A group photo of attendees at the National Strategic Planning Workshop on Cancer Control held in Nay Pyi Taw from 12-14 December. The meeting concentrated on implementation of a National Cancer Control Plan.
Dr. Soe Aung says the rising, troubling rate of cancer in Myanmar could be reversed in two simple steps – early detection and prevention, which includes a healthier lifestyle and vaccination.
Much too often in Myanmar, cancer patients are first seen by doctors only when the disease has already progressed to its end stages, when it is harder to treat and when the survival rate is low.
“Awareness is the key,” said Prof. Soe Aung, a Yangon oncologist and the president of the Myanmar Oncology Society, at a gathering of health professionals last month at Yangon General Hospital.
Awareness for the people of Myanmar include the dangers of tobacco and betel, early signs of cancers and the need to seek proper medical advice early.
“If you don’t know about early warning signs, the value of early intervention or the risks of smoking or chewing betel, behaviour will not change”, Prof Soe Aung said.
Asia accounts for 60 per cent of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 106 million in 2030. According to the International Agency for Research on Cancer (IARC), Myanmar faced an estimated 64,000 new cancer cases in 2012. Since that time, the figure has steadily increased. Cancer deaths are predicted to increase by over two thirds by 2030.
For Myanmar men, the most prevalent cancer is lung or oral cancer, which is linked to smoking and the chewing of betel. For the female population of Myanmar, the biggest cancer risks are cervical and breast cancer. Testing, annual screenings and early intervention for both types of cancers are currently inadequate, Prof Soe Aung said.
But there is good news about cancer, for the world and for Myanmar. Cancer research and treatment has progressed by leaps and bounds and now more people are beating cancer today than ever before. Survival has doubled in the last 40 years and half of people diagnosed will survive cancer for more than 10 years.
Vaccinations for women against the human papilloma virus (HPV), which is strongly linked to cervical cancer, are now widely available.
But how this progress can be shared in Myanmar is the next, critical step. Oncologists and cancer experts in Myanmar said an important first step would be to create a comprehensive database of cancer incidence, cancer prevention and treatment programmes in Myanmar to share knowledge and prevent duplication of efforts.
There is currently no reliable nationwide data on cancer in Myanmar, only records kept by each hospital. But change is occurring in Myanmar. Health officials say the country’s first National Cancer Control Plan will soon be implemented, which will include accurate results data on mortality rates.
This and other topics were recently discussed at the National Strategic Planning Workshop on Cancer Control from 12–14 December 2016 in Nay Pyi Taw.
“The main objective of the workshop was to support the implementation of the National Cancer Control Plan focusing on priority activities identified by the Ministry of Health and Sports” said Dr. Maung Maung Lin, a National Professional Officer for the World Health Organization in Myanmar. “Through the development of an integrated national action plan with specific activities supported by each partner, based on resources, organizational capacities and ongoing future activities planned in the country, we can maximise efforts in line with the respective mandates, priorities and areas of expertise of the partner and achieve better results for cancer prevention, care and control”.
Dr. Maung Maung Lin said priority areas include prevention, early detection and treatment, capacity building in terms of training adequate human resources for cancer control programmes, radiation safety and the establishment of a population-based cancer registry, which is essential for the future planning of the cancer control programme.
Another potentially big step in bringing Myanmar in line with the rest of the world is occurring now in Singapore, at the European Socity of Medical Oncology (ESMO) Asia Congress.
“We need to have a close collaboration with all partners, both national and international, concerning prevention, creating awareness, early diagnosis and treatment of cancer”, said Dr. Maung Maung Lin.
The ESMO, which was formerly a European-centric organisation, is holding a major gathering for only the second time in Asia. Closer to home, some cancer specialists say an increased role by the government would help in the fight against cancer. According to the latest statistics, Myanmar spends roughly two percent of its GDP on healthcare.
“There are two main reasons for this inaction.” said Dr Soe Aung. “First, being a Low-Medium Income Country, the government has other competing priorities, like infectious diseases, maternal and newborn health, etc. Secondly, some are so used to an age-old mindset and find it difficult to get rid of a tendency to regard cancer as a ”can’t-do-much-and-not-worth-investing“ issue. We are steadfastly persevering in our advocacy to overcome this”.
Dr Soe Aung said there are also challenges from the community side that include poverty and the stigma of cancer.
“Low socioeconomic status, communication difficulties because of rough geographical terrains in remote areas, language barriers among ethnic groups (there are more than 100 ethnic groups, each with their own dialect), insufficient media access, traditional taboos and stigma are hampering our efforts at oncological health education to all communities across the country” Prof Soe Aung said. “This leads to a lack of awareness, late presentation, and failure to seek proper treatment. Our society, in collaboration with the Ministry of Health and Sports and various other stakeholders, is working hard to overcome these issues. It will take time.”