Dr. Alito Soares
Guido Valadares National Hospital , Timor LesteTitle: Breast Cancer in Timor-Leste
Abstract
Timor Leste is a lower-middle income country currently entering a period of rapid economic and social development and a progressive population. Total population is 1.3 million, with three-quarters living in rural areas and one-fifth in the capital of Dili. The progress includes development health system in managing the burden of non-communicable diseases such as cancer.
There is no systematic cancer reporting in the country, however manual records indicate breast cancer involves about 10% of the workload for the general surgical department. The majority of breast cancer patients present with advanced stages. It is estimated that at least 50% of breast cancer patients treated at HNGV are palliative, with over 80% mortality overall. Timor-Leste National Breast Cancer Control (TLNBCC) project was established in 2017 at HNGV. The objective is “Improving Breast Cancer Outcomes in Timor-Leste” through cancer control involving prevention, early detection, diagnosis and treatment.
Materials and methods
TLNBCC has four elements: 1) addressing community education around early detection and awareness, 2) health professional education (particular in regional clinics and health posts) around the signs and symptoms of breast cancer and prompt referral for proper management, 3) improving diagnostic and treatment facilities at HNGV, and 4) developing a palliative care service.
Results
HNGV single tertiary care provided breast clinic consultation since 2015; total 249 women are with breast cancer and around 82 mastectomies. Thus it is likely many cases are simply not presenting to the tertiary hospital this is due to patients not resenting with their cancer due to fear, lack of health knowledge, lack of transportation and due to seeking traditional treatments. Some advanced cases presenting to regional or rural health services may not be referred due to lack of available treatment facilities.
Discussion
There are very limited cancer services in country, with limited histopathology and no chemotherapy and radiotherapy. Immediate action to improving diagnostic and treatment facilities at a national level will make a significant impact to improve breast disease. Early referral, increasing community awareness, acceptance treatment will increase surgically curable disease.
Conclusion
Community awareness, health professional education and prompt referral, along with developing the diagnostic and treatment facilities at a national level, are the foundations for improving breast cancer outcomes in Timor-Leste.
Biography
Alito Soares studied undergraduate medicine in Indonesia, and later did Masters in Surgery in Fiji National University (FNU). I was head of the Emergency Department from 2014-2016, and Head of Surgery from 2017-2021 and appointment as Executive Director at Guido Valadares National Hospital (HNGV) Dili Timor Leste. Alito pioneered the establishment of the Breast Cancer Society of Timor Leste where he is the president from 2017-2023. I also an honorary supervisor for the Master of Surgery program by Fiji National University at HNGV. Some of the students are now specialist surgeons working at HNGV. Currently works as Consultant General Surgeon at HNGV and with Interest in Breast Cancer Surgery. I also pioneer of establishing Breast Clinic and Oncology Clinic in Country and also contributed significantly to developed Standard Treatment Guideline.
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