Indonesians tend to ignore advice on cancer, data shows

Maria Endah Hulupi, The Jakarta Post, Jakarta

The early detection of cancer, followed by immediate and effective medical attention, increases the chances of successfully treating the disease.

That is the common advice. In reality, many people seek treatment when the disease is at the hard-to-cure stage.

According to data from Dharmais Cancer Hospital in West Jakarta, between 1994 and 1998, 80 percent of breast cancer patients arrived at the hospital with advanced cancer, when the disease had already spread to other parts of the body.

There were even patients -- whose mother, other family members, or both, had breast cancer and knew they were classified as those at high risk to the disease -- who came to the hospital and were later detected with the third or fourth stage of the cancer, by which time they had already developed the symptoms.

That is not the case in developed countries where the majority of patients with cancer, especially breast cancer, manage to detect the disease early on and receive early treatment, ensuring a greater chance of being cured.

Most people with cancer, which according to Webster's Medical Desk Dictionary is defined as a "malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis", are not aware of having this life threatening disease, as there are often no clear symptoms of cancer until it has spread to other parts of the body.

"At its early stage, surgery to remove the affected part can be performed and the disease can be treated successfully," said the hospital's director, Syamsuridjal Djauzi.

At its advanced stage, when the cancer has spread to other organs, all treatments, including chemotherapy and radiotherapy, need to be carried out.

Chemotherapy is the use of chemical agents, which can reach all parts of the body to control the disease. The treatment can be combined with, among other things, surgery to ensure its effectiveness. Common side effects of this therapy include nausea, hair loss, anemia, contracting infections and mouth sores.

Radiotherapy is the use of radiation to kill cancerous cells (or other health irregularities that respond well to it). Unlike chemotherapy, this procedure can minimize the potential damage to normal tissue. Side effects of radiotherapy usually depend on the part of the body that is being treated. It can cause nausea when the stomach or liver is being cured, or hair loss and skin reaction in the area of treatment.

Syamsuridjal said that, apart from being cheaper, the chances of curing cancer at an early stage are higher.

"Little can be done when a cancer has reached its advanced stage and treatments are only palliative, easing the pain of the disease without curing it," said one of the hospital's oncologists, Ronald A. Hukom.

The country's leading hospital on cancer provides treatments for the 10 most frequent cancers: cervical, breast, bronchus, Non-Hodgkin's Lymphoma (a type of malignant growth of lymphoid tissue), nasopharynx (affecting the nose and pharynx), ovarium, rectum, acute myeloid leukemia (AML), colorectal (a disease of the lower digestive tract) and acute lymphoblastic leukemia (ALL).

Earlier, the hospital had launched an early cancer detection program to enable people at high risk and the general public to undergo periodical health checkups.

People are advised to watch for possible symptoms like: irregularities or changes when going to the toilet, irregularities in the digestive system, accompanied by painful swallowing, a hoarse voice and a lingering cough, a lump in the breast, itchiness accompanied with a change in size and appearance of a mole, abnormal bleeding and the discharge of mucus, developing a festering wound that will not heal.

Family Cancer Clinic

Early this year, Dharmais Cancer Hospital plans to launch a program, called Family Cancer Clinic, aimed at providing people, whose family members have cancer, with adequate information on the disease. It also issues guidelines on how to adopt a healthy lifestyle, which is the most effective preventative measure.

The information includes:

* Quit smoking. Smoking can cause lung cancer. Pregnant women can harm their unborn children if they continue smoking.

* Reduce the intake of fatty foods, as they can increase the risk of developing cancer, especially colorectal, prostate and breast cancers. Obesity may also be linked to cancer of the inside lining of the uterus (endometrial) and gall bladder.

* Ensure an adequate intake of fiber. High fiber foods, like bread, corn, fruit and vegetables help ward off colorectal and stomach cancer.

* Reduce the intake of smoked or other preserved food because they can contribute to cancer of the esophagus and stomach.

* Eat food containing vitamins A and C. These vitamins can be found in fruit and vegetables, which help ward against esophagus, larynx, stomach and lung cancers.

* Increase consumption of cabbage, cauliflower, broccoli, mustard greens and kale as they help prevent stomach, colorectal and respiratory tract cancers.

* Reduce consumption of alcohol as it may increase the risk of liver and stomach cancer. When combined with smoking, it may contribute to cancer in the mouth cavity, in the throat, larynx and esophagus.

* Undergo periodic health checks for early detection. Self examine your breasts every month. You are advised to immediately consult with doctors if you notice health irregularities like a lump, abnormal bleeding and a hoarse voice.

* Reduce stress and adopt a balanced lifestyle with healthy foods and adequate exercise.

* Avoid having more than one sexual partner.

* Reduce exposure to direct sunlight.