Pantai Jerudong Specialist Centre
World Cancer Day is marked all over the world on every February 4. This year was the first event uniting the global cancer community amid the COVID-19 pandemic.
World Cancer Day is led by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration penned in 2008.
The UICC is the largest and oldest international cancer union comprising over 1,200 organisations in 172 countries. It is dedicated to taking the lead in convening, building capacity and advocating initiatives that unite the cancer community to reduce global burden, promote greater equity, and integrate cancer control into the world’s health and development agenda.
Brunei Darussalam, represented by Pantai Jerudong Specialist Centre (PJSC), has been a UICC member since 2019, signifying the country’s commitment in joining the international cancer community in the fight to reduce cancer burden globally.
In 2020, nearly 10 million people died of cancer, a figure that is more than HIV/AIDS, malaria and tuberculosis combined. If left unchecked, the number of deaths will increase to 13 million per year by 2030. Last year alone, the estimated number of new cases rose to 19.3 million.
By implementing strategies on prevention, early detection and treatment, up to 3.7 million lives can be saved each year. The year 2021 is the final year of the three-year ‘I Am and I Will’ UICC campaign for World Cancer Day. It is an empowering call to action urging personal commitment.
It calls for us to counter the negative attitude that is convinced that nothing can be done about cancer, and instead promotes that all our actions have an impact on those around us, in our communities and country. Collective actions and cooperation lead to more engagement and opportunities towards a future without cancer.
World Cancer Day has grown into a positive movement globally to unite under one voice to face one of our greatest challenges in history. Every year, hundreds of activities take place around the world to inform, educate, raise awareness and inspire action; and most of all, act as a reminder that we all have a role to play in reducing the global impact of cancer.
COVID-19 AND CANCER
This year is the 21st anniversary of World Cancer Day. It takes on even greater importance with the call to refocus efforts on cancer control after a year challenged by the global pandemic.
Without a doubt, COVID-19 has shown the extraordinary efforts of cancer organisations, cancer care providers, cancer patients and volunteers who have rapidly responded to the crisis.
The pandemic has had widespread health impacts, including cancer care. As healthcare resources were being shifted to meet COVID-19 challenges, cancer screening and early detection programmes were put on hold.
According to the National Cancer Institute, the pandemic will result in nearly 10,000 additional deaths due to breast and colorectal cancer over the next decade.
In Brunei Darussalam, under the Ministry of Health’s (MoH)recommendations, cancer screening programmes, appointments for pap tests, mammograms and colonoscopies were postponed for the healthcare system to prepare for COVID-19 patients.
By Allah the Almighty’s grace, the outbreak was successfully and swiftly brought under control and there were no major disruptions in cancer services during the COVID-19 pandemic.
By the second half of last year, cancer services resumed as usual with additional strict preventive infection control measures put in place in hospitals to reduce the risk of infection to cancer patients.
The pandemic has also reinforced the concept of “shielding” for cancer patients who have a lower immune system because of the treatment. “Shielding” means staying at home at all times and reducing contact with other people to lower the risk of infection.
Alhamdulillah, because of the coordinated efforts to control the pandemic from the early stages, Brunei Darussalam does not have a single case of a cancer patient suffering from COVID-19.
TREATMENT AND COLLABORATION BROUGHT CLOSER
One of the challenges faced due the pandemic was the inability to travel overseas for specialised treatment. Efforts were then shifted to expediting the availability of such services locally.
Thus, on October 8, 2020, brachytherapy was first introduced at PJSC, a therapy that involves radiation delivered from a tiny source implanted directly into or next to the tumour.
The first case treated with brachytherapy in Brunei was cervical cancer. Before the availability of the treatment, cancer patients had to travel to hospitals in Singapore. Now, almost all of cancer patients in the country are treated locally, and the standards of treatment are of international standards.
Even cancer teams have adapted to the pandemic. Collaborations with regional centres have transitioned from in-person meetings to virtual platforms and medical conferences organised into webinars.
DETECT EARLY, PREVENT CANCER
Cancer is the nation’s top cause of death, overtaking cardiovascular diseases in 2009. Over 700 cancer cases were diagnosed in 2019. One in four people is at risk of developing cancer in Brunei, with women more susceptible than men.
The risk of women developing cancer is 29 per cent compared to 27 per cent for men.
The top cancers for men and women in 2020 were colorectal cancer and breast cancer, respectively.
The MoH introduced nationwide screening for colorectal and breast cancers in November 2019 to ensure early detection.
The National Cervical Cancer Prevention and Control Programme had been established since 2009.
Early cancer diagnosis is vital in allowing effective treatment to begin, which will improve patients’ survival rate. The screening for cervical cancer takes on more precedence as the World Health Organization in November 2020 rolled out the Global Strategy to Accelerate the Elimination of Cervical Cancer as a public health problem.
The following 90-70-90 targets must be met by 2030 for countries to be on the path towards cervical cancer elimination: 90 per cent of girls fully vaccinated with HPV vaccine by age 15; 70 per cent of women screened with high performance test by age 35 and again by age 45; and 90 per cent of women identified with cervical disease receive treatment (90 per cent of women with precancer treated, and 90 per cent of women with invasive cancer managed).
The Early Detection and Cancer Prevention (EDCP) Services at PJSC is a newly established unit under The Brunei Cancer Centre (TBCC) that serves as an extension to the MoH’s cancer screening and assessment services.
It was officially opened on November 30, 2019, coordinating individual care and referral for early detection and education for prevention of cancer especially for individuals with symptoms, high risk or with family history of cancer.
The focus of the EDCP is the delivery of health education and knowledge on general symptoms and types of cancer to the public, especially those with history of cancer in the family, to empower them to take the necessary actions for early detection of cancer symptoms and signs.
EDCP also organises family group counselling and facilitates genetic testing for family of clients with hereditary cancer syndromes.
RENEWING OUR COMMITMENT
Although the ongoing COVID-19 pandemic undoubtedly has required a change in how we generate support for cancer awareness, the enthusiasm and push for action has not wavered.
The fight for the prevention of late-stage cancers and the elimination of cancer itself are an ongoing battle that we must all be committed to pursuing especially in the current climate that has placed cancer screening and prevention in a lower priority, and even compromise cancer care in a number of countries.
Alhamdulillah, Brunei Darussalam is not as affected by COVID-19 as other countries. Through the steadfast leadership 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, the outbreak was successfully controlled in the early stages. This then allowed the MoH and other agencies to focus on the ongoing challenge of non-communicable disease (NCD) prevention and control including cancer.
Personally, we all saw and experienced how combined effort from every person is necessary in breaking the chain of COVID-19 infection. Similarly, the fighting against our common public health enemy – cancer – takes concerted effort.
Join us to support World Cancer Day by renewing our pledge and commitment towards ‘I Am and I Will’, make an impact on your own health and spread awareness by talking more openly about cancer with family and friends.
Support our ‘I Am and I Will Virtual Run’ and stay updated on World Cancer Day activities on our social media @pjscbrunei on Instagram and Facebook.