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ri, not her real name, is a 45-year-old woman with cervical cancer. She went to alternative healers because she was afraid of doctors and could not afford hospital treatment.

However, after months of taking alternative medication without showing any signs progress and having spent a fortune, she went to a doctor with her cancer already in an advanced stage.

Delayed cancer treatment is common in Indonesia. As we commemorate World Cancer Day on Feb. 4, we will be reminded of the four pillars that serve as the foundation for cancer management: healthy lifestyle, delivering early detection, equal treatment for all and maximizing quality of life.

WHO data revealed 14 million new cases and 8.2 million cancer-related deaths in 2012. In Indonesia, the Basic Health Survey in 2013 discovered that almost 3.5 per 1,000 citizens aged above 45 years old had been diagnosed with cancer. Drajat Setiadi of the Indonesian Oncology Society says, however, that the figure is just the tip of an iceberg.

The first pillar of this year'€™s campaign against cancer concerns the right to choose a healthy life, given that doing so reduces the risks of cancer.

A healthy lifestyle is the key to achieving the global goal of reducing premature deaths from cancer by 25 percent by 2025.

A healthy life can take the form of smoking cessation, reducing alcohol consumption, adopting a healthier diet and increasing physical activity. At least half of the most common cancers can be prevented through a healthy life.

Indonesia faces a daunting challenge in this movement due to the fact that smokers account for 30 percent of men in the productive age, most of them from poor families.

The government can initiate action and policies to support a healthy life by transforming parks into comfortable jogging tracks and increasing excises for cigarette, fast food, alcohol and carbonated drinks.

We, the community, can participate in the campaign. Schools may provide a cafeteria selling healthy meals only, build facilities for exercising and include nutrition and physical activities as part of the school curriculum.

Offices can provide smoke-free environments in all indoor workplaces.

The healthy life campaign requires the government to change its paradigm from a curative to preventive approach. The real financial advantage of shifting this mindset is the drastic fall in health budget.

Investing in cancer prevention may cost countries in the world US$2 billion a year, compared with the $458 billion they spend on curative cancer treatment.

The second pillar is ensuring the availability and access to early cancer detection programs.

With the majority of patients only seeing doctors when they are already in the advanced stage, we need a single screening for women aged between 30 and 40 to reduce their lifetime risk of cervical cancer by 25 percent.

Population-based screening should be nationally implemented and awareness about early cancer warning signs and symptoms needs enhancement.

Breast cancer and cervical cancer are the two most prominent cancers in Indonesia. They affect women in their productive age. Most women with the cancer discover their diseases very late despite the fact that they can be detected early using an easy method.

Regular clinical breast examinations can detect breast cancer while a visual acetic acid (IVA) procedure can identify cervical cancer. Those procedures can be conducted at community health centers or Pus-
kesmas.

The good news is that both CBE and IVA are included in the national health insurance (JKN) program, so they are theoretically accessible anywhere in Indonesia.

Sadly, the coverage of those programs remains low. From 36.7 million Indonesian women aged between 30 and 50 with risks of cancer, only 1.75 percent is covered by the early detection cancer program.

The third pillar envisions the equal right to access quality, effective cancer treatment for all.

Income gaps can lead individuals to postpone health care, therefore local leaders should inform people that cancer treatment is covered by the JKN.

The pillar is difficult to realize, however, because many Indonesians are not yet registered in the JKN program.

According to the 2013 Basic Health Survey, approximately 50 percent of Indonesians do not have health insurance.

There are also many cases of cancer patients registered in the JKN scheme but are not willing to go to the hospital because they cannot afford transportation.

This problem is mostly faced by those who live outside Java. The solution is to provide an oncologist in every public hospital in all regencies and municipalities across the country.

The final pillar demands our understanding and response to the serious impact of cancer on the emotional, mental and physical state of patients. It will maximize the quality of life of not only patients but also their families and caregivers.

Cancer patients are not the only ones who can suffer from distress; their caregivers may experience the same mental problems.

Health professionals must be equipped with communication skills to handle emotional distress facing cancer patients.

Doctors may use the media to raise public awareness about the impacts of cancer on both emotional and physical wellbeing.

Commemoration of World Cancer Day is by no means a routine. Actions should follow if we really want to beat cancer.