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INTEGRATED SYSTEM in

COMPREHENSIVE
CANCER TREATMENT
Dr. Farid W Husain, SpB
DIRECTOR GENERAL MEDICAL CARE

2009
Background
o By 2020 cancer is expected to kill more than 10 million
people a year.
o More than 75% of new cancer cases and cancer deaths
will be in the developing world.
o Cancers in develop More than 70% of cancers in
developing countries are diagnosed too late for cure
o 40% of all cancer death can be prevented
o Radiotherapy, which could cure up to 50% of cancers in
combination with other treatment or alone, is largerly
unavailable in developing countries.
o Fewer than 25% of cancer patient in low and middle
income countries have access to radiotherapy treatment.
STRATEGIC MANAGEMENT
CANCER CARE

o Developing health Technology Assesment in


Diagnostic and Therapy

o Developing Competency Based Training.

o Developing partnership with Educational institution


and Medical collegiums.

o Developing National Referal Centre in Cancer.


HEALTH
SERVICES
Macro Micro
Health Security Health Accountability
( Inter Sector ) • Health Promotion ( Intra Sector )
• Specific Protection Health Sector
• Physical ( Primary Prevention ) •Counseling
• Chemical
•Early Detection •Diagnostic
• Psycho
• Prompt Treatment •Treatment
• Socio economy
• Disability Limitation •Emergency
• Cultural Service
( Secondary Prevention ) •Follow up
• Rehabilitation •Referral
( Tertiary Prevention )

PUBLIC HEALTH MEDICAL


SERVICE + SERVICE
• EQUITY
Population • EFFECTIVENESS Individual
• EFFICIENCY
CONTINUUM OF
HEALTH SERVICES

BASIC SCIENCE APPLIED TECHNOLOGY SERVICES


SCIENCE

PRIMARY PREVENTION
* MEDICINE Public Health
* NON MEDICINE • Health Promotion
• Biological • Specific Protection ( Preventive Oriented C are )
• Chemical
• Physical Health Sciences SECONDARY PREVENTION • Ambulatory Care
• Humaniora & • Early Detection • Acute Institutional Care
• Mathematic • Prompt Treatment ( Treatment Oriented Care )
Social Sciences
• Disability Limitation
TERTIARY PREVENTION • Long Term Inst.Care
• Rehabilitation • Home & Comm.Based C.
( Long - Term Care )

PUBLIC HEALTH AND


MEDICAL SERVICES
TERTIARY CARE

PRIMARY CARE SECONDARY CARE PRIMARY CARE

EMERGENCY EMERGENCY
TRANSITION TRANSITION
CARE CARE
• Early Detection • Rehabilitation
• Health Promotion
• Prompt Treatment • Health Promotion
• Specific Protection
• Disability Limitation • Specific Protection

CLIENT CONTACT WITH SERVICES


• Ultimate
•Research (basic)

National Referal Cente •Education

•Prompt treatment
•Rehabilitation
•Intrensif Care
•Research
•Education

• EARLY DETECTION
• PROMOSI
• PREVENTIF
• EMERGENCI

• OBAT MANDIRI
• TRADISIONAL
Program of Action for Cancer
Therapy (PACT)
o International organizations, civil society and the
donor community must work together to increase
the resources dedicated to :
n cancer prevention,
n early detection,

n treatment

n palliative care
Program of Action for Cancer
Therapy (PACT)
o The international Atomic Energy Agency (IAEA)
took action to combat cancer in developing
countries by launching a Program of Action for
Cancer Therapy (PACT) in 2004.
o PACT’s mission is to improve cancer survival in
developing countries by generating
radiotherapy investments into public health
systems.
o PACT will meet its goals by building public-
private partnership, mobilizing resources from
nontraditional sources and ensuring the
effective and sustainable transfer of radiation
medicine
BALANCE INVESTMENTS IN CANCER CONTROL
from Prevention to End-of-Life Care

Integrated System for Comprehensive Cancer Control


Maximize the Impact of Interventions Including
Radiotherapy through Balanced Investments across the system

Population Based Cancer Control Program


(WHO Guidelines on planning, management and evaluation)

Administrative, Financial and Technical Capacity to manage the Programme

Cancer Knowledge Transfer and technology Evaluations

Cancer Epidemiology and Surveillance System

Multi-diciplinary Education, Cancer Training and Research


(Advocacy, Public education, Policy, Legislation and resource Mobilization)

Palliative Care
PREVENTION Early Detection Diagnosis &Treatment Symptom Control & Management
(Opiate and Radiotherapy)
Controlling Cancer Early Diagnosis Follow Up Psychosocial and spiritual Support
Risk Factors and Screening and rehabilitation
Bereavement Support
For families and Caregivers

PREVENT DETECT EARLY TREAT & CURE CARE


MEDICAL SERVICES EFFORT IN
CANCER CARE
1. Improvement of Quality in Health Services, which more
efficient and effective in cancer services :
• Early diagnosis and prompt treatment
• Improving accessibility of cancer services.
2. Increasing Health promotion and prevention in Cancer
Control
3. Research and Development in Cancer registry.
4. Developing standard and guidelines in cancer services.
5. Human Resourse Development à training.
6. Decrease morbidity and mortality in cancer and
7. Improving quality of life among cancer patient.
CONCLUSION
o Problem : Increasing trend of risk factor, morbidity,
mortality in cancer
o Early detection and prompt treatment in cancer
cases in hospital à hasn’t applied optimally
o Developing Managerial aspect, Human resources
and technology in cancer services and therapy
o Integrated System in Cancer Treatment has to
develop as a policy in Cancer Services.
o Guideline and standard for cancer Treatment related
with Integrated system in cancer treatment (PACT)
will be develop in cooperation with professional
organization, national Cancer Control programmer,
and other stake holder.
Conclusion

o Developing Political will and commitment


in cancer care in hospital
o Advocation to related stakeholder :
Dinkes, Profesional Organization, etc
o Training to improve Human Resource in
cancer care
o Monitoring and Evaluation in Cancer
care