Cancer incidence in women has been slightly higher than men in Malaysia, related somewhat to the lifestyles and socioeconomic development of the country. It is one of the debilitating health problems affecting women. Of the 10 most common cancers affecting women of Malaysia, breast cancer is the biggest threat, followed by colorectal and cervical cancer according to the latest available national report in 2006. Malaysia offers a variety of treatment centers and choice of treatments; some are guided by the availability of national guidelines, such as that for breast and cervical cancers. Research has actively been conducted to find out the best and future approach on screening, diagnosis and treatment for cancers affecting women. This is made possible with the government taking the lead and the important works which are highly supported by the relevant non-governmental bodies and the public. Improvement is still needed for increasing coverage of screening and public awareness on cancer prevention.

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Background: Hepatocellular carcinoma (HCC) frequently recurs after curative resection. In the present study, we assessed the survival of HCC patients with or without preoperative transarterial immunoembolization (TIE) in relation to changes in serum cytokine levels and histological characteristics of resected specimens.
Methods: After confirmation of the safety and feasibility of preoperative TIE in a preliminary study of 9 patients, 15 pa-tients who planned to undergo curative resection of HCC were randomized to the TIE group (n=8) or the control group (n=7). TIE was performed with a mixture of OK-432, fibrinogen, thrombin, and lipiodol. Hepatic resection was planned 2 weeks after TIE.
Results: In the preliminary study, none of 9 patients with TIE developed complications that were severe enough to postpone the scheduled operation. Retrospectively, the 3-year disease-free and overall survival rate in the 9 patients who received preoperative TIE were both 100%; in contrast, the disease-free survival and overall survival were 27% and 64%, respectively, in 22 patients who received a hepatectomy around the same period without TIE. Furthermore, the prospective study revealed that the 3-year disease-free survival and overall survival in the TIE group were 88% and 100%, which were significantly higher than the corresponding rates in the control group (17% and 57%, respectively, both: p<0.05). Serum levels of interleukin-12 and interferon gamma were increased after TIE. Histologically, significant infiltrations of dendritic cells were observed in embolized areas, but the infiltration of FOXP3-positive cells was significantly suppressed after TIE.
Conclusion: Preoperative TIE suppresses recurrences of HCC after surgery. The suppressive effect might be caused by increased levels of helper T-cell 1 cytokines, the accumulation and maturation of dendritic cells, and the suppression of T-regulatory lymphocytes.

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