DISEASE: Focus on cancer prevention

2009/07/30

THE health minister and the Ma-laysian Oncological Society president’s recent statements that there were only 50 oncologists in the country has me worried (“Travelling far for cancer treatment” — NST, July 24).

However, their solution to the problem, that is training 50 more oncologists, left me wondering whether 100 will be enough.

While the Oncological Society has expressed concern about the incidence of renal cancer (2.3 per 100,000), lung cancer is a much bigger problem (30 per 100,000) and it is the No. 1 cancer that is screaming for attention.

Overall, cancer is the third- biggest killer in the country and even having 100 oncologists may not be enough to treat the smoking-related cancers.

It appears that oncologists have been more focused on curative aspects and not actively engaged in cancer prevention.

They have left policy advocacy to other non-governmental organisations to tackle.

In other countries, oncologists are actively participating in tobacco control.

Smoking is the main preventable cause of disease and death.

While the Health Ministry has taken many positive steps towards tobacco control, it has succumbed to tobacco industry pressure on several important measures.

For example, smoking is still not banned in restaurants, and kiddie packs (fewer than 20 sticks) are still sold, although they are banned under the law.

According to the Health Ministry, the recommended ratio of oncologists to population is one per 250,000.

In contrast, there are about 95,000 retailers selling cigarettes throughout the country; this works out to a retailer-smoker ratio of about one per 50.

While cancer patients have limited access to cancer specialists, cigarettes, like no other product, have such easy consumer accessibility. I am not a statistician, but this simple reality worries me.

It should worry more both the ministry and the Oncological So-ciety.

It is strange that Kedah and Perlis sell cigarettes but do not have oncologists to treat the victims of tobacco. Instead, the ministry is referring cancer patients from Perlis and Kedah to Penang for treatment.

Here is an outrageous but practical suggestion: until Kedah and Perlis have their oncologists, every cigarette retailer in both states should be required to display a warning at point of sale: “Kedah has no cancer doctor”.

If this sounds silly, license cigarette retailers instead and reduce their numbers.

There is no reason why cigarettes should be sold rampantly and be easily available to the poor and children. The poor are most vulnerable to diseases and they can least afford the treatment.

In a 2006 Malaysian study on lung cancer, it was found that a patient spends more than RM8,000 annually for treatment. In a private hospital, the treatment would cost a lot more.

I am sure the cost of cancer treatment will go up in the future. While it is important to have more oncologists to treat the increasing number of cancer patients, both the ministry and the Oncological Society should be more proactive and develop and enforce preventive measures.

I urge the ministry to ban smoking in all restaurants, ban the sale of kiddie packs, increase tobacco tax thereby making them less affordable, and license all cigarette retailers.

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