CANCER is the leading cause of death in Brunei Darussalam for the past few years.
Over 600 new cases of cancer are diagnosed each year in the country, according to The Brunei Cancer Centre (TBCC).
Over 100 breast cancer and more than 100 colorectal cancer cases are diagnosed yearly, and the numbers are increasing.
At the TBCC, the number of patients being treated annually has increased. More than 10,000 patients visit the outpatient unit in a year, and the daycare unit has over 5,200 patients undergoing chemotherapy annually, that is about 25 patients per day.
The inpatient ward saw about 1,800 patients admitted in year 2017, TBCC said in a statement.
“In Brunei Darussalam, cancer has been the number one killer over the past eight years. Globally too, the incidence and deaths from cancer is increasing. About 14 million cases are diagnosed worldwide annually, out of which eight million die each year. Globally, the incidence will increase to 19.3 million by 2025, draining financial resources in most countries,” TBCC said in the statement which was issued in conjunction with World Cancer Day.
World Cancer Day is celebrated every year on February 4, to raise awareness, educate public and also emphasise the need for prevention, early detection and early treatment. It is also to galvanise government authorities to upgrade services. The concept of a World Cancer Day was established during the World Summit Against Cancer held in Paris on February 4, 2000 and was coordinated by UICC (Union for International Cancer Control).
The theme for year 2016-2018 is ‘We Can, I Can’. The aim is to get everyone – as a collective or as individuals – in the fight against cancer, not just the cancer patients and their families. Cancer knows no boundaries, so a cooperative approach to research, advocacy, prevention and treatment must be established, TBCC said.
According to the centre, cancer burden is increasing because of an expanding and ageing population; increase in modifiable risk factors such as smoking, alcohol consumption, western diet and reduced physical activity; and cancers related to preventable and treatable diseases such as Hepatitis B and C infections and human papillomavirus (HPV) infections.
There are many myths surrounding cancer that need to be dispelled like: “Cancer is a disease of the wealthy, elderly and mainly in developed countries.” Cancer can affect the rich or poor, young or old. The common cancers like breast, colorectal and cervical cancers are now affecting the younger people and increasing in developing countries.
‘Cancer is a death sentence’
The truth is that many cancers can be cured if detected early by screening.
“Cancer occurs due to fate, or black magic, or curses.” Many cancers can be prevented by stopping smoking and early screening with PAP smears, mammograms and colonoscopy can lead to curative treatment.
“Cancer can spread to another person if there is close contact.” Cancer is not infectious.
“Avoid sugar if you have cancer.” There is at present no correlation between cancer growth and increased sugar intake.
What is cancer?
Cancer is a disease that occurs when normal cells in the body lead to uncontrolled growth causing a lump called tumour, or in some cases like leukaemia spread in the blood.
Lumps can be benign or malignant. Benign lumps are not cancerous, grow slowly and do not spread. Malignant tumours are cancers and spread locally or to distant sites (metastasis). There are about 200 different cancers.
The causes of cancer include:
1) Carcinogens – Substances that damage the genetic information in the cell, and change their behaviour.
2) Age – The older the person is, the more likely he is exposed to more carcinogens and for changes to take place.
3) Genetics – Some are born with some genetic abnormalities, which increase their risk to cancer.
4) Immune system – People with weakened immune systems have higher risk of cancer.
Certain lifestyle and envi-ronment factors – like smoking, alcohol, ionising radiation, obesity, diet with excess red and processed meat and infections like Hepatitis B and HPV, increase the risk of cancer.
What can be done?
One third of cancers can be prevented by quitting smoking, limiting alcohol intake and maintaining healthy lifestyles.
Another third of cancers can be detected early and get cured. This includes breast self examination, mammograms, colonoscopy to detect early polyps, PAP smears.
Vaccinations against Hepatitis B and HPV
Not disregarding early signs – like breast lumps, neck lumps, unusual weight loss, chronic cough, altered bowel habits and bleeding from various sites.
Cancer is not a “taboo” subject. Speaking to your family and friends will ensure that early signs will not be missed.
Recent worrying trends have been:
– Younger people are getting cancer especially breast and colorectal cancer.
– Many patients are seeking treatment late and come with advanced disease in Stage 3 and 4, and hence chances of cure diminish.
– Many are attracted to alternative treatments and promised cures. They come late with advanced disease.
– There is a phobia of “cancer diagnosis” and many family members are not aware of the illness of their loved ones, until too late.
– A lot of misconception of cancer treatments – like chemotherapy and radiotherapy, mainly by word of mouth, from friends and websites.
“In reality, there are many cancer survivors, treated many years ago with surgery or chemotherapy and radiotherapy, leading normal lives. The good news is that with modern treatments, including chemotherapy, immunotherapy and targetted drugs, better anti-vomiting drugs and better radiotherapy facilities, more cancer patients are surviving longer and many are cured. There are quite a few stage 4 patients, leading relatively normal lives for four to five years or more with treatment,” TBCC said.
The Brunei Cancer Centre was incorporated in 2010 and is now part of PJSC (Pantai Jerudong Specialist Centre).
It offers in a modern setting, most of the needed services to handle cancer patients, with experienced staff and with the latest equipment and drugs. The services include outpatient services – cancer case referrals and follow up; Day Care Unit – chemotherapy given as a day care; and inpatient ward services.
Treatment modalities available at TBCC are:
Chemotherapy, immuno-therapy, targetted drugs; Radiotherapy, brachytherapy, stereotactic radiotherapy; Nu-clear medicine for imaging and treatment; Palliative care services; Specialty nursing; Dietitian services; and Multidisciplinary meetings to optimise treatment.
Almost 90 per cent of cancer patients have their chemotherapy given as a day care basis – without need to be admitted to the ward – by trained oncological nurses.
“Most of the newer chemotherapy drugs – targetted drugs for certain cancers – are now available for TBCC patients, under the health services provided by the Government of His Majesty Sultan Haji Hassanal Bolkiah Mu’izzaddin Waddaulah ibni Al-Marhum Sultan Haji Omar ‘Ali Saifuddien Sa’adul Khairi Waddien, Sultan and Yang Di-Pertuan of Brunei Darussalam,” TBCC said.
“The key take home messages are prevention, early detection and early treatment. Another important factor is to get early professional help from doctors,” TBCC added. – The Brunei Cancer Centre
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