Closing the care gap: World Cancer Day 2022

CLOSING THE CARE GAP: WORLD CANCER DAY 2022

FEBRUARY 4, 2022 @ 11AM

In the Malaysian cancer care landscape, many care gaps abound; and these gaps continue to present massive obstructions and hurdles which make it impossible to provide better cancer care for all.

The 4th of February 2022 is World Cancer Day and this year, the theme being rolled out by the global organization Union for International Cancer Control (UICC) is “Close the Care Gap” which will be commemorated across more than 120 countries.

The ‘Care Gap’, simply put, is the difference between the recommended level of care that an individual should be getting and the level of care that an individual is actually getting. In the Malaysian cancer care landscape, many care gaps abound; and these gaps continue to present massive obstructions and hurdles which make it impossible for us to provide better cancer care for all Malaysians.

Care gaps exist across the different phases of a disease journey; from prevention through diagnosis, treatment and post-treatment support. One of the major care gaps in the prevention aspect is the continued differences in terms of awareness and understanding of cancer and what causes it.

This lack of understanding and awareness disables individuals and communities from undertaking preventive health activities which can help in lowering their risk for cancer; such as going for regular cancer screening.

Additionally, across the care continuum, Malaysians from lower socio-economic groups and those living in rural areas continue to face additional care gaps in terms of cancer care. People living in rural part of Sabah, Sarawak and even many parts of Peninsular Malaysia do not have high-quality cancer care facilities nearby them. Travelling to get to these facilities costs time and money which often is lacking for these groups of people.

Care gaps also abound in the treatment aspect of cancer care; with many effective new medications and treatment unable to be accessed by many due to the financial challenges faced both by individuals in paying for treatment; as well as the government that continues to be the largest funder and provider of cancer services nationally.

Post-treatment support of people-living-with cancer including rehabilitation programmes, return-to-work programmes, psychosocial support as well as palliative and long-term care is also far from being optimal- with little to no strong framework of services being provided.

The worst news of all is this: All these care gaps were existent even before the time of Covid-19; and they have been exacerbated and made worse manifold due to Covid-19! The epidemic has left our country with depleted resources and an exhausted health system with catastrophic consequences for many people-living-with cancer.

Many people-living-with cancer succumbed to the disease due to their inability to obtain care- often due to reasons such as financial disability, geographical disability, limitations in place due to Covid-19 restrictions, and mental health challenges which proved to be a tremendous additional burden for individuals and their families.

But this World Cancer Day is not about identifying these gaps; but also to making meaningful strides in closing them. The Ministry of Health Malaysia, for example, is taking different steps to close some of the care gaps in cancer care. This includes public-private partnerships to remove the backlog of patients requiring surgeries, of which cancer patients are a significant part. The Ministry also must be lauded for striving to close one of the greatest care gaps, that of exposure of the next generation to known cancer-causing agents – with the move for a Generation End-Game for tobacco substances via legislation.

EFFORTS NEED TO BE MADE
However, much more remains to be done. It is postulated that financial difficulties caused the government to cancel the building of a Northern Cancer Centre which would have eased many of the care gaps faced by Malaysians living there. However, in the case of Sarawak which faced a similar issue, it is heartening to see the state government stepping up to fund the construction of a Sarawak Cancer Centre as it was felt that the need for such a hospital was too great to be put off.

Closing the care gaps in cancer is not only the job of the government or the Ministry of Health but is a shared responsibility of us all. Everyone can do their little bit- from convincing your loved ones to go for a cancer screening or reduce the risk of getting cancer by getting a spouse to quit smoking.

What are we doing to close the care gap?
Dr Murallitharan M, National Cancer Society Malaysia (NCSM) says that the society has already begun on-the-ground work; going into communities all across the country to disseminate health education and cancer awareness.

"We will also, this year, engage in a wider behavior and lifestyle modification programme in community spaces working with partners from Japan including Astellas and the Asia Cancer Forum."

"In order to overcome the equity and geographical gaps, we are embarking on nationwide cancer screening ‘tours-of-duty’; with new cancer screening vehicles and teams partnering with ETIQA, MCIS and Berjaya Cares to reach out into the most rural areas and pockets of lower socio-economic communities to ensure we aid in screening and detecting cancer early wherever and whenever we can. Together with multiple private and public partners including the Ministry of Health, Malaysia; Protect Health and other government agencies- we will strive to close the care gap all throughout the nation.

What can you do to close the care gap? Care truly begins at home; and that’s where care gaps can be found as well. Care gaps can totally be reduced if cancer incidence itself is reduced- and this is where prevention remains paramount. Healthy nutrition and good lifestyle practices are activities that individuals and communities can undertake, and merely by consistently and constantly following such practices, we can close a large gap in terms of preventive cancer care.

Assist in volunteering, or even initiate community activities to assist cancer prevention and control activities; and yes, even donate towards research and services that can help other Malaysians in managing cancer.

With or without Covid-19, cancer has and will continue to remain a serious health problem in Malaysia. Over these few years, even though there has been no spotlight on it, we continue to be affected by and succumb to this disease. Many of the challenges in managing this disease is due to the care gaps inherent within the system. Together, this year, let’s make a pledge to work towards closing them.