While Malaysia is well known as a popular tourist destination for its many natural and historical sights, you may be surprised to learn that Malaysia is also equally popular for its medical tourism. When we say “medical tourism”, we do not actually mean tourists who come to the country to have a vacation, or take a tour around, hospitals in the country. Medical tourism instead refers to people from abroad who come to Malaysia to receive medical treatment.
Malaysia’s medical tourism industry has seen significant gains over the years, with more than 1.2 million healthcare travellers coming to the country to seek medical treatment, recording a whopping RM1.7 billion in revenue. This is all thanks to the government’s many initiatives, programs and organisations that have helped to build up the country’s reputation as a trusted health tourism destination worldwide, with excellent care facilities, state-of-the-art equipment, and highly affordable treatment rates and options.
Under the guidance of the government, in conjunction with the Malaysian Healthcare Travel Council (MHTC), a blueprint was developed to set the medical tourism roadmap for 2021 to 2025, in the hopes of making further gains to boost medical tourism in the country. This is particularly important as the country now moves into the endemic phase. With international borders now reopened to travellers, it is estimated that Malaysian medical tourism will see even more gains as it welcomes medical travellers once again.
Medical travellers come to Malaysia seeking specific treatment and surgery options for their healthcare needs, every one of them hailing from various corners of the globe. The most sought after ones are:
- Aesthetic Dermatology
- Hepatitis C
Malaysia is internationally recognised as a reputable cardiology hub in Asia, as well as being as a cancer care centre of excellence. With its roots having grown since the 1960s, Malaysian cardiology has seen significant leaps and bounds in terms of treatment options, improving recovery rates, excellent service, and the latest medical equipment.
The National Heart Institute (IJN) was established in 1992 to help improve the country’s proficiency in treating cardiovascular diseases via education, medical research and healthcare policies. Thanks to their efforts, IJN has helped Malaysia in pursuing and achieving, various accomplishments in delivering quality cardiovascular care. IJN has also treated approximately four million patients from all over the world since its establishment.
In 2020, IJN was recognised as the first hospital outside the United States to perform an implant of the world’s smallest pacemaker, the Micra AV pacemaker. A pacemaker is a device that is used to remedy irregular heartbeats in a person. This has paved the way for more minimally invasive procedures to implant a very small pacemaker, without leading to potential long-term health consequences from implanting traditional pacemakers.
An angiogram is taken during this process, which uses X-rays to study the condition of blood vessels in the body. These tests are done to check for any possible blockages in any blood vessel, especially the major arteries and/or veins. This will help inform doctors of the right treatment method to use to cure the ailment.
Coronary Artery Bypass Grafting (CABG)
CABG is an open heart surgery method to treat severe coronary heart disease. The procedure involves the use of a graft, which is a blood vessel taken from another part of your body. The graft will be attached to create a bypass that transfers blood around narrowed or clogged parts of major arteries. Narrowed or clogged arteries are caused by a buildup of fatty deposits, which may be due to atherosclerosis or some other cause. The procedure helps to improve blood flow and oxygen supply to the heart by completely bypassing the affected artery.
Percutaneous Coronary Intervention (PCI)
Sometimes referred to as Percutaneous Transluminal Coronary Angioplasty (PTCA), PCI is a minimally invasive surgical procedure to open blocked arteries. This is an alternative treatment method to CABG, where a stent is used to widen a narrowed or clogged artery to allow blood and oxygen to flow unobstructed to the heart. A catheter will be used to guide the stent to where the blockage is located. Once there, a balloon is inflated to open the stent and lock it in place within the artery. The catheter is then carefully removed, and the stent will remain there permanently to keep the artery open.
The term ‘cardiothoracic’ refers to the organs located in the chest, including the heart and lungs. Cardiothoracic surgery involves diagnosing and treating diseases and injuries that affect the heart, lungs, and other parts of the body, like the trachea or the oesophagus.
Malaysia is also known as the fertility hub of Asia, with a robust medical infrastructure to support new innovations in fertility treatments and international recognition from various accreditation bodies. In fact, eight fertility centres – out of a total of 30 other fertility centres outside of Australia and New Zealand – have achieved accreditation for complying with the Reproductive Technology Accreditation Committee’s (RTAC) International Code of Practice. Malaysia is well equipped to perform Assisted Reproductive Technology (ART) procedures, such as In Vitro Fertilisation (IVF), with a remarkably high success rate.
Sunway Medical’s Fertility Centre offers a number of treatment and diagnosis options at affordable rates while meeting the highest quality standards.
Preimplantation Genetic Testing (PGT-A/PGT-M)
PGT is a type of genetic test that can help doctors reduce the risk of future parents’ passing on genetic diseases, possibly lower the chances of a recurrent miscarriage, and improve the odds of pregnancy success. There are two main types of PGT testing: PGT-A (which stands for Aneuploidy) and PGT-M (which stands for Monogenic, or single gene, disorders).
PGT-A is used to identify embryos that may be affected by chromosomal abnormalities that could affect an embryo. Meanwhile, PGT-M is to determine if there is a specific genetic disease in an embryo. Both tests can be done together, but there are specific conditions that need to be met for each test.
In Vitro Fertilisation (IVF)
IVF is a procedure where an egg is collected from a woman’s ovaries, fertilised by sperm in a lab, then the fertilised egg is transferred to the uterus. IVF is the most effective form of assisted reproductive technology, but it may also be a time-consuming and expensive procedure, the latter being especially true in some countries. IVF is generally recommended for cases of infertility, which may be due to low sperm counts, ovulation problems, genetics, damage to the reproductive organs, or some other reason.
Fertility screenings are usually conducted prior to an IVF procedure, to check the quantity and quality of eggs or sperm. For women, synthetic hormones may also be injected to help stimulate the ovaries to produce multiple eggs. This is because some of these eggs may not fertilise or develop normally after fertilisation.
Intracytoplasmic Sperm Injection (ICSI)
Somewhat similar to IVF, this procedure involves injecting a live sperm directly into the centre of an egg, as a means to fertilise the egg, in a laboratory. This particular treatment was created to help infertile men or couples who had failed to fertilise an egg in a previous IVF procedure. Once mature eggs are collected from the woman’s uterus, they are safely taken out to be carefully incubated. A semen sample is taken from the men, which is then centrifuged through a special medium that separates live sperm from dead ones. Once a live sperm is collected, it is then injected directly into the egg.
Cancer survivors who wish to start a family of their own may do so thanks to oncofertility treatments. There are a number of options available, such as shielding the reproductive organs with a lead apron to minimise long-term radiation damage that may arise from radiotherapy; and preserving a woman’s ova (egg), a man’s sperm, or even reproductive tissues, for future fertility treatments.
Malaysia also happens to be recognised as a cancer centre of excellence, with over 128 medical and clinical oncologists from both the public and private health sectors as of early 2022. The country was even listed as the third most prepared country in the Asia Pacific to fight cancer, based on a study conducted by the Economist Intelligence Unit.
Cancer treatments in Malaysia emphasise both palliative care for terminal cancers, and rehabilitation care for survivors. Many hospitals are also able to cater to various types of cancers and the latest medications are not readily available in other parts of the region. At the same time, Malaysia is still able to provide high-quality cancer treatments at very affordable prices.
Prince Court Medical Centre and Gleneagles Kuala Lumpur offer oncological services ranging from cancer screenings to cancer treatment, including radiotherapy, chemotherapy and immunotherapy courses.
This is a surgical procedure to remove a cancerous tumour in the body, along with any nearby healthy tissue. Tumour removal is usually done in early-stage cancers where the tumour is still benign and has not spread cancer cells to other parts of the body. The type of surgical method used will depend on the size of the tumour, and whether it may cause damage to other parts of the body.
For small tumours, a minimally invasive procedure will be used, such as laparoscopic surgery. The tumour will be small enough to be removed via a laparoscope, which is inserted into the body via a small incision. Larger tumours may need a larger incision to be removed, while in some cases, large tumours may only be partially removed if there is a risk of damage to the body or if it is simply too large.
Sometimes, reconstructive surgery may be performed after the tumour is removed. Reconstructive surgery can help repair any major changes to the body after cancer surgery.
Radiation therapy, or radiotherapy, involves the use of high radiation doses to kill cancer cells and shrink tumours. Radiotherapy achieves this by damaging the DNA of cancer cells, preventing them from replicating while they are broken down and removed by the body. It still takes some time for the radiation to kill cancer cells, sometimes taking weeks or even months of radiotherapy courses. Radiotherapy is also a directed treatment method, in that radiation is directly targeted at parts of the body where cancer is detected.
While radiotherapy is effective at fighting cancer, it does cause a number of side effects due to the high dosage of radiation that the body receives. These may include nausea, vomiting, hair loss, fatigue, and many others.
Chemotherapy, or simply chemo, is the use of anti-cancer drugs to kill cancer cells. Unlike radiotherapy, chemotherapy will work throughout the entire body and not only in specific areas. Chemotherapy is sometimes used in conjunction with other cancer treatments, such as radiotherapy, to improve the overall effectiveness. However, chemotherapy may also be used on its own to fight cancer. Depending on the type and severity of cancer, specific chemotherapy drugs may be recommended at specific doses over a set amount of time.
Much like radiotherapy, chemotherapy can also affect other healthy cells and cause a variety of side effects, some of which may have long-term adverse effects.
Orthopaedic conditions are of growing concern as the world’s population ages. Injuries, age and long-term wear-and-tear can lead to a host of physical issues, from chronic pain to disability. It was even reported that 20 per cent of all chronic pain cases worldwide are due to orthopaedic conditions, such as osteoarthritis. Younger people are also being diagnosed with orthopaedic conditions since the pandemic forced people to work from home, with issues arising due to poor posture, long sedentary hours working, and more.
As Malaysia improves itself to become a leading medical hub in the region, the government and organisations such as the Malaysian Orthopaedic Association are making efforts to improve orthopaedic care in the country through continuing medical education, introducing new innovations, and improving healthcare outcomes.
For those who deal with persistent joint pain, swelling or stiffness, an arthroscopy may be done to determine what is causing the discomfort. An arthroscopy involves the use of an arthroscope, a small, thin tube-like device that has a camera and light source. It is inserted into the body via a small incision, which doctors use to examine the interior of the affected joint.
Arthroscopies are both a diagnostic test and a corrective surgery option, as the surgeon can use tiny surgical instruments inserted via other incisions to remove unwanted tissue or repair damaged areas, such as torn ligaments. Some procedures may need a combination of open surgery and arthroscopy to treat.
Joint Replacement Surgery
Joint replacement surgery, such as for the hip or knee, may be needed if either joint has suffered severe damage due to physical injury, arthritis, or some other health complication. An arthritic or damaged joint is removed and replaced with a metal, plastic, or ceramic prosthetic, as a reproduction of a normal, healthy joint. Joint replacement surgeries have improved over the years with technology, introducing new benefits such as minimal risks during and after surgery, faster rehabilitation with less pain and a shorter hospitalisation time, and even improved range of motion thanks to improvements to prosthetics.
Also known as knee ligament surgery, this procedure generally involves repairing a damaged anterior cruciate ligament (ACL), a major ligament in the knee. A ligament is essentially a strong type of connective tissue that attaches one bone to another, keeping the knee stable and limiting the joint’s movement. ACL damage can be caused by overexertion of the joint during sports or other intense physical activities.
The reconstruction process will have the torn ligament surgically removed and replaced with a band of tissue, or tendon, which connects muscle to bone. This graft tendon may be taken from another part of your knee or from a donor.
With the help of a licensed orthopaedic physical therapist, injuries and disorders that affect the musculoskeletal system can be corrected over time through a physiotherapy regime. Physiotherapy aims to reverse the effects of pain and loss of motor functions caused by orthopaedic conditions, and slowly help a person regain their independence. Therapy approaches generally focus on improving a person’s mobility, increasing their strength, getting used to their prosthesis, and enabling them to perform activities of daily living (ADLs) without needing any assistance. Therapy may also grant opportunities to develop new adaptations to the environment, or how to break down tasks into more manageable chunks.
The COVID-19 pandemic has been a major roadblock to providing timely healthcare to people who need it. Thanks to advances in technology, however, telemedicine has made a comeback to offer people timely medical services and consultations without having to leave the comforts of their own homes. The international private healthcare company, Columbus Asia, offers such an end-to-end service to enable people to receive enhanced healthcare from their medical professionals.
Gastroenterology in Malaysia has also seen steady improvements over the years, as medical travellers have also sought quality gastroenterological treatments provided by the hospitals in the country. One example is the collaborative effort between Fujifilm and the University of Malaya Medical Centre (UMMC) announced in March to build the country’s first endoscopy training centre.
A colonoscopy is a diagnostic method where a colonoscope, which is a long, flexible tube with a camera attached to one end, is inserted into the body via the rectum. The colonoscope is used to view the inside of the colon to look for signs and symptoms of potential gastrointestinal problems, such as colon cancer. The procedure generally takes between 30 to 60 minutes to complete.
A colonoscopy may also be used to remove polyps (abnormal tissue growths) or abnormal tissue with the use of specialised medical equipment, which is inserted into the colon via small incisions to the body.
A colostomy is a procedure to create a temporary or permanent opening for the colon through the abdomen. This opening is called the stoma. The procedure is normally done after bowel surgery to treat specific injuries or illnesses, allowing the bowels to “rest” if it is a temporary measure. Permanent colostomies may be required if any part of the digestive tract has to be removed due to cancer or some other complication. The gastrointestinal complication being treated will be the deciding factor on the type and location of the colostomy.
Depending on the treatment, the stoma will serve as an exit point for stools. A colostomy bag will be attached to the stoma, where the stools will accumulate, The bag can then be removed and the bag cleaned. There may be a second possible stoma for mucus that the resting part of the colon will produce.
After the colostomy is performed, the stoma may initially look reddish and bruised, but this will heal over time. Keeping the stoma clean is an important part of post-surgical care, so methods to clean the colostomy bag and the area around the stoma will be taught before discharge.
Fundoplication is a surgical treatment to help correct gastroesophageal reflux disease (GERD), or acid reflux. This is usually done as a last resort if other non-invasive treatment methods have not been able to resolve GERD symptoms. Fundoplication will require wrapping the upper portion of the stomach, called the fundus, around the lower part of the oesophagus. This reinforces the lower oesophageal sphincter, reducing the risk of acid reflux from flowing back into the oesophagus. The most common fundoplication method is the Nissen fundoplication.
Eye health is becoming more important following the COVID-19 pandemic, as more people are constantly using digital devices to communicate, learn, and entertain themselves. Poor habits, such as sitting too close to bright screens, can eventually lead to a degradation in a person’s ocular well being. With the International Specialist Eye Centre (ISEC) having earned a number of accolades, such as Ophthalmology Service Provider of the Year in the Asia Pacific for 2017 and 2019, Malaysian ophthalmology is definitely able to meet the needs of medical travellers.
A vitrectomy is an eye surgery to treat various problems with the retina and vitreous, a gel-like substance in the middle part of the eye. The procedure may be done to remove blood or any other foreign substances that may be preventing light from focusing properly on the retina, or repair a detached retina, both of which can cause vision impairment or loss. The procedure will remove some or all of the vitreous and replace it with a substitute, such as saline. As the eye heals, the substitute will slowly be replaced by a natural liquid that the eye makes.
LASIK is the abbreviation of “laser in-situ keratomileusis”, corrective treatment for nearsightedness and astigmatism, or any vision defect that causes light to bend as it. LASIK is a quick corrective procedure that makes use of a special laser that corrects the shape of the cornea so that light correctly focuses on the retina in the back of your eye. There are many benefits to getting LASIK surgery, including little to no pain involved; there is no need for bandages or stitches, and it has a very high success rate. It also takes approximately 30 minutes to complete.
A cataract is when the lens of the eye begins to cloud or becomes more opaque. This generally occurs due to ageing, side effects of medications, or other causes. Chemical changes due to these factors affect the transparency of the lens, reducing the amount of light that the eye receives. At its onset, a person’s vision may not be significantly affected, but may eventually become so severe that no shapes or movements can be seen. A cataract cannot be treated with glasses or contact lenses and requires surgery to correct.
The surgical procedure to remove a cataract is called phacoemulsification. The procedure involves breaking up the centre of the lens into small pieces, which are then suctioned out of the eye at the same time. An intraocular lens is then inserted as a replacement lens. The intraocular lens may either be placed in front or behind the iris, and can be made of hard or soft plastic, or even soft silicone.
Urology is a medical speciality which treats the urinary tract of both men and women, and also the male reproductive system. Some of the more common urological complications in men stem from enlarged prostates or prostate cancer, with the latter being the second most commonly occurring cancer in men and the fourth most common in the world. Despite the worrying trend, Gleneagles and Sunway Medical Centre are well equipped to help medical travellers ease their worries with the best health care they can get.
A cystoscopy is a diagnostic procedure that uses a cystoscope. The cystoscope is a tube with a camera and light on one end, which is inserted into the urethra (which carries urine out of the body) and passed into the bladder to examine it. Much like other diagnostic tools which use a similar method, such as colonoscopies, this procedure will help check for urinary tract complications, and in some cases, may also be used to treat said complications. Treatment is done with supplementary tools inserted through the cystoscope, which can remove tissue samples, inject medications to help with specific issues, or even remove bladder stones.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL is a treatment technique that uses high energy shock waves to break up kidney stones into much smaller fragments, allowing them to be removed from the body during urination. The treatment will either require the person to lay in a tub of lukewarm water, or on top of a soft cushion or membrane that the sound waves can pass through. The treatment process takes between 45 to 60 minutes, with about one to two thousand shock waves needed to properly break up the kidney stones.
While this is an effective non-invasive treatment method, the size, number, location and composition of the stones must be accounted for before treatment begins. If there is anything that prevents accurate detection of the kidney stones, such as the presence of anatomical abnormalities, then other methods will need to be considered instead.
Laser therapy uses a high-energy laser to remove overgrown prostate tissue that occurs in cases of benign prostatic hyperplasia (BPH) or prostate enlargement. There is a high chance of recovery and minimal side effects thanks to this procedure, in contrast to non-laser treatments or surgery. It may also be recommended (as a precaution) for those who are taking blood-thinning medications. Depending on the severity of the prostate enlargement, one of two therapy methods will be used that target and remove prostate tissue that obstructs urine flow.
People seek aesthetic treatments to improve their physical appearance via cosmetic procedures. Such treatments are generally expensive due to the medical, anaesthetic and other associated costs pertaining to the treatment itself, as well as the services provided before, during and after treatment. The quality of care also hinges on the doctor’s qualifications, board certification, and medical accreditation.
Because of the lower costs of aesthetic treatments in Malaysia, as opposed to similar treatment costs in a traveller’s home country, medical travellers would much rather opt for a more affordable option while receiving equally satisfactory care that they would normally receive.
Cosmetic, or aesthetic, dermatology focuses on addressing patient desires to improve or restore the appearance of the skin, or enhance physical characteristics. Cosmetic dermatology procedures may involve the removal of wrinkles; age spots; dark marks on the skin; cellulite and/or fat in specific areas; and removal of dead skin – among other things. Most of these treatments are also non-invasive, requiring no surgical processes. These may include the use of botox injections to reduce the appearance of wrinkles; laser treatments for acne or hair removal; and collagen stimulation using light-based therapy.
Reconstructive surgery is performed to repair parts of the body affected by deformities caused by birth defects, injuries sustained, or life-threatening diseases like cancer. These are considered medically necessary, as they help to restore lost or impaired function, such as in the case of rhinoplasties, or nose surgery, to help fix the nasal area and reverse impaired breathing due to a broken nose. Other reconstructive surgery methods include cleft lip and palate repair; facial reconstruction due to physical trauma or burns; and breast reconstruction for breast cancer survivors.
Cosmetic Plastic Surgery
Cosmetic plastic surgery, unlike reconstructive surgery, aims to enhance a person’s overall cosmetic appearance. Where cosmetic dermatology relies on non-invasive methods to improve or restore a person’s skin and overall appearance, cosmetic plastic surgery – as the name suggests – involves a surgical intervention to make physical changes that do not have any medical benefit or necessity. Some options for cosmetic surgery include breast augmentation, facelifts, and liposuction.
The non-medical nature of cosmetic plastic surgeries tends to exclude it from being covered by medical insurance, and with the relatively high price for such surgery in other countries, many tourists come to Malaysia to have it done at a much more affordable price.
The World Health Organisation (WHO) estimates that 58 million people have chronic Hepatitis C virus infections globally, with 1.5 million new cases and approximately 300,000 deaths per year. As part of its efforts to meet WHO’s mission to reduce new viral hepatitis infections by 90 per cent by 2030, Malaysia has redoubled its efforts to position itself as the Hepatitis C treatment hub of Asia.
In a landmark move, Malaysia became the first country in the world to receive conditional approval for the new Hepatitis C drug, ravidasvir, used in combination with sofosbuvir to treat Hepatitis C. This revolutionary new combination therapy has an astounding 97 percent success rate, requiring only a 12-week treatment course to cure Hepatitis C. This is in contrast to the 24-week course required using the existing daclatasvir-sofosbuvir combination therapy. Another win in Malaysia’s book is the relatively low cost of the ravidasvir-sofosbuvir combination, which is estimated to be at USD100 when produced locally. This means both Malaysians and international medical travellers will be able to afford a simple and highly effective treatment option to cure hepatitis C.
Neurological disorders continue to be a health concern worldwide as it sees a continuing upward trend. For example, approximately 55 million people worldwide are diagnosed with dementia, with 10 million new cases reported annually. While most neurological disorders do not have a cure yet, current treatment options help to slow down the progression of these disorders and improve a person’s overall quality of life as they age.
Specific medications will be prescribed to help mitigate the long-term damage caused by these conditions. For example, persons with Alzheimer’s disease may be prescribed cholinesterase inhibitors to reduce the breakdown of the naturally occurring chemical, acetylcholine, in the brain. Acetylcholine is important to the brain, as it allows nerve cells in the brain to communicate with one another. For Parkinson’s, a person may be prescribed Carbidopa-Levodopa, a drug that converts the chemical levodopa into dopamine. Dopamine is important to transmit messages around the brain, and a reduction in dopamine levels can impair cognition.
In more serious cases, neurosurgery may be required to treat nerve disorders, trauma to the brain or head, or even spinal injuries.
Gleneagles, Pantai, and Thomson Hospitals offer a wide variety of services to help mitigate neurological conditions while delivering excellent care throughout treatment.
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