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What does it take to diagnose cancer with precision—and compassion? Malaysia’s National Distinguished Professor, Datuk Prof Dr Lai-Meng Looi, shares her decades-long journey as a leading pathologist and pioneer at Cancer Research Malaysia (CRM).
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00:00We are seeing younger people getting cancer compared to decades ago when cancer was really a disease of older people.
00:06Developing a vaccine obviously is something that Cancer Research Malaysia would strive for.
00:12Prevention is the most logical step to take.
00:15There's a lot that is available in the healthcare system for screening, for support, for rehabilitation.
00:22But as I say, to navigate all that is a huge maze.
00:25Any cancer patient can tell you it's hugely expensive, hugely exhausting.
00:30Whatever we say we can provide will not be equitable if we do not get our act together to see what we can do.
00:46Welcome back to another episode of Life Confessions where we have amazing guests join us
00:51and we learn from their life and their research and their expertise.
00:58Today with us is Datuk Professor Dr. Lui Lai Ming.
01:02She is Malaysia's inaugural National Distinguished Professor and also Senior Consultant Histopathologist at UMMC.
01:10Thank you so much for joining us today, Professor.
01:13Thank you very much.
01:15You also sit on the Board of Trustees at Cancer Research Malaysia.
01:18Yes, I do.
01:19You have so many achievements and roles that there is so much to ask you.
01:27Well, it's just part of living.
01:31Well, let's start.
01:32What first inspired you to, you know, specialize in cancer pathology and diagnostic innovation?
01:38And why do you believe this work is so vital for Malaysia?
01:42Well, in terms of pathology in the first place, it was something that really captured me when I was a medical student.
01:52Right.
01:53It was a field and still is, of course, a field that explains the science behind disease.
01:59So it's the foundation of medicine and that really captured me.
02:03So I decided to be a pathologist actually when I was a medical student.
02:07All right.
02:08Not many in my class made up their minds about their career so early, but I did.
02:14And when it comes to cancer pathology, it's so much part of a life of a pathologist when you make diagnosis because so many patients with serious illness have cancer.
02:26It is cancer already among the top five cause of morbidity or illnesses and death among patients, among people globally and certainly in Malaysia as well.
02:46So obviously, it's a very big part of the life of a pathologist because we are the diagnosticians who finally give the answer or the diagnosis of what's behind an illness that the patient comes to hospital to seek relief for.
03:05Therefore, it is obviously very crucial because it's a very serious illness and it consumes so much of the work of doctors and health care professionals to look after them.
03:23But from the point of view of the patient and of society, it's also very serious because it's a huge part of the health care budget to care for them.
03:34And socio-economically, it's also very exhausting and tapping on the family of cancer patients that afflicted.
03:43So therefore, to be involved in cancer pathology and in its diagnosis is a very important area, a vital area to be involved in.
03:58And that's why so many people appreciate you for what you do.
04:01And do you find that people come up to you and because this job can sometimes feel because you're not always meeting people directly, the people that you actually are helping.
04:14Do you find that there are instances where people come up to you and directly show appreciation for what you do?
04:19Well, I do. I mean, people are generous souls, generally.
04:24If they have a chance to express their gratitude or any views, they will do that.
04:29You're right in that. In pathology, we're a little bit in the background.
04:33But we do meet patients. We do meet them at the discussions about their welfare.
04:41And there are always occasions for public engagement or public awareness talks where they do get very curious and they do appreciate that the diagnosis is very important.
04:56Because without the correct diagnosis, you cannot have the correct treatment.
05:00Absolutely. You sit on the Board of Trustees of Cancer Research Malaysia, CRM.
05:07Tell us a bit more about how you define CRM's mission in advancing accurate cancer diagnosis.
05:14Well, CRM is a unique organisation.
05:17CRM is a non-profit organisation, probably the only one in Malaysia that actually focuses on cancer research.
05:26And the cancer research is focused on how to narrow the gap for survival of cancer patients.
05:35It jives with the sort of thing I do because a lot of the ways to improve survival of cancer patients is to firstly understand what cancer is all about.
05:53Of course, there are different ways of approaching how you help cancer patients.
05:58But if you do not investigate what cancer is all about, you will not be able to progress in finding new ways to define it, to diagnose it, to find new things about it,
06:14and therefore to create or find, innovate new ways of treatment.
06:23So what Cancer Research Malaysia sets out to do is to look at where Malaysia stands in terms of the cancer scene.
06:36It does not strive to, like, you know, defeat cancer globally.
06:44It's a huge, lofty kind of thing, you know, like I want to save the whole world kind of stuff.
06:50But it is very pragmatic.
06:54It focuses on what is the big issue for Malaysia.
06:58And you realise that the statistics are quite clear in that, well, almost 50, more than half of cancers in Malaysia are in Asian patients.
07:12And yet the survival rate of cancer patients in Malaysia is way below the global average.
07:19Oh, okay.
07:20Which is sad.
07:22And if you look at research on cancer, only 10% of cancer research come from Asia.
07:31So that's a huge gap.
07:32And that's why Cancer Research Malaysia sets out to focus on cancers that are important for Asia,
07:41particularly important for Malaysia,
07:44so that we're not left behind in the seeking of new knowledge.
07:49Without that new knowledge, there's going to be, it's not going to be easy to find ways to improve the survival
08:00or fill the gaps of whatever gaps we have in the cancer scene formulations.
08:05So I felt that it was an area that I could put my energy into because it's non-profit.
08:17It's really there to try to help.
08:19And it's got a logical approach to how it wants to go about filling the different gaps within the cancer scene in Malaysia.
08:31Considering the work that CRM has already done,
08:35have you seen any discrepancies between the research that's done globally
08:40and the research that has been done by, or the work that has been done by CRM?
08:44Well, we have found things that explain why Malaysians are different.
08:48One of the projects and one of the discoveries in the sense that Cancer Research Malaysia has found
08:58is that through looking at, say, just breast cancer,
09:02because it's one of the most important cancers in Malaysia,
09:06Cancer Research Malaysia has already created the biggest genomic map of Asian breast cancers.
09:14That's the biggest in the world.
09:15I think most breast cancers that we know the genes about, the genetic background about,
09:20are really from the more advanced countries in the Western type of population.
09:25Right.
09:26So with this big genomic database of Asian breast cancers,
09:34you can say, well, so what?
09:35I mean, it's a huge collection.
09:37It's a collection you put on the shelf.
09:39We've been deep diving that data.
09:42And from there, we can curate out, for example,
09:49how to look at risks for our Asian cancer patients.
09:55Right.
09:55We can look at the genetic differences,
09:58and there are mutational and gene differences,
10:02which are the genes that are more important for us,
10:05and which are the risk factors more important for us, and so on.
10:10You mentioned it might be lifestyle changes that has led to some of these different cancers being more prevalent.
10:16What are the biggest risk factors for cancer at this moment in time,
10:21and which ones can people actually control?
10:24Because we know that some of it is genetic,
10:27and we are predisposed to it already from birth.
10:31What are the ones that are the biggest risk factors,
10:34and what can we control?
10:38Even though I say lung cancer has changed,
10:41I still think that the biggest risk factor to lung cancer still remains smoking.
10:48People need to hear this.
10:49You can say, oh, lung cancer is now not so much small cell,
10:55and therefore you don't have to worry about smoking.
10:59That is a fallacy.
11:01Smoking is still the biggest risk for cancer,
11:06not just of lung.
11:08Because smoking also is related to so many other things,
11:14like cardiovascular disease and so on.
11:17So there is a lot tied up with the dangers of smoking.
11:25Right.
11:25Of course, the other risk factors are viruses, which are known agents.
11:31So the human papillomavirus, the cancer-causing types,
11:35there's enough research done in Malaysia as well as globally
11:39that shows that this is a major risk factor for cervical cancer.
11:43And therefore, vaccinating girls at the right age
11:49has been a very important move that the government took.
11:53And that, I think, will make its mark in due course in the incidence.
11:57Some people feel that men should also take the vaccine for HPV.
12:02What are your thoughts on that?
12:04I think they should.
12:05Because the virus is transmitted through contact between men and women,
12:12and the men obviously will also carry the virus.
12:18So it is a logical step to also eliminate it in men.
12:22Right.
12:22And although it doesn't cause cancer in the male organs so much as women,
12:29it also can.
12:31So why not eliminate it?
12:34We've got a pretty good vaccine.
12:37Yeah.
12:37And it's a wise move.
12:40I would agree.
12:41It could be a step forward if they would make it perhaps even a part
12:45of our vaccination schedules that we have as a part of our lives
12:49that we are all adhering to already.
12:51Exactly.
12:52So we should take the logical beneficial steps.
12:56Right.
12:56Any other big risk factors that come to mind?
12:59Well, of course, the other one, hepatitis B.
13:01I mean, people get vaccinated now, so it should help for that.
13:07The other, a bit more subtle, but obesity is a fairly big factor
13:11for cancers like the large intestine, colorectal cancer.
13:17And that's rising very rapidly in the population.
13:23Of course, the pathway, the science behind it is not as straightforward.
13:28Right.
13:28But obesity links to a lot of inflammatory changes and so on,
13:34which finally lead to the inability of the body to eliminate mutations and so on.
13:41So it is quite important to have the right type of lifestyle
13:49so that you don't fall into all the ill effects of obesity.
13:52And honestly, I think the environment, our environment is quite cancer inducing.
14:00We are seeing younger people getting cancer compared to the decades ago
14:06when cancer was really then a disease of older people.
14:10And of course, for young children, because then for young children, it's more genetic-based.
14:16But now we see younger people getting breast cancer, getting colorectal cancer and so on.
14:23I think a lot of it is the environment we live in.
14:26Our environment has just too many carcinogens.
14:30In the air, we breathe.
14:31In the food we eat.
14:32In the water we drink.
14:34We are doing it to ourselves in many cases.
14:37I think we are just not managing our environment well.
14:41Right.
14:41Yeah.
14:43And some of it can be...
14:46Well, some of the factors that you have mentioned,
14:47we can take responsibility for on a personal level.
14:52But for other factors, it may be more systemic.
14:56Because for some factors like...
15:00For example, this is so difficult to discuss.
15:04Because when it comes to obesity, I always feel, in my own opinion,
15:07that is both an issue that is personal and also societal at the same time.
15:13Right?
15:13If you make all the food already unhealthy around you,
15:17then you're putting too much response...
15:18People may expect too much from a person to be responsible all their own.
15:25For a risk factor of someone who is obese,
15:28is there a percentage that we can look at
15:30when it comes to the risk factors of developing cancer?
15:34I can't put a figure to it.
15:38Because a lot of obesity actually expresses itself with the other chronic diseases.
15:43Like diabetes, hypertension, chronic heart disease.
15:47Right.
15:47You know.
15:49Right.
15:50They get stents put in.
15:51They die of heart attacks and so on.
15:53But certainly, when it comes to cancer,
15:56I mean, there's a risk for colorectal.
15:59Even for breast cancer, there is a risk.
16:01But the percentage of the amforia can't just immediately say.
16:05Right, right.
16:06But it's definitely a factor.
16:07It's definitely a factor.
16:09Right.
16:09And it may also explain why the age group is getting younger for getting cancers.
16:15It's because the obesity rate is rising among younger people.
16:21It's something we need to definitely take a look at as a society as well.
16:25Now, it's very exciting, Professor,
16:27that we've learned about the development of oral cancer vaccines.
16:32Can you share the key challenges and breakthroughs
16:34in developing the oral cancer vaccine currently in clinical trials?
16:39And what surprising insights have emerged so far, if any?
16:43Well, developing a vaccine, obviously, is something that Cancer Research Malaysia would strive for
16:50because, as you have also mentioned earlier,
16:54prevention is the most logical step to take.
17:00But developing a vaccine is not an easy task
17:05because bringing bench to bedside is a cliché,
17:09but it is a very long route and a very tough route.
17:14And to just look at what kind of vaccine can work
17:20is a lot of laboratory work that involves cell lines,
17:24picking on which particular target a vaccine should work on,
17:31testing out on cell lines and animal models.
17:34And I won't bore you with all the detailed experiments
17:38and the heartbreaking failures along the way.
17:41But they did find a vaccine that was promising
17:46in that when we worked on animal models,
17:49it seemed to work against oral cancer.
17:54And of course, oral cancer is something we were interested in
17:58because it's a neglected cancer that the West will not work on,
18:02but it's important for Malaysia.
18:04So it goes back to the theme that we want to look at,
18:07cancers that are important for Asians.
18:10But after having done that,
18:13to bring it to clinical trial is important
18:15because you cannot just jump from something that works in animals to humans
18:21and just like that, you expect it to take off.
18:24Obviously, it's not, I mean, logically, you know, that's a big jump.
18:28I said, you know, how do you know?
18:31I mean, we are animals, true, but we're not mice.
18:35Sometimes we are mice, but generally, no.
18:39And there are a lot of phases when you want to bring something to clinic.
18:45Right.
18:46In clinical trials, we may be familiar with something,
18:50the four phases of clinical trials.
18:52But in simple, logical reasoning,
18:55you would think that the first step would be to make sure
18:58that this product, let's say a vaccine,
19:01doesn't do any harm to the human body.
19:07Even if you say it's super good for killing cancer cells,
19:10but will it just kill the person straight away?
19:13Of course.
19:13Side effects and what else does it do?
19:15So the first is to see whether it produces,
19:18it's tolerated by the human body.
19:21If there are side effects, is this acceptable?
19:24Side effects that are so minor that you don't have to worry too much about.
19:32Then if that works, then you go to the next phase and say,
19:35well, does it set out to do what it's supposed to do?
19:39Does it knock off the cancer cells that it's supposed to knock off within the human body?
19:46So that's the next phase.
19:48And then the next phase is to find out, you know,
19:51if you do it in an unbiased way,
19:54what they call a randomized controlled trial,
19:59do you really get significant results
20:04that it really is not a spurious kind of observation?
20:09Imagine against a control group to make sure that it's actually the vaccine that is making.
20:13It's a non-biased kind of control group,
20:15comparable groups.
20:18And then, of course, the last phase would be
20:20the question of, so what?
20:23So you've got something,
20:25but is it better than what we already have?
20:28So is it superior?
20:30Is it at least non-inferior?
20:33Is it cheaper?
20:34Is it more affordable?
20:36I mean, these are all the big questions you have to do.
20:40So it is challenging for an organization like Cancer Research Malaysia,
20:46which is not a huge institution with a huge amount of funding behind it.
20:55Our job was merely to look at research.
20:58So to be able to take it to clinical trials means you need partners.
21:05Partners are willing to invest in the trials,
21:10and seeking for partners was the biggest challenge
21:14because this is the first time we are trying to bring our own product
21:21and say, you know, give it a try.
21:24It may work.
21:26And we have to show very good science behind it that it works.
21:30Yeah.
21:31So that's the challenge.
21:34This process can be so heartbreaking for someone who's involved in it,
21:39like such as yourself.
21:40I mean, what guiding principles, Professor, or values do you lean on
21:45when experiments or trials don't go as planned sometimes?
21:50Well, the experiments will always have some that don't go to plan.
21:54So it's something that you have to be aware of
21:58when you start off with experiments.
22:00Right.
22:00You are right.
22:02The guiding principles are important
22:04because that's how you face disappointments.
22:09And in clinical trials,
22:12the guiding principles are actually fairly straightforward.
22:16As a medical doctor, it's more or less ingrained in me,
22:20and I'm sure in all the medical scientists and researchers too.
22:24The first principle would be do no harm.
22:27Yeah.
22:27I mean, you just have to know that
22:30if you're setting out something that might do harm,
22:33then don't do it.
22:34Right.
22:35I mean, if the experiment doesn't work,
22:38and you try to find out why it didn't work,
22:41but if you force it and it does harm,
22:44then you should stop it.
22:46So examine what went wrong
22:48and correct what may be the step
22:55that has made the experiment fail.
22:57Right.
22:59But in that process,
23:01make sure that it doesn't cause any increased risk
23:08or increased,
23:09I've used the word harm
23:12because we've used the harm to the patient.
23:16So the willingness to pull out an experiment
23:18that is really more harmful than beneficial
23:21is very important.
23:23You have to take that step.
23:25Right.
23:25Knowing that whatever failure that you face
23:30brings you closer perhaps to the end goal,
23:34which is a vaccine that is viable
23:37and does no harm.
23:40Does no harm.
23:40And it's safe.
23:42Right.
23:42I mean, it has to be safe.
23:44Otherwise, you shouldn't be.
23:48Yeah.
23:48Is the goal keeping you moving then
23:50is knowing that you're getting closer to the end goal?
23:53I think that's the point.
23:54I think everything has to be refined
23:56so that it's effective.
23:58It's, you know,
24:00it is efficacious.
24:02Right.
24:03It is useful.
24:05Right.
24:06It does fill a gap that is there.
24:09Right.
24:10And most importantly, it's safe.
24:13And I think the second principle I've always held
24:17is that to be ready to be audited.
24:19Hmm.
24:20Don't hide anything.
24:23Right.
24:24Because you need to,
24:25an independent audit to see, you know,
24:29whether what you're doing is correct
24:33in both the scientific aspects
24:35as well as the ethical aspects.
24:38Hearing you speak about your process
24:40and the way you think
24:43when it comes to developing the vaccine
24:46makes me feel secure
24:47knowing that when this vaccine finally
24:49comes to market,
24:50I'd be willing to actually take it
24:52because you take it so seriously as well.
24:56Professor, what programs has
24:57Cancer Research Malaysia launched
24:59to improve public understanding
25:02of cancer prevention and early science?
25:05Some people might feel that
25:06there is so much information about this already,
25:09but I personally don't think that there's enough.
25:12So what do you think
25:14when it comes to improving
25:15public understanding of cancer prevention
25:17and early science?
25:21It's a bit of a loaded question.
25:23I mean, Cancer Research Malaysia
25:24is a research thing.
25:26So obviously it's not...
25:28Not on the awareness side as much.
25:30I mean, it does try to promote awareness,
25:33but it is...
25:34The main focus is...
25:36is discovery, innovation,
25:41improving understanding, and so on.
25:45But we do have a lot of engagement
25:47with the public in that...
25:51Lots of public have come to visit us,
25:53for example, just to see what we do.
25:55I think that inspires them.
25:57We do have...
25:59One of the programs
26:00that we are quite far into the game
26:04is a patient navigation program.
26:06It may not be so much awareness
26:09of cancer as such,
26:11but that public engagement,
26:13I think, spins off to the public.
26:17In patient navigation,
26:19we help patients understand
26:22all the...
26:24how to navigate
26:25all the complex areas
26:27that relate with a cancer diagnosis,
26:33including the screening,
26:36because some people don't screen
26:37because it's so difficult.
26:38They don't know where to go.
26:41And it's so...
26:42There are so many...
26:47It's complicated.
26:48Complicated.
26:49Right.
26:49You know.
26:50Because there are many...
26:52The road from discovering...
26:55from diagnosis
26:56to being able to say
26:59a person is either in remission
27:01or cancer-free,
27:03there are many roads.
27:04Yes.
27:05Yeah.
27:05You put that very well.
27:07But for a cancer patient
27:08receiving a diagnosis,
27:10can you imagine
27:11he's got to...
27:13He or she has to navigate
27:14to CT scan,
27:15to staging,
27:17then he's got to go
27:19for rehabilitation,
27:20he's got to go for treatment,
27:22and clinics after clinics,
27:25and it's costly,
27:27he has to pay this,
27:28he has to do that,
27:30and he has some...
27:32He or she has to travel
27:33long distances,
27:34and after that,
27:37the follow-ups,
27:39I think a lot of people
27:40give up.
27:41They give up
27:41because it's...
27:43They're just too tired
27:44and they don't have
27:45all the help
27:46within their family.
27:48Right.
27:48So,
27:49the patient navigation program
27:51that Cancer Research Malaysia
27:53put so much effort into,
27:56I think,
27:56has improved
27:58the survival
28:00of cancer patients
28:01quite a lot
28:02in that
28:03the percentage
28:05of patients
28:07able to complete
28:09their treatment
28:09and get
28:11to...
28:12to follow
28:14the treatment pathway
28:16has improved
28:19from,
28:20I mean,
28:21to one-figure
28:21kind of percentage
28:22to double figures.
28:24Wow.
28:25And we hope
28:26to do a lot more.
28:27So,
28:27we're setting up
28:28quite a lot of
28:29navigation programs
28:32throughout Malaysia,
28:34both East Malaysia
28:35and West Malaysia
28:36and in partnership
28:37with the Ministry of Health.
28:39Right.
28:39It sounds like
28:40the biggest benefit
28:41of the patient navigation program
28:42is time,
28:44is to be able
28:44to save the patient
28:45time
28:46when it comes
28:47to seeking out
28:48that next step
28:49in their
28:50treatment.
28:53Time
28:53is obviously
28:54one of them.
28:55the other
28:56is just
28:57assurance
28:57that they
28:59really do
29:01reap the benefits
29:02that already exist
29:03within our
29:04healthcare system
29:05for them.
29:06There's a lot
29:07that is available
29:08in the healthcare system
29:10for screening,
29:11for support,
29:11for rehabilitation,
29:13for treatment,
29:15for whatever.
29:16But,
29:16as I say,
29:18to navigate
29:18all that
29:19is a huge maze.
29:20Yeah.
29:21And people lose
29:22out because
29:22they give up.
29:24Where do they go
29:25to find out
29:26what services
29:27they need then?
29:29Where's that first stop
29:30that a cancer patient
29:32who first found out
29:33at diagnosis point
29:35that they have,
29:36they've diagnosed,
29:37they've been diagnosed
29:38with cancer,
29:39where do they go
29:40to find out
29:40what their options are?
29:42Is there a place?
29:43Well,
29:44I suppose
29:45in the first place
29:46when the diagnosis
29:47is made,
29:47they talk to their doctor
29:48and the doctor
29:49will say that
29:50you need to be
29:51staged.
29:52We need to know
29:53how advanced
29:54a cancer is
29:55because
29:55an early cancer
29:57is different
29:58from an advanced cancer
29:59so you have to go
30:00for staging scans
30:02so they've got
30:03to navigate
30:03to imaging
30:04and so on.
30:07Not everybody
30:07knows where
30:08to go
30:09for that.
30:10Are there support
30:12services to,
30:13is that someone
30:14they can talk to?
30:15Is that,
30:15that's basically
30:16the program.
30:18The health service
30:19is sometimes
30:19so busy.
30:23I mean,
30:23you can,
30:24the nurse
30:24or the doctor
30:25can say,
30:26so you,
30:27I give you
30:27an appointment,
30:28you can go down
30:29to imaging,
30:31then your mind
30:31is where on earth
30:32is imaging.
30:32Yeah.
30:33And who's going
30:34to take me there?
30:35Yeah.
30:35If you have
30:37somebody with you
30:38who's able
30:39to navigate
30:40with you,
30:40that's fine
30:41but not everybody
30:41has that.
30:42So this patient
30:44navigation program
30:45provides that
30:46kind of support.
30:47Right.
30:47You can go
30:48to the,
30:49the navigation
30:50center
30:51which then
30:52helps you
30:52to say,
30:53well,
30:53this is where
30:54you go,
30:54this is how
30:55it will take you,
30:56these are the
30:57people who,
30:58who provide
30:59that kind
31:00of support
31:00service
31:01actually help
31:02them go around.
31:02Is it all online?
31:04It's online
31:05and it's in person
31:06as well.
31:07As well,
31:07okay.
31:08Is there an app
31:08for it as well
31:09or is it?
31:12I'm not sure
31:13that there's an app
31:14in it
31:14but I,
31:15that's a great idea.
31:16Yeah.
31:17I'm sure that
31:17there are already
31:18many services
31:19where the appointments
31:20are online
31:21but you still
31:22have to turn up
31:23so somebody
31:25has to tell you
31:25where to go.
31:26Right, right.
31:27Well,
31:27it's,
31:28it seems like
31:29a step forward
31:30but it also seems
31:31like there might,
31:31may as well be
31:32some gaps.
31:32that need to be filled
31:33to help a person
31:34especially someone
31:35who's trying to navigate
31:36it alone
31:36without support
31:37from family
31:38perhaps.
31:39Yeah.
31:39Yeah,
31:40a person who's already
31:40feeling ill
31:41and then having
31:42to deal with that
31:43but it's great.
31:44But this I think
31:44is more personal
31:45than just an app.
31:46Yeah,
31:47yeah,
31:48absolutely.
31:48It also helps
31:49to actually
31:50seek out
31:51all the benefits
31:52the government has
31:52for people who,
31:53there's some things
31:54that are free,
31:55there's some things
31:56that are discounted
31:57for cancer patients
31:58and patients
31:59may not know.
32:00Yes.
32:01So this
32:02navigation
32:03or the navigators
32:05help you
32:06reap all those benefits
32:08and also
32:08puts a human face
32:10to the care.
32:12Are they found
32:12in
32:13in every
32:15public hospital?
32:17We're increasing
32:18the numbers.
32:19Right.
32:19So in the past year
32:20I think
32:21it's probably
32:22increased by
32:23almost
32:25twice
32:27the numbers
32:28already
32:28because we've
32:29got
32:29good support
32:31from Minister
32:32of Health
32:32to set up
32:33such centres.
32:34Okay.
32:34So over time
32:36I think this is
32:36something that
32:37become
32:37quite
32:38hopefully
32:40quite well
32:40established
32:41within the
32:42healthcare service.
32:43To find out
32:44where the centres
32:45are
32:45is it
32:47it's actually
32:49all over
32:50the major
32:51hospitals
32:51now
32:52and even
32:53some of
32:54the district
32:54hospitals.
32:55Located on
32:56site.
32:56On site.
32:57Right.
32:58That's definitely
32:58helpful.
32:59Yeah.
33:00Good to know
33:00that there is
33:00someone that
33:01they can turn
33:02to to help
33:02figure out
33:03what do I do
33:04next
33:05and where
33:05do I go.
33:06How is
33:08Cancer Research
33:09Malaysia
33:09partnering
33:10with the
33:11Ministry of
33:12Health
33:12to improve
33:13national
33:13screening
33:14programmes?
33:15This would
33:16be a part
33:16of the
33:17prevention
33:17as well
33:19or detection
33:19early
33:20right?
33:20Early detection.
33:21Yeah.
33:22I suppose
33:23to some
33:26extent it's
33:26incorporated
33:27in the
33:27navigation
33:28programme
33:28that there
33:29is also
33:29a screening
33:30component.
33:34I think
33:35the country
33:35has its
33:36own
33:36screening
33:37programmes
33:37already
33:38existing
33:39so it's
33:39really
33:40helping
33:41patients
33:42assess
33:43those
33:44screening
33:45programmes
33:46that
33:46are
33:46available
33:47just for
33:47the person
33:48to actually
33:49go for
33:49the screenings
33:50make an
33:51appointment
33:51because I
33:53know that
33:53at one
33:54point
33:54every
33:55Malaysian
33:56man and
33:57woman who
33:57turned 40
33:58would receive
33:59a letter
34:00that would
34:01invite them
34:02to a
34:03full body
34:04screening.
34:05I gotta say
34:05I missed
34:06mine
34:06I did
34:06not get
34:07it
34:07so yeah
34:09things like
34:10that where
34:10you get a
34:11reminder to
34:12go and get
34:13a check-up.
34:14Yeah I
34:15think in the
34:16healthcare
34:16services they
34:18take care of
34:19that.
34:19As a
34:20research
34:20institution we
34:21cannot impose
34:22on that
34:23but what we
34:24can do in
34:25the research
34:25area is to
34:26perhaps
34:27work on
34:30perhaps new
34:32targets of
34:34screening and
34:35so on.
34:36I can't
34:37say that
34:37we have
34:38created a
34:40big mark
34:41there yet
34:42because most
34:43of the work
34:43that we're
34:44doing in
34:45discovery
34:46science have
34:47been more
34:48on the
34:48genetics part
34:49of it and
34:50then working
34:51towards a
34:52more accurate
34:52diagnosis and
34:54a more precise
34:55diagnosis which
34:58can make a
34:58difference
34:59subsequently to
35:00how to
35:01treat the
35:01patient because
35:02a precise
35:03diagnosis
35:03stratifies out
35:06which patient
35:08responds to
35:09what treatment
35:10better and
35:12you don't
35:12therefore waste
35:13the treatment
35:14you offer a
35:15patient a
35:16treatment that's
35:16not going to
35:17work because
35:18that cancer
35:19doesn't have
35:19the correct
35:20pathway for
35:21that drug to
35:22work.
35:23Knowing exactly
35:24what you have
35:24or is close to
35:25exactly what you
35:26have.
35:26Yeah it's not
35:27a targeted
35:28treatment kind
35:29of thing
35:29personalized
35:30medicine.
35:31That has been
35:32more the focus
35:32and then
35:33subsequently into
35:34into the
35:39modifying
35:39treatment or
35:41repurposing drugs
35:42that will target
35:43the right
35:44aspects.
35:45That has been
35:46cancer research
35:47malicious strength
35:48in research.
35:52So that's why
35:53I can't answer
35:55the screening
35:56part so much
35:57because that's
35:57really the
35:58operational part
35:59of the
36:00Ministry of
36:00Health.
36:01That makes
36:01sense.
36:02That makes
36:02sense.
36:03You know
36:03Professor you've
36:04done so much
36:05in your career
36:05already as a
36:07mentor and
36:08leader.
36:09What do you
36:09hope your
36:11legacy at
36:12Cancer Research
36:13Malaysia will
36:14be for the
36:15next generation
36:16of Malaysian
36:17pathologists and
36:18cancer researchers?
36:20You've done so
36:21much already.
36:22How do they
36:22continue to build
36:23on what you
36:26said?
36:27Well I don't
36:28see this as a
36:29personal legacy.
36:31I mean it's
36:32what we all
36:34do in the
36:34profession, in
36:35whichever profession
36:36you have chosen
36:38to be.
36:40I tend to look
36:42at legacy
36:43in two ways.
36:45The one that I
36:46really want to
36:46see happen is
36:47not so much a
36:49personal legacy
36:50but to which I
36:51have also put a
36:52lot of effort.
36:54And that is
36:55actually public
36:57awareness of
36:59the importance
37:00of research.
37:04People don't
37:05realize that
37:07research is
37:09their responsibility.
37:11And my reason
37:12for saying that
37:14is because if
37:16you're trying to
37:17fight a battle
37:18like cancer,
37:20you cannot fight
37:21it if you don't
37:22know your
37:22enemy.
37:24The more you
37:24know your
37:25enemy, the
37:26better your
37:26chance at
37:27fighting it.
37:29And therefore
37:29cancer research,
37:31to fight
37:33cancer, if you
37:33do not invest
37:34in research,
37:36you're going to
37:36be in status
37:37quo.
37:38And finally the
37:39cancer wins.
37:41Because the
37:41cancer mutates
37:43and progresses
37:44and it's got a
37:46mind of its own,
37:47so to say.
37:48And then here
37:49you're just
37:50staying behind
37:50and not
37:51researching it.
37:52So you can
37:53say, oh,
37:53others can do
37:54the research.
37:55But if
37:56public do
37:57not support
37:59research and
38:00cancer research
38:01at that,
38:03you're not
38:03investing in
38:05your future.
38:06You're not
38:07investing in the
38:08future of your
38:09children and your
38:09grandchildren who
38:11will also face
38:12cancer.
38:12And to
38:15better reverse
38:16cancer and
38:17reduce the
38:17harm and the
38:18fear of cancer,
38:19you have to
38:19research it.
38:20So to me,
38:22I'm answering
38:22your question
38:23in a roundabout
38:24way, but I've
38:26spent a lot of
38:26time trying to
38:27explain to
38:28people why
38:29cancer research
38:30is necessary
38:31and they should
38:32support it,
38:33whether by
38:33donations or
38:34by whatever
38:35in kind means,
38:37and not say
38:38that it's some
38:38other person's
38:40responsibility.
38:41It's to be
38:41undervalued.
38:42Is that what
38:43it feels like?
38:43It's undervalued?
38:45It's undervalued.
38:47I wouldn't put
38:48it in so
38:49negative.
38:49It's just that
38:50they don't
38:52understand the
38:53importance of
38:54their personal
38:55contribution towards
38:57research.
38:59And then, of
39:00course, my
39:00second message
39:02in terms of
39:04legacy to
39:06the pathologists
39:08that I've
39:08trained and to
39:09the researchers
39:10I've trained
39:10is to be
39:12true to
39:12your research.
39:13I mean,
39:14you have to
39:15put passion
39:18into your
39:18research.
39:19You have to
39:19be creative
39:20and not just
39:22say that my
39:23PhD is in
39:24this and
39:25therefore I'm
39:25going to
39:26only focus
39:26on this.
39:28I mean,
39:28you have to
39:29think out
39:30of the box.
39:32You have to
39:32be creative,
39:33to be bold,
39:34to be
39:34innovative,
39:36to seek.
39:38new pathway.
39:41Do you see
39:42this happening?
39:43There will be
39:44that spark in
39:45some of them
39:46and there will
39:47be some who
39:48will just say
39:49that I'd
39:52stay in the
39:52safe kind of
39:53research.
39:55You've seen
39:55both sides.
39:56I've seen
39:56both sides.
39:57I mean,
39:57that's people.
39:58That's people.
39:59But researchers
40:02have to be bold
40:03and innovative
40:05to seek out
40:07new angles
40:09to tackle
40:10cancer.
40:11And to see
40:12the change
40:13and development
40:15that will help
40:16ultimately not
40:17just if a
40:19person is
40:20looking for
40:21to be
40:22appreciated
40:23while also
40:25helping people
40:26at the same
40:26time,
40:27this is the
40:28perfect avenue
40:29for it.
40:30Because you
40:31achieve both
40:32at the same
40:32time.
40:32Exactly.
40:33Yeah.
40:34Okay,
40:34Professor,
40:35we've come to
40:35the rapid fire
40:37question segment
40:38of this
40:39interview and
40:40we're going to
40:41use this rapid
40:42fire segment
40:44or part of
40:45the interview
40:46to try to
40:47debunk or
40:48learn more
40:48about some
40:49commonly held
40:50beliefs
40:50about cancer.
40:53So,
40:53short,
40:54succinct answers
40:55about your
40:56thoughts on
40:56what people
40:57think.
40:58Okay,
40:58let's go with
40:59the first one.
41:00Does eating
41:01sugar feed
41:02cancer cells
41:03and make
41:03tumors grow
41:04faster?
41:07Well,
41:07I would
41:10say no.
41:13All cells
41:14need sugar.
41:16Cancer cells
41:16will grow
41:17faster
41:18irregardless
41:19of whether
41:20you feed it
41:20more sugar
41:21or not,
41:21it will
41:22just take
41:23whatever
41:23sugar it
41:23wants.
41:24And by
41:25depriving
41:26sugar or
41:28starving what
41:28you think is
41:29starving or
41:29cancer,
41:30you probably
41:30will deprive
41:31your normal
41:32cells of
41:32what it
41:33needs as
41:33well.
41:34That's
41:34clarifying a
41:35lot already.
41:36Do
41:36antioxidant
41:38supplements
41:38like high
41:39dose vitamin
41:40C or E
41:41protect against
41:42cancer?
41:43Protect against
41:44cancer?
41:44I mean,
41:46there's some
41:47logical basis
41:47to it in
41:48that it
41:49helps your
41:52body to
41:52fight DNA
41:54damage.
41:56But what I
41:56would say,
41:57if you're going
41:57to depend on
41:58supplements like
41:59this to fight
42:00cancer, I think
42:00it's not going
42:02to be a very
42:02effective way
42:03of fighting
42:06cancer.
42:06I think
42:07a balanced
42:08diet with
42:09more balanced
42:11antioxidants
42:12would do a
42:12better job
42:13than just
42:14focusing on
42:15one or two
42:16supplements.
42:16This isn't a
42:17silver bullet.
42:20This is one
42:22that you hear
42:22a lot.
42:23Well, I seem
42:23to read up a
42:24lot on in
42:25social media.
42:26Do cell
42:27phone or
42:27Wi-Fi
42:28signals
42:28significantly
42:29raise
42:30cancer risks?
42:32You hear about
42:33those 5G
42:34towers that
42:35people keep
42:36associating
42:37with
42:37diagnosis.
42:39Your thoughts,
42:39Doctor?
42:40Professor?
42:41I don't think
42:42that science
42:42will support
42:43that.
42:44It's a
42:45totally
42:45different
42:46frequency.
42:48Wi-Fi
42:49is radio
42:50frequency.
42:51Yeah.
42:53Whereas what
42:54causes cancer
42:55is ionizing
42:55radiation.
42:57And this
42:58is just not
42:58ionizing
42:59radiation.
43:00No.
43:00So many
43:01people need
43:02to hear that
43:02from you,
43:03Professor.
43:04Absolutely.
43:04Next question.
43:07Is it
43:07true that
43:08using plastic
43:08containers in
43:10microwaves
43:10release cancer
43:13causing
43:13chemicals?
43:15Microwavable
43:16plastics are
43:17made so that
43:18they don't
43:18release these
43:19chemicals.
43:20So, no.
43:22Short and
43:22direct.
43:23And finally,
43:24will cutting
43:25out all
43:26fats from
43:27a person's
43:28diet help
43:29prevent cancer?
43:30Well, that's
43:31a very
43:32nice wish
43:33list, but
43:34I would
43:35say no.
43:37You need
43:37some fat.
43:38Yeah.
43:40There are
43:40some good
43:41fat from
43:42avocados,
43:44nuts,
43:45and so on.
43:47Which are
43:49important for
43:51your cells.
43:52I mean,
43:52many of your
43:53cell membranes
43:54need fat,
43:55and your brain
43:55needs fat.
43:56Yeah.
43:56So, if you
43:57cut it all
43:58out, I
43:58think your
43:59body will
43:59suffer a
44:00lot more.
44:00Right.
44:02So, don't
44:02cut fats
44:03out completely.
44:04No.
44:05I mean,
44:05basically,
44:06everything has
44:07to be in
44:08a balanced
44:09form.
44:10So, I
44:10think to be
44:11a diet
44:11extremist is
44:12actually quite
44:13harmful.
44:14No matter
44:15what that
44:15diet is,
44:16if you're
44:17going to
44:17an extreme
44:17of any
44:18form of
44:18diet.
44:19Right.
44:20And this
44:21is a
44:21closing
44:22question that
44:23we ask
44:23all of our
44:24guests,
44:24professor.
44:25And we
44:26want to
44:27know your
44:27thoughts.
44:28If you
44:28had the
44:29opportunity
44:29to make
44:31one change
44:32as Prime
44:33Minister of
44:33Malaysia
44:34for a
44:35day,
44:36just one
44:36day,
44:37what would
44:37it be
44:38and why?
44:38What would
44:38that change
44:39be?
44:40Oh, my.
44:45Basically,
44:46I want to
44:47get all the
44:47stakeholders on
44:48cancer together
44:49and let
44:50them meet
44:51each other
44:51and
44:53talk about
44:56what they
44:57can do
44:58collectively
44:59to
45:01improve
45:02the cancer
45:03scene.
45:04And the
45:04biggest
45:05challenge
45:05that I
45:06see is
45:08that we've
45:08got different
45:09pockets of
45:10talent and
45:12approaches
45:14to cancer
45:17all with
45:18good purpose
45:20in mind,
45:21helping cancer
45:22patients,
45:22but it's
45:23not effective
45:24if they work
45:24in silos.
45:26I think
45:26the biggest
45:27challenge is
45:28availability
45:30of, say,
45:32diagnostics
45:33and therapeutics,
45:35accessibility,
45:37and more
45:38importantly,
45:38affordability.
45:40I mean,
45:40there are lots
45:41of things that
45:41Malaysia has,
45:43from screening
45:44to diagnosis
45:45to treatment
45:46to palliative
45:47to whatever,
45:48but it
45:50is not
45:52available to
45:53everyone
45:53because it's
45:55not affordable
45:55for everyone.
45:57And we
45:58know that,
45:59I mean,
45:59any cancer
46:00patient can
46:01tell you it's
46:01hugely expensive,
46:03it's hugely
46:04exhausting,
46:05and whatever
46:07we say we
46:08can provide
46:09will not be
46:10equitable
46:10if we do
46:12not get our
46:13act together
46:13to see what
46:15we can do.
46:15So I think
46:16somebody,
46:17maybe the
46:18Prime Minister,
46:19can bring
46:19them all
46:19together
46:20and get
46:22them to
46:22meet each
46:23other,
46:23whether they
46:24are academics
46:25or researchers
46:26or innovators
46:27or entrepreneurs
46:28or lawyers
46:29or social
46:31workers and
46:32patients
46:33and
46:33You highlight
46:34that amazingly
46:35good point
46:36that people
46:37overlook all
46:37the time,
46:38which is
46:39sometimes the
46:39only thing
46:40stopping a
46:41person from
46:41getting the
46:43treatment,
46:43any treatment
46:44really,
46:44but in
46:45this case,
46:45the cancer
46:45treatment
46:46that they
46:46need,
46:47the only
46:47thing sometimes
46:48is the
46:49cost.
46:50It's the
46:51ability to
46:51afford it.
46:53And that is
46:53tragic.
46:54That is it.
46:54The iniquity
46:55of affordability
46:57is a major
46:58issue.
46:59So cancer
47:00faced by a
47:02person who
47:02has resources
47:03is very
47:05different from
47:06someone who
47:07does not have
47:07resources.
47:08It's not too
47:09late to run
47:09for the next
47:10election,
47:10you know.
47:10It's a big
47:11iniquity issue.
47:12I'll vote for
47:12you.
47:14Thank you so
47:17much for
47:17joining us
47:18today.
47:18You're
47:19welcome.
47:19Thank you
47:20to Datuk
47:20Professor Dr.
47:21It was such
47:22a pleasure.
47:23Datuk
47:23Professor Dr.
47:24Louis Lai
47:25Ming,
47:25we learned
47:25so much
47:26today and
47:27we look
47:27forward to
47:28our next
47:28guest as
47:29well.
47:29He will
47:30join us
47:30on Live
47:30Confessions
47:31here on
47:32Shock.
47:33Thank you
47:33again,
47:34Professor.
47:34Thank you
47:35very much.
47:35Thank you
47:36very much.
47:37Thank you
47:38very much.
47:39Thank you
47:40very much.
47:41Thank you
47:42very much.
47:43Thank you
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