Cancer is the second leading cause of mortality worldwide. According to statistics by the World Health Organisation (WHO) 8.8 million mortalities – or one in six deaths – in 2015 were due to cancer.

Experts predict that the cancer burden can be reduced through screening and early detection, as many cancers yield a greater probability of cure and less morbidity when patients are diagnosed and treated early and adequately.

However, roughly 70% of deaths caused by cancer occur in low- and middle- income countries, where diagnostic and treatment services are often inadequate or inaccessible. While over 90% of high-income countries reported having pathology and treatment services generally available, less than 30% of low-income countries reported likewise.

Multidisciplinary approach in treating patients with cancer

Besides treating cancer patients, oncologists also conduct cancer screening for the general population or individuals who are at risk of developing cancer, and are heavily involved in genetic research and clinical trials of potential cancer treatment as well. These specialists also coordinate palliative care in patients with terminal diseases, and are skilled in handling ethical issues that may arise in treatment of cancer, such as patient autonomy.

Although oncologists work closely with other specialists such as radiologists, pathologists and surgeons when treating patients with cancer, the approach in cancer therapy is often co-ordinated by the oncologist.

The field of oncology has several major branches. For instance, medical oncologists use chemotherapy or other forms of anti-cancer medication such as targeted therapy to treat cancers, surgical oncologists perform biopsies and surgical removal of tumours, while radiation oncologists treat cancer with radiation therapy.

In order to make an accurate diagnosis, oncologists rely on diagnostic tools such as tissue biopsies and examination of specimens under a microscope, imaging studies including X-Rays, CT and MRI scans as well as ultrasounds, radiological techniques such as scintigraphy and nuclear medicine.

However, the most important diagnostic tool in oncology is a complete medical history of the patient, and oncologists are experts in identifying symptoms that point towards the possible diagnosis of cancer.

More oncologists needed to win the race against cancer

A study by the American Society of Clinical Oncology (ASCO) in 2007 predicted that incidences of cancer would soon outpace oncology services. In 2014, an analysis anticipated that demand for oncology services will grow by 40% by the year 2025, while supply may only increase by 25%.

“Unless oncologist productivity can be enhanced, the anticipated shortage will strain the ability to provide quality cancer care,” wrote authors of the study.

Unfortunately, Malaysia is already facing critical shortage of oncologists – with only less than half of the number of specialists needed nationwide. According to the president of the Malaysian Oncological Society, Dr Matin Mellor Abdullah, the country only has 105 to 110 oncologists in both private and public health sectors.

In order to meet the recommended 10 to one million specialist-to-population ratio however, “we will need to have between 240 and 300 oncologists,” he said.

The health ministry has offered more scholarships for doctors to take up oncology, and even invited Malaysian oncologists who are currently practicing overseas to return home in order to improve the number of specialists in the country.

Besides a shortage of oncologists, the number of cancer cases is increasing worldwide, and numbers are expected to rise by about 70% over the next 20 years. Following the global trend, Singapore has seen higher number of cancer cases over the past few years. According to statistics by the National Registry of Diseases Offices, 13,416 individuals were diagnosed with cancer in 2014 – a huge increase from 12,651 and 11,341 in 2013 and 2010 respectively.

"This trend remains a concern as it means we have not been making much headway in the prevention of cancers,” said director of the National University Cancer Institute, Associate Professor Chng Wee Joo. MIMS

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