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span class="inline inline-left">Growing concern: A physician and paramedic demonstrate the use of Positron Emission Tomography-Computed Tomography (PET-CT) at the Mochtar Riyadi Comprehensive Cancer Center in Jakarta. JP/Wedra AjistyatamaCancer rates are increasing around the world. Cancer is now the second largest (23.5 percent) cause of death worldwide, topped only by heart disease (33.5 percent). The World Health Organization forecasts that there will be 11 million cancer-related deaths in the world in 2030.

It has been estimated that there will be 16 million new cancer cases every year, and 70 percent of those new cases would be in developing countries by 2020. What is more alarming is that, increasingly, cancer attacks younger people who are supposed to still be in the productive stages of their lives.

When someone in the family suffers from cancer, the entire family is affected. The situation is even worse if the patient with cancer is the family’s breadwinner.

In the low-income and developing world, where there is no insurance to cover incapacitation due to cancer, the cost of the procedures to control the progression of cancer and prolong the life of the patient can be really staggering.

The above were some facts about cancer discussed by Dr. Aru W. Sudoyo in a presentation during a recent Cancer Night organized by the Indonesian Association of Oncologists (Perhimpunan Onkologi Indonesia, or POI).

Oncologists are physicians who are specially trained to study, diagnose and treat cancerous tumors. They come from a variety of specializations, including pediatrics, gynecology, hematology, radiation and surgery.

Founded in 1987, POI is a subset of the Indonesian Association of Medical Doctors (Ikatan Dokter Indonesia, or IDI).

POI is deeply concerned with the future of Indonesia’s struggle against cancer. “Due to lack of awareness and perhaps lack of financial resources, cancer patients are usually brought to us when they are already in the very advanced stage,” said Dr. Sudoyo.

“When cancer is detected early, the chances of the patient being cured is high, but the more advanced it is the less possibility of the patient’s survival and the less affordable the cost.”

Quoting WHO, he said that 30 percent of cancer cases are actually preventable and 30 percent are curable if they are detected early enough. So, one of the best strategies is to detect the onset of cancer growth as early as possible.

But here lies the real challenge: There are only 932 oncologists in Indonesia — a country with a population of more than 240 million. Dr. Sudoyo also broke down the numbers: 275 pathologists, 93 surgical oncologists, 48 gynecologic oncologists, 204 urologists, 138 digestive surgeons, 50 ENT/head-neck surgeons, 70 medical oncologists, 41 radiation oncologists and 11 specialists in palliative medicine.

The stark scarcity of doctors with expertise in cancer is exacerbated by the fact that they are not evenly distributed throughout the archipelago. In fact, the eastern part of Indonesia — the provinces of Maluku, East Nusa Tenggara and Papua — does not have access to an oncologist. POI finds this very worrying, especially as the traditional diet of the local people may contain carcinogenic substances and HIV/AIDS is already widespread in these areas.

POI has planned a series of initiatives to help address the growingly grim picture.

First, they will help spread the knowledge about cancer among health workers, including nurses and those who work in the field. Prevention is always the best approach to an illness, and education is the best tool of prevention.

Because it takes so many years to become a certified oncologist, POI is also planning to accelerate the spread of knowledge by holding seminars and training programs to enable other medical professionals such as internists, general surgeons, pediatricians and general physicians to help treat the disease.

Some may be invited to come from their assigned posts to Jakarta for a “Training the Trainer” program. When they return to their posts, they are expected to spread the knowledge and skills needed in the early detection of cancer.

In addition, hospitals — especially those in far-off regions, must be equipped with cancer management facilities. Other possible measures include empowerment of cancer research at universities.

Cancer Night was meant to promote awareness about the seriousness of cancer that Indonesia is facing. It was also a fundraising event as POI needs financial resources to realize its goals.

“This is a huge task and it is the responsibility of our entire nation,” said POI chairman Dr. Dradjat
Ryanto Suardi in his welcoming address during the event.

Efforts will also require the full involvement, not just support, of the Indonesian government through the Health Ministry. The threat of cancer in Indonesia is already alarming and could reach epidemic proportions by 2030.

“We must start doing something,” said Dr. Suardi.