Data on children with cancer in Indonesia and their mental conditions

Cancer in children is still a serious health problem in various parts of the world, including Indonesia. Globally, the World Health Organization (WHO) estimates that around 300,000 children aged 0-19 years are diagnosed with cancer each year. However, not all children receive effective treatment.

The biggest obstacle faced by Indonesia in overcoming cancer in children is the difficulty of preventing and early detection. In addition, mistaken and delayed diagnosis, lack of access to health facilities, and the risk of cancer recurrence after treatment are also obstacles to recovery.

So, what is the situation with cancer in children in Indonesia?

Types of childhood cancer in Indonesia

Based on data from the Union for International Cancer Control (UICC), the number of children suffering from cancer has increased by about 176,000 each year. The majority of children with cancer come from low to middle income countries.

In Indonesia, every year there are around 11,000 children who are newly diagnosed with cancer. Cancer cases in children in Indonesia are quite rare, but this disease is one of the main causes of death for 90,000 children each year.

The types of cancer that attack children are generally different from adults, although there are several types of cancer that can appear in both. Quoting a report from the Indonesian Ministry of Health, the types of cancer that mostly attack children include:

1. Leukemia

Leukemia is the most common type of cancer in children. In fact, one third of cancer cases in children in Indonesia are leukemia. In 2010, the number of leukemia sufferers was 31% of the total childhood cancers. This percentage continues to increase to 35% in 2011, 42% in 2012, and 55% in 2013.

Leukemia is a cancer that attacks white blood cells. There are four types of leukemia that affect children, namely:

Acute lymphocytic leukemia
Acute myeloid leukemia
Chronic lymphocytic leukemia
Chronic myeloid leukemia

The death rate from leukemia in 2010 and 2011 was 19 percent. This figure increased to 23% in 2012 and 30% in 2013. If cancer is detected early and the patient is treated effectively, the life expectancy for the next 5 years for leukemia can reach 90 percent.

2. Retinoblastoma

Retinoblastoma is a type of cancer that attacks the eye, to be precise the inner layer of the eye called the retina. This disease causes the formation of malignant tumors on the retina, either in one eye or both.

In Indonesia, about 4-6% of cancers in children are retinoblastoma. Patients generally experience symptoms in the form of a spot in the middle of the eye, enlargement of the eyeball, reduced vision, and blindness.

Without treatment, retinoblastoma can cause death. If the tumor is in only one eye, the patient's life expectancy can be as high as 95 percent. Meanwhile, if the tumor is in both eyes, the life expectancy ranges from 70-80 percent.

3.Osteosarcoma (bone cancer)

Osteosarcoma is a cancer that attacks the bones, especially the bones of the thighs and legs. Bone cancer is actually quite rare, but this disease ranks third in cancer for children in Indonesia. In 2010, osteosarcoma reached 3% of all cancer cases in children.

In 2011 and 2012, the number of children suffering from bone cancer in Indonesia reached 7 percent. Meanwhile in 2013, the number of osteosarcoma sufferers was 9% of the total cancer cases that occurred in children. If the cancer has not spread to other areas of the body, the patient's life expectancy can reach 70-75 percent.

4. Neuroblastoma

Neuroblastoma is cancer of the nerve cells called neuroblasts. Neuroblasts are supposed to grow into normal functioning nerve cells, but in neuroblastoma, these cells actually grow into dangerous cancer cells.

In 2010, there were not many cases of neuroblastoma in Indonesia, namely only 1% of the total cases of cancer in children. However, the numbers increased to 4% in 2011 and 8% in 2013.

Neuroblastoma with low risk has a life expectancy of 95 percent. Meanwhile, neuroblastomas that are more malignant and at high risk have a life expectancy of 40-50 percent.

5. Lymphoma

Lymphoma is cancer that attacks the lymph nodes. In Indonesia, the number of lymphoma sufferers in 2010 reached 9% of the total cases of childhood cancer, then increased to 16% in 2011. In 2012 and 2013, the number of children suffering from lymphoma cancer in Indonesia decreased to 15% of the total cases.

Children with stage 1 or 2 lymphoma have a life expectancy of 90 percent. If the lymphoma has reached stage 3 or 4, the life expectancy is below 70 percent.

The influence of cancer on the psychiatric children in Indonesia

Cancer greatly affects the patient's mental condition, especially in children who are prone to stress due to chronic diseases. This is also Indonesia's big task in dealing with cancer in children.

According to deep research American Cancer Society, children who suffer from cancer are more at risk of experiencing psychotic disorders than children their age. Psychological disorders not only occur when children undergo treatment, but also after they recover from cancer.

These psychological disorders include anxiety disorders (41.2%), substance abuse (34.4%), and disorders mood and others (24.4%). Psychotic disorders and personality disorders occur in less than 10% of children.

Other research in Wiley Online Library helped discover other psychological disorders experienced by children with cancer. The researchers found cases of depression, antisocial disorders, post-traumatic stress disorder (PTSD), to schizophrenia.

Based on a report by the Ministry of Health in 2015, about 59% of children with cancer have mental problems, then 15% of them have anxiety disorders, 10% are depressed, and 15% are affected. post traumatic stress disorder (PTSD).

The psychology journal of State University of Malang, entitled Quality of Life for Cancer Patients, concluded that cancer provides significant physical and psychological changes to individuals, from sadness, worry, to fear of the future and death.

Every year, cancer attacks tens of thousands of children in Indonesia. This disease not only affects their physical condition, but also their psychological condition. This is why cancer treatment needs to address both aspects.

Early detection, adequate care, and support from those closest to you are various factors that will help children with cancer in Indonesia. Apart from improving the quality of life of children, these factors can even help them achieve recovery.