Closing The Care Gap: World Cancer Day 2022 — NCSM

With or without Covid-19, cancer has, and will continue to remain a serious health problem in Malaysia.

February 4, 2022 is World Cancer Day, and this year, the theme being rolled out by the 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 continuing differences in terms of awareness and understanding of cancer and its causes within Malaysians.

 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 such facilities costs time and money, which is often lacking for these groups. 

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 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 due to the pandemic. The pandemic has left our country with depleted resources and an exhausted health care system, with catastrophic consequences for many people living with cancer.

Many people living with cancer have 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. 

World Cancer Day is not about identifying these gaps, but to make meaningful strides in closing them. The Ministry of Health (MOH), 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 form a significant part. The MOH must also 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 towards a generation endgame for tobacco substances.   

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 in that part of the country.

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 facility was too great to be put off. 

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

What are we doing to close the care gap? In terms of awareness, the National Cancer Society Malaysia (NCSM) has already begun on-the-ground work, including visiting communities to disseminate health education and cancer awareness.

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

In order to overcome equity and geographical gaps, we are embarking on nationwide cancer screening tours of duty, partnering with ETIQA, MCIS and Berjaya Cares to visit rural areas and lower socioeconomic communities to ensure the people get early aid in screening and detecting cancer.

Together with multiple private and public partners, including the MOH, ProtectHealth Corporation, and other government agencies, we will strive to close the care gap 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.

Ensuring healthy nutrition and good lifestyle practices are things that individuals and communities can undertake, and by consistently following such practices, we can close the gap in terms of preventive cancer care.

Other measures include assisting in volunteer work and initiating community activities to promote cancer prevention and control activities, and even donating 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 the years, Malaysians continue to be affected by and succumb to cancer.

Many of the challenges in managing cancer are due to the care gaps inherent within the system. Together, this year, let’s make a pledge to work towards closing them. 

This letter by the National Cancer Society Malaysia (NCSM) was written by Dr Murallitharan M; Dr Saunthari Somasundaram, Mandy Thoo, Niranjni Jayabalan, Vicneswary Balakrishnan, Mahirah Maasom, Subashini Rajendran, Dr Tan Jia Hwong, Dr Jessica Ann Canute, and Dr Jason Leonard Pereira.

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