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The Star
13 hours ago
- Health
- The Star
Game-changing treatment for advanced prostate cancer
Prostate cancer is the third most common cancer among Malaysian men, with cases rising steadily since 2012. While it trails behind colorectal and lung cancer, it is still a significant concern. What's more worrying is that many cases are detected late. Early-stage prostate cancer is highly treatable, but late-stage cases are far more difficult to manage. What is prostate cancer? The disease begins when cells in the prostate – a small, walnut-sized gland below the bladder – start to grow uncontrollably. In its early stages, prostate cancer often causes no symptoms. But as the tumour grows, it can press against the urethra – the tube that carries urine – leading to changes in urination. Left untreated, the cancer can spread to nearby tissues, lymph nodes, or even the bones, making it more difficult to treat and manage. Yet, many men overlook the early signs. However, symptoms such as difficulty urinating, weak flow, or frequent trips to the bathroom at night may be early warning signs of prostate cancer. Sunway University consultant urologist and urologic oncologist Professor Dr Tan Guan Hee explains that these symptoms often go unnoticed or are mistaken for benign prostate conditions such as benign prostatic hyperplasia. 'Many men assume it's just part of getting older and delay seeing a doctor,' he says. 'Unfortunately, this means prostate cancer is often diagnosed at a later stage, when it's more difficult to treat.' As Malaysia's population continues to age, the number of prostate-related issues is expected to rise in tandem. Despite this, there is a general lack of awareness of the problem, minimal symptoms in early stages, and a cultural reluctance to seek help for intimate health issues. When prostate cancer is detected early, treatment options such as surgery or radiotherapy are often effective and potentially curative. However, late-stage prostate cancer, which may have already spread to bones or lymph nodes (metastasised), requires more advanced interventions. This is where radioligand therapy (RLT) offers new hope. Overcoming stigma One significant and often overlooked challenge in managing prostate cancer is cultural reluctance. Many patients delay seeking care due to embarrassment or denial, particularly Asian men, who may be more reserved about discussing health issues. Doctors often find that families bring in patients who have ignored symptoms for years. Prof Tan says: 'Addressing this cultural barrier requires greater public awareness, normalising conversations around men's health, and encouraging routine screening and early intervention.' Beyond individual awareness, family involvement plays a critical role in detecting early symptoms of prostate cancer and preventing critical outcomes. 'If children notice their father is frequently going to the toilet, they might realise something is amiss and encourage him to seek medical help,' he suggests. Treatment for prostate cancer depends on what stage the tumour is at. — Photos: Canva Precision treatment According to consultant clinical oncologist Dr Nik Muhd Aslan Abdullah, treatment for prostate cancer has come a long way since the 1990s. While surgery, radiotherapy and hormonal therapy remain standard options, recent advances in precision medicine have led to more targeted, effective treatments. Choosing the most appropriate treatment depends on several factors, including: > The stage of the cancer > The patient's age > Personal preferences > Underlying health conditions that may make certain treatments, such as surgery, unsuitable. 'In the past, our precision treatment options were quite limited. 'But today, we are guided by clearer staging and more accurate tools,' he says. Dr Nik outlines the four key stages that influence treatment strategy: > Stage 1: The tumour is confined to the prostate and involves no more than half of the gland. > Stage 2: The tumour remains within the prostate but is more advanced. > Stage 3: The tumour has grown beyond the prostate and may have reached nearby structures such as the seminal vesicles, rectum or bladder. > Stage 4: The cancer has spread to the lymph nodes or distant parts of the body, such as the bones. 'To determine the stage, we typically rely on three approaches: physical examination, blood tests, particularly for prostate-specific antigen (PSA), and imaging. 'Conventional imaging includes computed tomography (CT) scans, magnetic resonance imaging (MRI), and bone scans,' he explains. However, these methods have their limitations. Dr Nik adds: 'They may miss early tumours or small areas of spread, and while blood tests are helpful, they cannot show the precise location of the cancer.' Sharper detection with PSMA PET-CT A key development is PSMA PET-CT imaging – a powerful diagnostic tool that combines positron emission tomography (PET) with CT to detect prostate-specific membrane antigen (PSMA), a protein found on most prostate cancer cells. 'About 80% of prostate cancer cells have a protein called PSMA on their surface,' explains Sunway University consultant nuclear medicine physician Associate Prof Dr Tan Teik Hin. 'We use this to both detect and treat cancer. The approach is simple: we treat what we see, and we see what we treat.' PSMA PET-CT works like a GPS for cancer cells. The CT maps the body's structure, while the PET scan lights up areas where PSMA-positive cancer cells are present. It can detect tumours as small as 0.3cm, far smaller than what conventional scans typically reveal. In an April 2020 ProPSMA study published in The Lancet , researchers found that this method was 27% more accurate than traditional imaging, often leading to significant changes in treatment planning. What is radioligand therapy or RLT? Once PSMA-positive cancer cells are identified, patients may be eligible for RLT. This treatment uses a radioactive compound that binds specifically to PSMA on cancer cells, delivering a precise dose of radiation directly to the tumour while sparing surrounding healthy tissue. Assoc Prof Teik Hin says: 'It's like sending a guided missile to destroy only the cancer cells. 'RLT is not entirely new. A similar concept – using radioactive iodine to treat thyroid cancer – has been in use for over 80 years. 'What's new is applying the same principle to prostate cancer using more advanced, highly specific radiotracers.' After treatment, a follow-up scan (SPECT-CT, a hybrid imaging technique that combines Single Photon Emission Computed Tomography and CT) is conducted to confirm that the radioligand successfully reached and treated the target. From left: Assoc Prof Teik Hin, Prof Tan and Dr Nik were the three medical professionals who led the roundtable discussion on RLT. — Handout Fewer side effects One of the greatest advantages of RLT is its specificity. Because the therapy targets only cancerous cells, it causes fewer side effects compared to systemic treatments like chemotherapy or hormonal therapy. Most patients tolerate it well, with mild side effects such as dry mouth, fatigue or nausea. More importantly, studies show that RLT can help delay disease progression, reduce symptoms like pain, and improve quality of life, especially for men with advanced or castration-resistant prostate cancer. While RLT is currently used mainly for patients with stage 4 prostate cancer who no longer respond to other treatments, ongoing clinical trials are exploring its use at earlier stages. PSMA PET-CT is also being studied for its ability to guide biopsies and detect cancer even before a formal diagnosis is made. 'Compared to systemic hormone therapy, which affects the entire body and can cause fatigue and mood changes, RLT offers a more targeted approach with fewer disruptions to daily life. 'We see a marked improvement in quality of life, and patients report less pain, more energy, and better sleep after the therapy,' says Assoc Prof Teik Hin. The treatment is available at government facilities such as the National Cancer Institute (IKN) in Putrajaya and Hospital Kuala Lumpur, as well as at several private hospitals. The cost of RLT varies depending on the hospital, the number of treatment cycles, and individual response to the treatment. As there is no fixed price, patients are encouraged to consult their medical team to discuss affordability and explore available financial support options. The three experts were discussing 'Size Matters in Prostate Cancer: Experts Highlight Advances to Close Critical Gaps in Care,' in a media roundtable held recently at a private hospital in Petaling Jaya, Selangor.


The Star
19 hours ago
- Business
- The Star
Boosting investor sentiment
PETALING JAYA: As Malaysia gears up to roll out a new investment incentive framework (NIIF) this year, economists believe the country must double down on administrative efficiency and investor support to stand out as a preferred investment destination in an increasingly competitive region. They said that the missing link may no longer be in the policies – but in ensuring the operating environment is truly conducive. Sunway University economics professor Yeah Kim Leng, who also serves as one of five advisers in the Policy Advisory Committee to the prime minister, said that having an attractive investment environment is no longer sufficient. 'We know there are general requirements for creating an attractive investment environment that encourages and fosters investor confidence. 'But that's not enough – confidence also depends on having a conducive operating environment,' Yeah told StarBiz. He said this includes ease of doing business, faster clearance and 'an efficient operating environment that allows them to operate in a more efficient and competitive manner at the lowest possible cost'. While Malaysia has made strides in improving its business environment, Yeah believes further regulatory and legal reforms – particularly at the operational and startup levels – are needed to boost investor sentiment. 'Support should not be limited to financial assistance, but also in terms of administrative and regulatory requirements,' he said. 'We must show our superior hand-holding strategies so that investors are comfortable and can implement their projects quickly.' Despite global headwinds, Malaysia continued to record strong investment numbers. In 2024, the country achieved a record RM378.5bil in approved investments, up 14.9% year-on-year – with domestic investments (DI) making up 55% or RM208.1bil, while foreign investments (FI) accounted for RM170.4bil. The momentum has continued this year. In the first quarter (1Q25) alone, Malaysia secured RM89.8bil in approved investments, up 3.7% from the same period last year – with FI contributing RM60.4bil or 67.3% of total investments, while DI accounted for RM29.4bil or 32.7%. Notably, RM48bil – or 53.4% – of total investments in 1Q25 aligned with focus sectors under the National Investment Aspirations, which prioritise economic complexity, high-value jobs, environmental, social and governance (ESG) adoption and strong domestic linkages. As of June 10, the Malaysian Investment Development Authority (Mida) was managing a pipeline of proposed projects worth RM48.5bil, alongside another RM59.3bil in potential leads currently under negotiation. On these fronts, Bank Muamalat Malaysia Bhd chief economist Mohd Afzanizam Abdul Rashid said the government should examine how well existing tools and support mechanisms are being utilised. 'I suppose we need to go back to the basic question – in light of the existing free trade agreements, what is the utilisation rate among Malaysian firms? Similarly, given all the government assistance which can take the form of grants, microfinancing, tax deductions etc, how much has been utilised,' he questioned. 'If the answer is low, then the government needs to find ways on how the utilisation can be improved.' Mohd Afzanizam also stressed the importance of a smooth experience when navigating government processes. 'At the end of the day, it is about a pleasant experience, especially when dealing with the various levels of government agencies.' He noted that the investment ecosystem spans federal and state authorities, investment promotion agencies and local councils – all of which must coordinate to reduce bureaucratic friction. 'This would mean that the degree of bureaucracy can be quite complicated and therefore, addressing such issues would make the country stand out from the rest of the pack.' Meanwhile, Yeah added that Malaysia could take a leaf out of Singapore's book, especially in terms of administrative efficiency. 'That efficiency, including fast approval and easy access to resolving investors' problems, make up part of the success story of Singapore being able to attract nearly 60% of the total foreign direct investment or FDI inflow into the Asean region.' Commenting on the upcoming NIIF – a new investment incentive structure set to be implemented in 3Q25 – Yeah said that while there is not much information yet, it is expected to enhance Malaysia's competitiveness by aligning incentives with investors' expectations. Still, he believes other key investors' concerns, such as the shortage of skilled labour, must also be addressed. 'There must be a programme to provide win-win solutions for both the government and investors. We can actually focus on fostering greater industry collaboration to provide specialised training,' he said. In the case of the semiconductor industry, for instance, he suggested Malaysia could consider a temporary freeze on foreign talent while ramping up local talent development. The country recently climbed 11 spots to 23rd place in the 2025 World Competitiveness Ranking – its best ranking since 2020, up from 34th last year. The annual report, published by the Switzerland-based Institute for Management Development, evaluates countries based on their ability to create and sustain a business-friendly environment that fosters long-term prosperity. Under the Madani Economy framework, Malaysia is aiming to break into the world's top-12 most competitive economies by 2033. The Ministry of Investment, Trade and Industry (Miti) recently reaffirmed in Parliament its commitment to attracting high-quality investments that align with Malaysia's long-term economic objectives. Together with Mida, Miti said global trade uncertainties call for effective strategies to keep Malaysia attractive to investors and stimulate private investment. 'The government prioritises quality investments that will enhance economic complexity, create high-value jobs for Malaysians, expand domestic linkages, develop new economic clusters and strengthen existing ones, improve inclusivity, and support the ESG agenda.' Miti said the upcoming NIIF, set to be implemented in 3Q25, marks a shift from the current practice of offering incentives based on specific products or activities. 'The NIIF will introduce a new evaluation mechanism for incentive offerings to ensure that better incentives are awarded to high-quality investments,' it said.


The Star
3 days ago
- Business
- The Star
‘Cut red tape, let business grow'
13MP must clear the way for private sector growth, say economists PETALING JAYA: The 13th Malaysia Plan (13MP) must help steer the country's transition towards becoming a high income nation by 2030 with emphasis on greater private sector participation and less bureaucratic red tape, say economists. Sunway University economics professor Dr Yeah Kim Leng is of the view that the 13MP must be in tune with the World Bank's definition of a high-income nation. 'It is important to accelerate economic growth so that the income gap with other high-income countries continues to narrow. 'The plans must also include pressing ahead with the required educational, health, infrastructural and environmental development that underpin a dynamic and resilient economy,' he said in an interview. The 13MP, which is to be unveiled in Parliament on Thursday, will chart a strategic road map for the nation's economy for the next five years. The plan, said Dr Yeah, should also contain mechanisms and policies to help Malaysia shift towards a value added technology and innovation-driven economy where private sector participation is crucial. 'There is also a need for policies to increase revenue mobilisation to keep abreast of the need for higher government spending while simultaneously raising spending efficiency and service delivery effectiveness. 'This can be achieved through digitalisation and technology adoption, especially the use of artificial intelligence.' The economic roadmap, he noted, must include the streamlining and restructuring of government linked companies and state-owned enterprises. 'This will help unlock the country's full economic potential through stronger investment, entrepreneurship and private sector-led growth,' he added. Economist Geoffrey Williams said the 13MP should focus on reducing the role and interference of government in existing business and commercial areas and leaving these to the private sector. 'The government should focus on areas that are the direct legitimate concern of government, including public health, education and social protection. 'Regulations should be slashed and focused only on minimum standards of health and safety, anti-corruption, good governance and anti-trust issues,' he said. The 13MP, he added, must take into account social issues, with the creation of sustainable living income levels in the form of a Universal Basic Income and a Universal Basic Pension. 'These must support policies to raise incomes through meaningful work with a fair share of value created going to employees. 'Free higher education should be a priority through the reform of the higher education system and replacing National Higher Education Fund Corporation loans with a sustainable financial system,' said Williams. The recent changes in the global economic landscape is also a factor that should be addressed under the MP13, he pointed out. 'The United States tariff issue has given us a lesson that protectionist policies come with reciprocal costs. 'So removing restrictions to market access should be a priority for 13MP,' he said. Economist Prof Emeritus Barjoyai Bardai said over-reliance on a purely capitalistic approach with regards to foreign direct investment has resulted in less than 200,000 companies controlling over 80% of the economy. He said there should be a shift towards developing the nation's micro-small and medium enterprises (MSMEs) which make up 65% of the nation's manpower or some three-million workers. The 13MP, he said, must also ensure the development of the nation's semi-conductor industry, which currently ranks seventh globally. Strategic Institute for Asia Pacific senior economic advisor Dr Anthony Dass said the 13MP must shift from the post Covid-19 recovery period to one of economic transformation to drive high-value growth, particularly in the digital and green economy. This, he said, must be coupled by inclusive development and fiscal reform, adding that efforts must also be carried out to boost high-tech investment while accelerating upskilling and technical and vocational education and training.


The Diplomat
6 days ago
- Business
- The Diplomat
Malaysian PM Unveils New Measures to Address Rising Cost of Living
Anwar Ibrahim announced a 100-ringgit payment to all adult citizens, and a further reduction in the price of state-subsidized petrol. Malaysia's prime minister yesterday announced a series of measures to address the country's cost of living crisis, including a cash handout for all adult citizens and a small cut to the price of state-subsidized petrol. In a televised briefing, Anwar Ibrahim announced a one-time cash disbursement of 100 ringgit ($24) to all Malaysians aged 18 and above, which he said will be redeemable at more than 4,000 stores beginning on August 31. He added that the government will also freeze planned hikes in toll rates on 10 highways and increase its subsidies for RON95, the cheapest and most popular fuel, reducing the price from 2.05 ringgit ($0.49) per liter to 1.99 ringgit ($0.47). 'The government is sticking to its plan for targeted RON95 petrol subsidies with details to be announced end-September,' Anwar said, as per Bloomberg. 'What's certain is that just like the approach of targeted electricity subsidies, the government gives its assurance that ordinary citizens won't be affected. In fact let me announce that the RON95 petrol price will fall for citizens.' The cash handout is expected to reach around 22 million people and cost the government around 2 billion ringgit ($472 million),. The cost of living has become an increasing subject of popular concern in Malaysia in recent months, which Anwar's opponents have used to attack his government. As Reuters reported, yesterday's announcement came ahead of a protest that opposition parties plan to hold in Kuala Lumpur on Saturday, which will call Anwar to step down 'over escalating prices and a failure to deliver on promised reforms.' Police say that they expect between 10,000 and 15,000 people to attend the protest. 'I acknowledge the complaints and accept that the cost of living remains a challenge that must be addressed, even though we have announced various measures thus far,' Anwar said during yesterday's announcement, adding that more initiatives to aid those in poverty will be launched today. Yeah Kim Leng, an economics professor at Sunway University in Kuala Lumpur, told Al Jazeera that Malaysian households, especially low- and middle-income households, 'will welcome the cost-of-living relief provided by the measures.' Addressing the increasing prices of basic goods has been on Anwar's agenda since he took office in late 2022, but he has also sought to reduce the spiraling expense of Malaysia's elaborate system of cost-of-living subsidies, which cover everything from fuel and electricity to rice, flour, and cooking oil. These subsidies cost the Malaysian government around 64.2 billion ringgits ($15.2 billion) in 2023. Just weeks into his term, Anwar announced a plan to review the subsidies, to ensure that they primarily benefit those most in need, rather than all segments of society. He said at the time that the purpose of such support was 'to ease the burden of the poor and of course the rich and the industry should not be enjoying it.' In recent weeks, as Reuters reported, Anwar's administration has carried out a number of measures to boost government revenue. It has raised electricity tariffs on heavy users, including power-hungry data centers. It has also revised its sales tax and expanded the scope of its services tax, a move designed to 'strengthen the country's fiscal position by increasing revenue and broadening the tax base to improve the quality of the social safety net without burdening a majority of the people,' according to the Ministry of Finance. However, critics have voiced fears that higher costs would eventually flow down to ordinary citizens, including lower- and middle-income earners. At a political rally in Alor Setar on July 17, former Prime Minister Mahathir Mohamad called on Anwar to step down, citing his governance failures, in particular his mismanagement of the national wealth, which had caused hardship for the Malaysian public. 'Today, everyone has gathered here because we face the same problem – our country is wealthy, but the people remain poor. This is clearly the result of incompetent governance,' Mahathir said. Shortly after Anwar took office, I noted that 'tackling concrete cost-of-living challenges, which cut across ethnic and religious lines, is a good way of winning broad support for his multi-ethnic Pakatan Harapan coalition, and defusing claims that it is seeking to undermine Malay privileges.' Conversely, however, failing to address these concerns – or being perceived to fail – could leave Anwar politically vulnerable to attacks from the right-wing Malay populists of the opposition Perikatan Nasional coalition Anwar's premiership is not seriously under threat, but he may continue to struggle to balance the imperative of reducing cost-of-living pressures for ordinary people and maintaining the government's fiscal health.


Al Jazeera
23-07-2025
- Business
- Al Jazeera
Malaysia's Anwar announces cash handouts in bid to ease living costs
Malaysian Prime Minister Anwar Ibrahim has announced a package of measures aimed at easing the cost of living, including a 100 ringgit ($24) cash handout for all adult citizens. In a televised address on Wednesday, Anwar said the assistance would benefit 22 million Malaysians and be redeemable at more than 4,000 stores from August 31 to December 31. Anwar said the government would also reduce the price of subsidised petrol from 1.99 ringgit per liter from 2.05 ringgit per liter for citizens, and freeze planned hikes in toll rates on 10 highways. An extra public holiday will also be scheduled for 15 September this year to coincide with Malaysia Day, the holiday marking federation, Anwar said. 'Malaysian households, especially those in the low and middle-income groups, will welcome the cost-of-living relief provided by the measures,' Yeah Kim Leng, an economics professor at Sunway University in Kuala Lumpur, told Al Jazeera. Anwar's announcement comes days before a planned rally in Kuala Lumpur to demand his resignation over rising living costs and his alleged failure to implement promised reforms. Police have said they expect up to 15,000 people to attend Saturday's protest, which was organised by the opposition Perikatan Nasional coalition.