hospital.

Universiti Kebangsaan Malaysia community health specialist Professor Dr Sharifa Ezat Wan Puteh, said that the capacity of oncologists and treatment centres is insufficient to meet the increasing demand.

She said an even greater concern is that patients are required to wait longer for appointments and treatment, which in turn reduces their chances of recovery.

“The facilities for treating and screening cancer patients in Malaysia are still not satisfactory. Furthermore, the number of cancer specialists is inadequate to cater to the growing patient numbers.

“We have several government hospitals offering treatment, but their numbers are far from sufficient,” she told Utusan Malaysia.

The National Cancer Institute revealed that five types of cancer are most prevalent among Malaysians, namely breast cancer, colorectal or colon cancer, lung cancer, nasopharyngeal or head and neck cancer, and liver cancer.

Dr Sharifa said this situation forces many patients to travel long distances to receive treatment, endure prolonged waiting times for appointments, and, in more distressing cases, some do not receive treatment in time because their condition has become too critical.

“This is happening because government hospitals are increasingly short of specialists, leading to longer waiting times for treatment and raising the risk of patients losing their lives.

“Delays in treatment can cause cancer to spread and worsen. Some patients initially have a chance of recovery, but due to a slow and inefficient system, they eventually lose all hope of survival,” she said.

Dr Sharifa said the government must urgently increase the number of cancer treatment centres and train more specialists to tackle this crisis.

“We can no longer afford delays. We need to expand treatment facilities, increase the number of specialists, and ensure that all citizens have access to quality treatment without having to wait too long.

“Additionally, awareness of the importance of early screening must also be broadened so that more patients can be diagnosed early before their disease becomes too severe,” she said.

According to data released by the Health Ministry, men are most commonly affected by lung cancer at a rate of 17 per cent, while women most frequently suffer from breast cancer, accounting for 32.9 per cent of total cases.

Taking these two cancers as examples, if lung cancer is detected early at Stage 1, the survival rate is 37.1 per cent, but if diagnosed late at Stage 4, the patient’s chances drop to just 6.3 per cent.

For breast cancer, patients have a very high chance of survival if detected at Stage 1, with a rate of 87.5 per cent.

However, if diagnosed at Stage 4, their survival rate decreases to 23.3 per cent.