KUALA LUMPUR, Dec 13 — Although Malaysia prides itself as a fast-growing nation with modern health facilities, the mortality rate among cancer patients is relatively high.
Malaysia’s 61 per cent cancer death rate has placed it amongst the poor outcome group countries, alongside Indonesia, Myanmar and Vietnam.
Cancer incidence in this country is also at a worrying level — in the absence of other causes, one in 10 males and one in nine females are at risk of developing the disease.
These statistics were revealed during a recent forum on cancer by consultant clinical oncologist Datuk Dr Mohamed Ibrahim Abdul Wahid, who is also Beacon International Specialist Centre medical director.
Lack of awareness, access to treatment
Speaking at the forum titled, ‘Equitable Public Access to Cancer Care: A Patient’s Perspective’ in Petaling Jaya, Dr Mohamed Ibrahim said about a third of cancer patients in the country who came to seek treatment for the first time were already at the advanced stages, namely stage three and four.
While not ruling out the lack of education or awareness as one of the reasons for them to seek treatment late, he also pointed to the lack of access to cancer care in government hospitals.
Many states such as Kedah and Perlis, as well as the east coast states, including Pahang, do not have public cancer centres and experts, the oncologist said.
In fact, in Sabah and Sarawak, there are only two public hospitals that offer cancer treatment.
“Patients in Kuantan, Kuala Terengganu and towns like Mersing or Batu Pahat (in Johor) have no access to cancer care services nearby and have to travel a long way to get treatment and diagnosis,” he said, adding that not having enough cancer specialists on the ground can also lead to improper check-ups and inefficient treatment.
The one-day forum was organised by Beacon International Specialist Centre and Galen Centre for Health and Social Policy. About 30 people, mostly from media organisations, participated in the forum.
Dr Mohamed Ibrahim also raised the issue of slow access to new breakthrough cancer drugs.
He said drugs already approved by the United States or European countries would usually take at least a year to be approved by Malaysia.
After approval is granted, it will then take another three to 10 years for the drug to be made available at government hospitals.
These drugs include those that produce significant results and can prolong the survival rate, and also drugs that can replace chemotherapy, thus sparing patients from its unpleasant side effects.
The delay in gaining access to new cancer drugs has created discrepancies between public and private cancer care services.
“So now we have a two-tier system. Those who can afford (to pay for the drugs) will enjoy the benefits of the breakthrough cancer therapy, while those who have financial challenges and need to go to the government hospital won’t get to benefit from some of the cutting edge technology drugs,” said Dr Mohamed Ibrahim.
More funds, better management
Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib, who also spoke at the forum, claimed that underfunding in the government healthcare sector was another pressing issue.
According to the standard set by the World Health Organisation, Malaysia as an upper middle-income country should be spending around seven per cent of its Gross Domestic Product (GDP) on healthcare.
Currently, however, the country only allocates around 4.3 per cent of its GDP to healthcare, out of which 2.3 per cent is spent on public healthcare.
“To put that into perspective, we are not spending as much as we should on public healthcare. It is not because we cannot afford it, it is because we are underfunding it (public healthcare),” said Azrul.
Citing 2014 statistics, which Azrul claimed have not changed much since then, non-communicable diseases (NCDs) accounted for 73 to 74 per cent of total deaths in Malaysia with cancer being the third leading cause of death.
However, he said, as a result of lack of investment in preventive measures, NCD cases, including cancer, are increasing annually, simultaneously with the treatment costs.
“We are just providing ‘sickness service’ in Malaysia, not a wellness or health awareness service. We are not doing much in terms of prevention,” he said.
Breast Cancer Welfare Association president Ranjit Kaur, meanwhile, said there was a dire need to change the people’s attitude towards cancer.
She said her association has spoken to many women regarding metastatic diseases and found that most of them believed that the disease will end in death.
“Many cancer patients believe that it is of no use to see a doctor because they think they are going to die anyway.
“So this misconception is also part of the whole contribution to the low survival rate,” she said, adding that the attitude of healthcare professionals dealing with metastatic cancer patients was also a cause for concern.
“We have quite a number of women (in our group) who seek public healthcare services and they find compassion missing.”
Ranjit said there is a need to educate healthcare professionals on cultivating a positive attitude towards their patients.
“There is so much of difference between telling a patient ‘there’s nothing much we can do, just go home and pray’ and ‘let us go through this together and we see how we can help you’,” she said, claiming that many metastatic patients are also deprived of treatment options.
“We do have what we call the right to healthcare service, so isn’t cancer care also a healthcare service that a patient is entitled to?” she asked. — Bernama
* The mortality rate among cancer patients in Malaysia is at 61 per cent, a relatively high figure considering the nation’s modern health facilities.
* This first of two articles on this issue examines the reasons behind the high mortality rate.