By: dr. Anton Sumarpo, Ph.D. – Faculty of BioMedicine i3L

Cancer is one of the major contributor for mortality rate in the world. On the other hand, although not included in the list of top-ten causes of death, there have been several reports concerning a significant increases of cancer-related mortality rate in Indonesia in the past ten years. Meanwhile, both lung and breast cancer are still leading the cancer incidence rate in male and female when compared to other cancer types.

Surgical resection, in combination with chemotherapeutic drugs and radiation are among the main therapeutic modalities for early-to-late stages of most solid cancers. However, many studies showed that the usefulness of each modality may depend on tumor location and stages; the latter is highly correlated with the prognosis. Of note, the effectivity of cancer therapy might be impaired because of acquisition of chemoresistance, which is a common drawback to most chemotherapeutic drugs.

It is evident that poorer clinical outcomes, despite various therapeutic modalities, are significantly correlated with the timing of detection, that is the first time when a patient is diagnosed with certain cancer. One of the most important way to reach the diagnosis is through the detection of cancer biomarkers, a molecule that is produced by cancer cells or included as a response of human body in the presence of malignancies.

Ideally, cancer biomarkers should be specific to a particular type of cancer and not present in normal tissues or in healthy individual; however, there are several types of biomarker that has already been present even before the starting of malignancies. One of the interesting example was published in TIME magazine five years ago. In May 2013, a famous holywood actress Angelina Jolie revealed that she carried a maternally inherited pathogenic BRCA1 mutation and had undergone surgery to remove the risk of developing breast cancer, known as bilateral risk-reducing mastectomy (BRRM). After surgery, her risk of developing breast cancer in later life fell significantly from 87% to 5%.

In Indonesia, the lack of awareness for cancer and willingness to conduct regular health monitoring with a necessity to check cancer biomarker of various cancers after reaching certain ages still remain a “chronic” problem in countries’ health system. This could be contributed not only by lack of governmental financial coverage for national health monitoring program, but also limited medical centers that are capable to conduct the biomarker checking. Rather than seeing the increased rate of “medical tourism” in neighborhood countries, contributed by the citizen of Indonesia, there is a huge hope for the government, especially Indonesia Health Ministry to pay more attention to generate a comprehensive national cancer statistics and conduct effective “home-made” program based on the statistics.