One way to fix Malaysia's lowest survival rate for breast cancer

SUBANG JAYA: Malaysia has one of the lowest survival rates for breast cancer in Asia Pacific but a landmark programme is trying to fix that.

It's called the Patient Navigation Programme and it aims to help deal with barriers that prevent women from getting screened and treated early, such as money for treatment, worries of who will care for the family or even transport to the hospital.

A pilot version of the programme has been implemented at the Hospital Tengku Ampuan Rahimah (HTAR) in Klang since 2015 by the Ministry of Health and Cancer Research Malaysia (CRM).

It has already produced positive results: women who went through the navigation programme received more timely mammograms compared to in the previous year: 96.4% compared to 74.4%.

The programme also demonstrated a 7.1% improvement in the treatment default rates (patients who drop out of treatment midway).

“There are many challenges and barriers that women face that prevent them from seeking treatment fast,” explained CRM’s lead investigator Prof Dr Teo Soo Hwang.

"Patients go through a really hard, convoluted journey after they are diagnosed.

“They need to figure out where money for their treatment is going to come from, what treatments to choose, who will look after their family while they are getting treated and so on," said Dr Teo.

“This one-of-a-kind programme puts patients at the centre of healthcare. It helps patients navigate through their barriers so that they can access treatment quickly and improve that chances of survival."

Presently, Malaysia has one of the lowest survival rates for breast cancer in the Asia Pacific region, with a five-year survival rate of only 49%, compared to 92% in South Korea, 83% in Singapore and over 60% in China and 52% in India, she said.

“The low survival rate is largely because of the late presentation of the disease – about 50% of patients seek treatment at stage three and four when the disease is harder to treat. It is also due to poor adherence to recommended treatment,” she said.

The Navigation programme is based in the hospital’s new Pink Ribbon Centre which is a one-stop centre just for breast cancer patients.

Specially trained “nurse and community navigators” at the centre help patients through their cancer journey by supporting them through their screening, diagnosis and treatment and also sorting out non-medical issues that prevent patients from getting treated, such as  the lack of finances, transport and so on.

“The navigators help patients find the solutions they need so that they can focus on getting treatment,” explains Dr Teo.

A study about this pilot programme was published this week in the American Society of Clinical Oncology scientific journal.

However, as the programme has been running for only three  years, data about the changes in the five-year survival rate of patients cannot yet be determined.

The issue of late presentation, explains Datuk Seri Dr Mohamad Yusof Abdul Wahab, head of the programme at HTAR, is not new.

“But until now, we have not been able to address it. Patient navigation represents a practical solution which is scalable to other hospitals across the country,” said Dr Mohamad Yusof who is also the head of general surgical services of the Health Ministry.

Supporting the joint initiative, director general of health, Datuk Dr Noor Hisham Abdullah said the ministry was in support of the “innovative initiative”.

“The Ministry of Health certainly supports and welcomes this initiative that puts patients at centre stage.

Look out for the full story on HTAR’s Patient Navigation programme in Star2 on Friday.