Affordable cancer treatment for the poor

Cancer is a disease that takes not only a physical toll on the patient but also their finances because of the cost of treatment and medication.

There are numerous non-governmental organisations in the country, many of which are headquartered in the Klang Valley, dedicated to helping cancer patients from poor families with these expenses.

Among them is National Cancer Society of Malaysia (NCSM), established in 1989.

NCSM president and medical director Dr Saunthari Somasundaram said the first charitable cancer treatment centre in Klang Valley had received more than 40,000 patients since it started operations.

"The centre was the brainchild of founder Datuk Dr S.K. Dharmalingam, whose vision was to make treatment available to cancer patients at affordable rates.

"We aimed to offer affordable cancer treatment to patients to ease their burden," said Dr Saunthari.

She said the organisation first began as a means to support Kuala Lumpur Hospital in treating its overwhelming large number of cancer patients.

"The centre provided timely treatment for those who needed it," she said, adding that the alternative was private hospitals, which many patients could not afford. Dr Saunthari said NCSM had teamed up with Tung Shin Hospital to run the centre so that it had convenient access to medical equipment.

"We would utilise the hospital's pharmacy, wards and X-ray services," she said.

"NCSM trained the centre's staff and the private doctors were under our payroll. "The charges for radiotherapy treatment were 50 per cent to 70 per cent lower than private medical centres.

"We were able to subsidise the treatment through the generosity of the public in donations," she said.

Radiotherapy uses radiation to kill cancer cells and shrink tumours, while chemotheraphy uses drugs to kill the tumour and the surrounding cells. Dr Saunthari said the NCSM centre in Tung Shin Hospital, however, ceased operations in October when its tenancy agreement ended following a six-month notice from the latter.

"The hospital is continuing with the cancer treatment services under its management," she said.

When asked if NCSM would be opening a similar centre at a different location, she said they would have to look into the cost of setting up a new centre.

"The place has to be safe for radiotherapy and other treatments.

"If we do set up a new centre, it will be where the community needs it the most and it will be outside the city centre because there are already 12 centres offering radiotherapy in Kuala Lumpur," she elaborated.

Dr Saunthari said NCSM was still focused on providing the best possible care and support to those affected by cancer through its other cancer centres - the Cancer and Health Screening Centre, Nuclear Medicine Centre, Resource and Wellness Centre, and the Children's Home of Hope in Jalan Raja Muda Abdul Aziz, Kuala Lumpur - as well as their branches in Penang, Ipoh, Seremban, Malacca, Johor Baru and Kuching.

Its Cancer and Health Screening clinic provides services including digital mammography, ultrasound, pap smear, bone density tests and supportive services such as counselling, breast prosthesis fittings and teaching of breast self-examination.

The NCSM Nuclear Medicine Centre is a centre for patients to undergo nuclear medicine imaging, which assists in providing diagnosis on cancer spread in organs and bones before initiating surgery, radiotherapy or chemotherapy.

Also aiding cancer patients who cannot afford the required treatments is Universiti Kebangsaan Malaysia Medical Centre-Makna Cancer Centre (UKMMC-MMC), a collaborative effort between National Cancer Council Malaysia (Makna) and UKM Medical Centre.

Makna communication head Lionel Lim explained that the cancer treatment centre, set up in 1999, was one of the largest in the country, comprising the Tengku Ampuan Afzan Oncology Ward, a radiotherapy unit, research facilities and a stem cell transplant unit.

"It enables even the poorest patients access to the best treatment facilities," he said.

He said specialists at the centre were under the purview of UKMMC while its support staff including staff nurses, counsellors, ward aides and assistants were under Makna's supervision.

"The support staff are paid a salary by Makna," he explained.

Makna covers a number of areas involving patients' treatment including transportation expenses, providing monthly financial assistance to poor patients, special chemotherapy drugs, and special equipment needed by patients.

"We allocate RM100,000 (S$37,900) a year to purchase non-formulary drugs for patient's use at the ward.

"The amount allocated annually for other purposes is RM10mil, which is to cover all patients helped by Makna seeking treatment at government hospitals nationwide," he added.

Lim said whatever treatment fees paid by patients was pumped back into the centre's operations and services.

"We also rely on individual and corporate donations to run the centre. "In addition, we raise funds through our yearly projects such as the Makna Founders Night Run and Klimb for Kanser," he said.

An NGO focused on the battle against breast cancer is the Pride Foundation. While it does not offer clinical treatment, it has set up a Pride Clinical Breast Examination (CBE) Clinic at its office in Section 5, Petaling Jaya.

"There are two types of routine screening for all women to detect breast cancer early - Breast Self-Examination (BSE) and Clinical Breast Examination (CBE).

"We realised that many women do not like to undergo mammograms.

"So at our clinic, experienced nurses will conduct free CBE, which is a first-level detection point, where they will examine the breasts and will tell whether a more detailed screening such as mammography, ultrasound or CT scan is needed," said Pride chief executive officer Kamarul Aznam Kamarozaman.

He said the foundation relied on donations from the public and corporations to continue providing this service as well as other programmes such as awareness and empowerment programmes that were organised regularly.

"Our Pride Patient Fund (PPF) provides financial assistance to breast cancer patients with a monthly income of less than RM3,000, to help them pay for their treatment, medication and personal needs.

"There are two types of PPR payments, which are staggered monthly payment (RM500 per month for six months) and one lump sum payment (RM500 one-off).

"With the escalating medical cost these days, we realise that RM3,000 may not be enough to cover their entire medical cost, but it does help elevate some of the financial burden the patient experiences," he said.

On how patients are selected for PPF, Kamarul said: "In addition to direct applications, we also receive many applications from breast cancer support groups nationwide as well as from referrals by breast cancer surgeons and doctors from all over the country."

(Published in The Star, 11 December 2014)