Cancer killed more than

People around the world

new cases around the world People living with cancer

Cancer will kill more than

People around the world

new cases around the worldPeople living with cancer

more people will live with cancer

more people will die from cancer

70% of them will be in Developing Countries

Including Indonesia

1 / 1000 4.3 / 1000 NEW CANCER PATIENTS IN INDONESIA

DHARMAIS CANCER CENTRE:(DCC)

WHERE ARE WE NOW?

HOSPITAL PROFILE R S K D

HM. Soeharto, President of Republic Indonesia and also the

chairman of Dharmais Foundation, along with Mrs Tien Soeharto,

officially inaugurated Dharmais National Cancer Hospital (RSKD)

on Oct. 30, 1993.

MISSION

Services

Education

Research

VISION

• Phase 1: (2010-2014)

– Comprehensive Cancer Centre

• Phase 2: (2015-2025)

– National Cancer Centre

Past Achievement INPUT

Paradigm & New Challenges

VISION

Where Are We now?

Where toGo!

= PROCESS

SYSTEM APPROACH

Mulai 1979

US MODEL CANCER CENTRE

1. Laboratory Research

2. Clinical Research

3. Population research

US Cancer Centre – mulai 1961

AACI MISSION :

• The Association of American Cancer Institutes is dedicated to promoting the common interests of the nation’s leading academic and free-standing cancer centers that are focused on the eradication of cancer through a comprehensive and multidisciplinary program of cancer research, treatment, patient care, prevention, education and community outreach.

Cancer centre category

• Cancer centre : 2 of 3 research area

• Comprehensive cancer centre : 3 areas

6 essentials characteristics

1. Facilities

2. Organisational capabilities

3. Interdisciplinary collaboration and co-ordination

4. Cancer focus

5. Institutional commitment

6. Centre director

Future direction of the US Cancer model:

• NCI efforts to increase translational research

• NCI should take advantage of the unique position of cancer centres

• NCI should improve the efficiency, effectiveness and evaluation of research

Indonesian Cancer Control Program

Palliative/Rehabilitation

Cancer Registry

Early Diagnosis & Prompt Treatment

Prevention Promotion

General Pathologists

4

26

5

14

35 23 49

7

1849

18111

259

74

20

TOTAL 275 / 208.130.095

(43.309.707)

( 11.331.558 )

(14.946.488)(4.211.532 )

( 121.352.608 )

( 11.112.702 )

Surgical Oncologists

17

624

73

Total: 95 / 208.130.095

(43.309.707)

( 11.331.558 )

(14.946.488)

(4.211.532 )

( 121.352.608 )

( 11.112.702 )

Gynecologic Oncologists

15

11

2

7 32 10 1

1

1

21

10

Total: 48 / 208.130.095

10

32

13

1

1

(43.309.707)

( 11.331.558 )

(14.946.488)

(4.211.532 )

( 121.352.608 )

( 11.112.702 )

Medical Oncologists

6 64 7 3

2

11

19

Total: 57 / 208.130.095

8

42

13

3

(43.309.707)

( 11.331.558 )

(14.946.488)

(4.211.532 )

( 121.352.608 )

( 11.112.702 )

Radiation Oncologists

1*0

1

1

4 44 7 1

11

16

Total: 41 / 208.130.095

3

35

11

1

Residents 41

(43.309.707)

( 11.331.558 )

(14.946.488)

(4.211.532 )

( 121.352.608 )

( 11.112.702 )

Data January 2010Hospitals with Radiotherapy : 21 (20 active)Linear accelerator : 16 Telecobalt : 17

Standard / Recommendation (IAEA)1 Linac / Cobalt per 1 million population1 Radiation Oncologist / 200 patient1 Medical Physicist / 400 patient4 RTT / 600 patient

(43.309.707)

( 11.331.558 )

(14.946.488)

(4.211.532 )

( 121.352.608 ) ( 11.112.702 )

Province

Jumlah

penduduk

(Tahun 2008)

Insiden

kanker baru (1

per 1000)

Kasus untuk

radioterapi

(50% kanker)

Instalasi pelayanan Radioterapi

Kapasitas

Pelayanan

Jan - Sept 2010

Keterangan

Nanggroe Aceh

Darussalam 4,163,250 4,163 2,082

Sumatera Utara 13,042,000 13,042 6,521 Medan (RS. Pirngadi)

Medan (RS. Adam Malik) 900

Sumatera Barat 4,076,000 4,076 2,038 Padang (RSUD. Djamil) 150

R i a u 5,190,000 5,190 2,595 Pakan Baru (RS. Pekan Baru) 180

J a m b i 2,778,000 2,778 1,389

Sumatera Selatan 7,121,799 7,122 3,561 Palembang (RSUD. M. Hoesin) 150

B e n g k u l u 1,640,000 1,640 820

L a m p u n g 7,390,000 7,390 3,695

Kep. Bangka Belitung 1,149,496 1,149 575

DKI Jakarta 9,150,000 9,150 4,575 Jakarta (RSCM) 1611

Jakarta (RS. Kanker Dharmais) 950

Jakarta (RSUP. Persahabatan) 510

Jakarta (RSP. Pertamina) 310

Jakarta (RSPAD. Gatot Subroto) 350

Banten 9,610,000 9,610 4,805

Jawa Barat 40,920,000 40,920 20,460 Bandung (RSUD. Dr. H. Sadikin) 1000

Jawa Tengah 32,630,000 32,630 16,315 Purwokerto (RS.Margono) 378

Semarang (RS. DR. Kariadi) 975

Solo (RS. Dr. Moewardi) 480

DI Yogyakarta 3,500,000 3,500 1,750 Yogyakarta (RS. Dr. Sardjito) 650

Jawa Timur 20,120,000 20,120 10,060 Surabaya (RSUD Dr Soetomo) 1450

Surabaya (RSAL. Dr. Ramelan) 224

Malang (RSUD. Dr. Saiful Anwar) 432

B a l i 3,520,000 3,520 1,760 Denpasar (RS. Sanglah) 325

Nusa Tenggara Barat 4,370,000 4,370 2,185

Nusa Tenggara Timur 4,530,000 4,530 2,265 Kalimantan Barat 4,250,000 4,250 2,125

Kalimantan Tengah 2,047,550 2,048 1,024

Kalimantan Selatan 3,450,000 3,450 1,725 Banjarmasin (RS. Ulin) 110

Kalimantan Timur 3,090,000 3,090 1,545

Sulawesi Utara 2,210,000 2,210 1,105 Manado (RS. Malalayang)

Sulawesi Tengah 2,440,000 2,440 1,220

Sulawesi Selatan 7,810,000 7,810 3,905 Makassar (RSUP. Dr. Wahidin S.) 234

Sulawesi Tenggara 2,080,000 2,080 1,040

Gorontalo 972,000 972 486

M a l u k u 1,320,000 1,320 660

Maluku Utara 960,000 960 480

Papua 2,600,000 2,600 1,300

INDONESIA 208,130,095 208,130 104,065 11,369

Ma

luk

uS

ula

wesi

Ka

lim

an

tan

SU

MA

TE

RA

JA

VA

Population (2008)

Predicted Incidence (1:1000)

Radio-Therapy

Needs (50%)

Hospitals with Radiotherapy Facilities

Capacity Jan-Sept

2010

NEW CANCER PATIENTS< 2010 1 / 1000

Ratio between total no.

of irradiated Patients vs

Estimated Need of RT

Services in INDONESIA

NEW CANCER PATIENTS

2010 > 4.3 / 1000

NATIONAL CANCER

BURDEN

OVERLOADED AND WAITING LIST

History of Cancer Registry In Indonesia

2006 Hospital Based Cancer Registry in

Jakarta as a model Population Based

Cancer Registry.

1987 Pathological based Cancer Registry,

13 Centers Diagnostic of Pathology

in Indonesia

1970 Population based

Cancer Registry

in Semarang, Central Java.

Source of Data

2 Clinics

79 Hospitals

Vital Statistics

Death Certificates

301 Primary

Health Care

Central National Data of Cancer

90 Laboratories

44 Municipals

Health Care

Microscopic Verification 74.6 %

Unknown Basic of

Diagnostic 5.00 %

Ill-defined site 0.64 %

Unknown Primary Site 2.01 %

Quality of Data

Jakarta Minimum Cancer Incidence (Coverage 70% )79 Hospitals. 2 Private Clinics, 90 Pathology Laboratories,

44 Municipals Primary health Care (as a coordinator of 301 Primary Health Care in District area).

Breast Cancer in RSKD

BCS vs Mastectomy in USA/RSKD

NCCS - DCCC

NCCS DCC

Public Sector cancer patient 69% 20%

Cancer cases 55% 20%

Radiation oncology cases 74% 30%

Number of Surgery 9,549 2.100

Outpatient attendance 117,696 97.199

Revenue/Bed USD 400,000 79,617

All type reaserach in DCC

Market ProfileMarket/ Level

of Service

Sophisticated

(estimated

10%[1] of

patient)

Moderate

(30%)

Simple

(60%)

High

(23%)[2]

Overseas and

Premium

Private

Hospitals

Overseas

Premium

Private

Hospitals

Premium

Private

Hospitals

Private

practice

Middle

(50,12%)

Private

Hospitals

MoH Hospitals

Private

Hospitals

District

Hospitals

Private

Hospitals

District

Hospitals

Private

Practice

Low

(26,97%)

MoH Hospitals District

hospitals

Community

Practice

District

Hospital

RS

KDR

SK

D

• Dr. Pagano, a former AACI president, spokeabout the NCI cancer center designationcriteria in the United States and Ms.Stewarttalked about AACI’s membership,mission and current initiatives and also metwith the OECI Board of Directors to discusspossible areas of collaboration.

Thank you