Lung Cancer Cases Remain High and Hospitals MUST Be Prepared to Act Fast

As of 2020, according to the Global Cancer Observatory (GLOBOCAN), Indonesia ranked third as the country with the highest number of lung cancer cases. In addition, lung cancer is the leading cause of death in Indonesia, with a mortality rate of 13.2% out of a total of 30,843 cases.

The main obstacle in detecting lung cancer is that early symptoms tend not to appear, so individuals do not feel the need to undergo a lung health check-up. Indeed, individuals must pay attention if they experience a prolonged cough, coughing up blood, chest pain, difficulty breathing, and hoarseness.

It Starts from Uncontrolled Mutations

The initial formation of lung cancer, as with cancer in general, begins with uncontrolled cell mutations. These mutations are caused by repeated genetic damage due to carcinogenic substances, such as cigarette smoke, radon gas, or asbestos. Initially, body cells have the ability to repair DNA damage in the cells. However, continuous exposure will damage the genes that regulate cell growth.

Because mutations in cells cannot be controlled, damaged cells do not die as they should. Cells continue to divide rapidly and form clusters of abnormal tissue. The continuous accumulation of abnormal cell growth eventually forms a tumor, or if in the lungs, it will appear as a lump. At this stage, the tumor can be benign (precancerous), but if not addressed, it will become malignant.

When a tumor has become malignant, invasive spreading will occur. In cases of lung cancer, cancer cells will penetrate the surrounding tissues and enter the bloodstream or lymph nodes, spreading to other organs such as the bones, brain, and even the liver.

Reviewing Risk Factors in the Environment

Cigarettes are one of the highest contributing factors to lung cancer, accounting for up to 80% of deaths among sufferers. In addition, individuals who inhale cigarette smoke (passive smokers) are at a 20%-30% risk of developing lung cancer.

Apart from cigarettes, exposure to toxic substances such as asbestos, arsenic, silica, diesel smoke, and chromium can increase an individual’s risk of developing lung cancer. Exposure to these substances is more dangerous if the individual is in an enclosed space. When individuals live in areas with high air pollution, toxic substances can enter the respiratory tract and gradually damage lung cells.

In addition to external factors, individuals with a family history of lung cancer also have a risk of 8%-14%. Having blood relatives (parents or siblings) with a history of lung cancer can increase an individual’s likelihood of developing the disease as well, especially if their parents were diagnosed at a young age.

Stages of Lung Cancer

The stage of lung cancer is used to describe the extent to which cancer cells have grown and spread in the body. Determining the stage is one of the important steps in the diagnostic process as it helps doctors identify the most appropriate therapy options, estimate the patient’s prognosis, and develop an optimal care plan. In general, the stage of lung cancer is determined based on the size of the tumor, the involvement of lymph nodes, and the spread of cancer to other organs.

In the early stage (stage I), cancer is still confined to the lungs and has not spread to lymph nodes or other organs. At this stage, the tumor size is generally still relatively small, so the chances of successful treatment tend to be better if detected and managed early. Entering stage II, the tumor size may increase or begin to involve lymph nodes around the lungs, although its spread is still relatively limited.

In stage III, cancer has spread more extensively to the lymph nodes within the chest cavity or to the tissues surrounding the lungs. This stage is often referred to as locally advanced because the cancer has not yet spread to distant organs, but its management becomes more complex and usually requires a combination of several treatment methods, such as surgery, chemotherapy, radiotherapy, or targeted therapy, depending on the patient’s condition.

Meanwhile, stage IV is the most advanced stage, where cancer cells have spread to other organs outside the lungs, such as the liver, bones, brain, or the opposite lung. At this stage, the goals of treatment generally focus on controlling cancer growth, prolonging life expectancy, alleviating symptoms, and improving the patient’s quality of life.

The High Mortality Rate from Lung Cancer Worldwide and in Indonesia

Lung cancer remains the leading cause of cancer-related deaths worldwide. According to GLOBOCAN 2022 data released by the International Agency for Research on Cancer (IARC), it is estimated that there were approximately 1.8 million deaths due to lung cancer throughout 2022. This figure represents nearly 1 in 5 cancer deaths globally, making lung cancer the type of cancer with the highest mortality rate compared to other cancers. The high mortality rate is influenced by various factors, including symptoms that often only appear at advanced stages, delayed diagnosis, and the still high prevalence of risk factors such as smoking habits, exposure to air pollution, and exposure to carcinogenic substances in the workplace.

A similar situation also occurs in Indonesia. GLOBOCAN data from 2022 indicates that lung cancer is the leading cause of cancer-related deaths in Indonesia, even though in terms of the number of new cases, it ranks second after breast cancer. The high mortality rate suggests that most patients are diagnosed only when the disease has reached an advanced stage, resulting in more limited therapy options and generally poorer patient prognosis.

The high mortality rate of lung cancer serves as a reminder of the importance of prevention efforts, early detection, and access to quality healthcare services. Education regarding risk factors, screening programs for high-risk groups, as well as the utilization of digital technology to support the diagnostic process and medical record documentation are essential components in enhancing the quality of cancer care. With an increasingly integrated service system, healthcare facilities can accelerate the diagnostic process, monitor the course of the disease more comprehensively, and support more accurate clinical decision-making to improve patients’ chances of successful treatment.

Challenges Faced by Hospitals in Managing Cancer Patients

The management of cancer patients is a complex and ongoing process, involving various disciplines, stages of care, and monitoring of the patient’s condition over an extended period. During the course of treatment, patients may undergo a variety of procedures, ranging from diagnostic examinations, medical interventions, chemotherapy, radiotherapy, to regular monitoring of therapy response. This complexity generates a very large and continuously increasing volume of clinical data, requiring hospitals to be able to manage patient information accurately, quickly, and in an integrated manner.

One of the challenges frequently faced by healthcare facilities is clinical fatigue or nurse fatigue, which is a condition of physical and mental exhaustion experienced by healthcare workers due to high workloads, the complexity of services, and repetitive administrative demands. In oncology services, healthcare workers must interact with a vast amount of important data, such as diagnosis history, laboratory test results, pathology reports, therapy schedules, medication usage, and the patient’s condition progression over time. When this information is spread across various systems or still managed manually, healthcare workers require more time to search for, verify, and update the necessary data.

This condition has the potential to increase the risk of data entry errors, information duplication, documentation delays, as well as the omission of important clinical information. As a result, the medical decision-making process may become suboptimal and potentially hinder the timely provision of interventions. In certain cases, limited access to complete and up-to-date data may also affect coordination among service units involved in the management of cancer patients.

Therefore, hospitals require an information management system that is capable of enhancing data accessibility, simplifying documentation processes, and supporting collaboration among healthcare professionals. With the availability of integrated and easily accessible data, medical personnel can focus more on patient care, while risks associated with administrative fatigue and recording errors can be minimized. Ultimately, effective data management not only supports hospital operational efficiency but also contributes to improving patient safety and the overall quality of cancer care services.

As a company focused on developing healthcare technology solutions, Medinfras is committed to supporting digital transformation in healthcare facilities through an integrated Hospital Management Information System (HMIS). By providing a system that supports real-time data availability and accessibility, Medinfras helps hospitals create more efficient workflows, enhance collaboration between service units, and reduce administrative burdens that could potentially trigger clinical fatigue. Through the appropriate use of technology, hospitals can focus more on delivering high-quality, safe, and patient-centered oncology services.