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CANCER PATIENTS with cancer
IN INDONESIA
DHARMAIS CANCER CENTRE:
(DCC)
WHERE ARE WE NOW?
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.

HOSPITAL PROFILE RSKD

 MISSION

Research

Education

Services
 VISION
• Phase 1: (2010-2014)
– Comprehensive Cancer Centre

• Phase 2: (2015-2025)
– National Cancer Centre
 SYSTEM APPROACH
Paradigm & New
Challenges

Past
Achievement = INPUT PROCESS VISION

Where Where
Are We to
now? Go!
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

Cancer Registry

Palliative/Rehabi
litation

Early Diagnosis
& Prompt
Treatment

Prevention
Promotion
 General Pathologists

4
26
7
5 ( 11.331.558 )
(14.946.488)
49 14 18 (4.211.532 )
9
74 25
(43.309.707) 35 23 49
20
( 11.112.702 )
181
11
( 121.352.608 )
TOTAL 275 / 208.130.095
 Surgical Oncologists

( 11.331.558 )
(14.946.488)
17 (4.211.532 )
3
7
(43.309.707)

62 ( 11.112.702 )
( 121.352.608 ) 4
Total: 95 / 208.130.095
 Gynecologic Oncologists

1
5
1 1 1
1 ( 11.331.558 )

1
(14.946.488) 1
10 2 2 (4.211.532 )
1
3
(43.309.707) 10
7 3
2 10 1
32 ( 11.112.702 )

( 121.352.608 )
1
Total: 48 / 208.130.095
 Medical Oncologists

2
( 11.331.558 )
(14.946.488)
8 1
1 1 (4.211.532 )
19 3
(43.309.707)
6 64 7
3
42 ( 11.112.702 )

( 121.352.608 )
3
Total: 57 / 208.130.095
 Radiation Oncologists

1
*0
1 ( 11.331.558 )
(14.946.488)
3 1 1
1 1 (4.211.532 )
16 1
(43.309.707)
4 44 7
1
35 ( 11.112.702 )

( 121.352.608 )
1
Total: 41 / 208.130.095
Residents 41
 ( 11.331.558 )
(14.946.488)

(43.309.707)

(4.211.532 )

( 121.352.608 ) ( 11.112.702 )

Data January 2010 Standard / Recommendation (IAEA)

Hospitals with Radiotherapy : 21 (20 active) 1 Linac / Cobalt per 1 million population
Linear accelerator : 16 1 Radiation Oncologist / 200 patient
Telecobalt : 17 1 Medical Physicist / 400 patient
4 RTT / 600 patient
NATIONAL CANCER Province
Jumlah
Population
penduduk
(2008)
Insiden
Predicted
Incidence
kanker baru (1
Kasus untuk
Radio-
Therapy
radioterapi
Hospitals with Radiotherapy
Instalasi pelayanan
Facilities Radioterapi
Kapasitas
Capacity
Jan-Sept
Pelayanan
(Tahun 2008) (1:1000)
per 1000) Needs
(50% (50%)
kanker) 2010 2010
Jan - Sept
BURDEN 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
NEW CANCER PATIENTS

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

< 2010  1 / 1000

R ia u 5,190,000 5,190 2,595 Pakan Baru (RS. Pekan Baru) 180
Ja mbi 2,778,000 2,778 1,389
Sumatera Selatan 7,121,799 7,122 3,561 Palembang (RSUD. M. Hoesin) 150
B e ngkulu 1,640,000 1,640 820
La mpung 7,390,000 7,390 3,695
Kep. Bangka Belitung 1,149,496 1,149 575
Ratio between total no. DKI Jakarta 9,150,000 9,150 4,575 Jakarta (RSCM)
Jakarta (RS. Kanker Dharmais)
1611
950
of irradiated Patients vs Jakarta (RSUP. Persahabatan)
Jakarta (RSP. Pertamina)
510
310
Estimated Need of RT Jakarta (RSPAD. Gatot Subroto) 350

JAVA
Banten 9,610,000 9,610 4,805
Jawa Barat 40,920,000 40,920 20,460 Bandung (RSUD. Dr. H. Sadikin) 1000

Services in INDONESIA OVERLOADED AND WAITING LIST

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 li 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

Kalimantan Barat 4,250,000 4,250 2,125

NEW CANCER PATIENTS Kalimantan Tengah 2,047,550 2,048 1,024

2010 >  4.3 / 1000

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)
Maluku Sulawesi

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
Ma luku 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
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 90 Laboratories

Central National Data

of Cancer Vital Statistics
Death Certificates
79 Hospitals

301 Primary 44 Municipals

Health Care Health Care
 Quality of Data

Microscopic Verification 74.6 %

Unknown Basic of
Diagnostic 5.00 %

Ill-defined site 0.64 %

Unknown Primary Site 2.01 %

 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 Profile
Market/ Level Sophisticated Moderate Simple
of Service (estimated (30%) (60%)
10%[1] of
patient)
High Overseas and Overseas Premium
(23%)[2] Premium Premium Private
Private Private Hospitals
Hospitals Hospitals Private
practice
Middle Private Private Private
(50,12%) Hospitals Hospitals Hospitals
MoH Hospitals District District

RSKD
Hospitals Hospitals
Private

RSKD
Practice
Low MoH Hospitals District Community
(26,97%) hospitals Practice
District
Hospital
• Dr. Pagano, a former AACI president, spoke
about the NCI cancer center designation
criteria in the United States and Ms.
Stewarttalked about AACI’s membership,
mission and current initiatives and also met
with the OECI Board of Directors to discuss
possible areas of collaboration.
Thank you