KUALA LUMPUR, May 6 — Lung Cancer Network Malaysia (LCNM) recently launched the first-ever clinical practice guidelines (CPG) for lung cancer in Malaysia at the third annual National Lung Cancer Symposium in Kuala Lumpur on April 26, 2025.
The guidelines developed by LCNM for the peri-operative clinical management of early-stage resectable non-small cell lung cancer (NSCLC) has been endorsed by the Malaysian Thoracic Society, Malaysian Oncological Society, Malaysian Association for Thoracic and Cardiovascular Surgery and the College of Surgeons, Academy of Medicine Malaysia.
Prof Anand Sachithanandan, a senior cardiothoracic surgeon, LCNM founding president and chair of the surgical guidelines expert working group said the CPG was most timely given the high disease burden here.
According to the latest National Cancer Registry report (2017-2021) lung cancer (mainly NSCLC) is the number 2 cancer in Malaysian men and number 3 cancer in women, with 95 per cent of cases detected late in advanced stages of 3 or 4, beyond a cure.
According to Prof Sachithanandan, the treatment paradigm for early-stage resectable NSCLC has evolved considerably due to tremendous progress in the diagnosis and treatment of lung cancer in recent years.
This CPG will elevate and harmonise the standard of medical care with provision of contemporary, high-quality comprehensive holistic care and timely intervention based on the best available scientific evidence and importantly, takes into consideration real-world factors based on local expertise, facilities and experience.
The optimal care for many lung cancer patients requires a multi-disciplinary approach and multi modal therapy with surgery often a key component, and this is reflected in the inaugural Malaysian guidelines, he added.
Beyond early detection, time to treatment initiation, reflex genomic testing to determine the tumour biology which guides type and sequence of treatments, and expert multi-disciplinary review for complex cases are critical for good outcomes, elaborated Prof Sachithanandan, who is also an honorary professor of cardiothoracic surgery at both University Malaya and Sunway University.
The members of the surgical guidelines expert working group comprised cardiothoracic surgeons and general thoracic surgeons from Ministry of Health (MOH) government hospitals, university hospitals, and the private sector, including Prof Sachithanandan (Selangor), Prof Soon Sing Yang (Sarawak), Dr Adrian Ooi Seng Wae (Malacca), Dr Diong Nyuk Chai (Johor), Prof John Chan Kok Meng (Kuala Lumpur), Prof K Sivakumar Krishnasamy (Kuala Lumpur), Assoc Prof Dr Adli Azam (Johor), Dr Lam Hong Yoong (Penang), and Dr Narasimman Sathiamurthy (Kuala Lumpur).
In Malaysia, operations for lung cancer (called surgical resections) are performed by cardiothoracic surgeons and some general thoracic surgeons, working across government, university, and private hospitals.
Patients should expect to receive high quality and timely care irrespective of where they seek treatment and by whom. These guidelines will further elevate and standardise such care in addition to serving as an educational tool for training younger specialists, said Prof Sachithanandan.
He reiterated that LCNM remains deeply committed to mentoring the next generation of lung cancer specialists and is highly supportive of the MOH’s aspirational Lung Health Initiative (LHI) to tackle the rising burden of non-communicable lung diseases here especially late-stage lung cancer.
“We greatly appreciate the health minister’s visionary leadership in spearheading Malaysia’s key role to table a landmark resolution at the upcoming World Health Assembly (WHA 2025) in Geneva, to make lung health including lung cancer care, a global health priority,” he said.
Prof Sachithanandan further opines that effective tobacco control and strategies to mitigate air pollution can prevent many lung cancers, together with targeted screenings in at-risk groups for early detection, will potentially save billions in treatment costs and lost productivity.
If detected early, lung cancer is curable with good long-term outcomes, and is more cost-effective to treat not only for patients and caregivers but the entire healthcare system.
However, this requires a whole-of-society approach in terms of awareness, education, eradicating stigma, implementing preventative strategies and appropriate funding for sustainable screening programmes. The LHI is a welcome step in the right direction.
