Oncology in Indonesia

Oncology is the branch of medicine that focuses on the research, prevention, diagnosis, and treatment of cancer. A medical professional who specializes in diagnosing and treating people with cancer is called an oncologist.

An oncologist can design a treatment plan based on detailed pathology reports that shows the type of cancer the patient has, how much cancer has developed, how fast the cancer is likely to spread, and what parts of the patient's body are involved.

The field of oncology has three main areas, which include:

• Medical oncologists use chemotherapy, hormonal therapies, and other types of targeted treatments to treat cancer. Most people think of medical oncologist as their primary cancer doctor. Medical oncologists help monitor and maintain patients' well-being, as well as helping patients manage side effects. Often patients follow up with their medical oncologist once their treatment is complete.
• Surgical oncologists perform the surgical removal of the tumor and surrounding tissue. They will help patients prepare for and recover from any surgical procedure they undergo during their cancer treatment. If your primary doctor suspects that you have cancer, a surgical oncologist is likely one of the first doctors you see. Surgical oncologists can perform biopsies, which involves removing a small tissue sample to be checked for cancer cells.
• Radiation oncologists treat cancer using radiation therapy. They use high-energy photon beams to target and destroy cancer cells. Approximately one-half of all cancer patients will undergo radiation treatment during their cancer care.

Because most cancers are treated with a combination of therapies, you could see two or all three different oncologists during the course of your treatment.

Besides the three main areas, there are also several other areas of oncology. These include:

• Pediatric oncologists diagnose and treat cancer in children. Some types of cancer appear more often in children and teenagers, such as leukemia, brain tumors, osteosarcoma, and Ewing’s sarcoma. Some pediatric oncologists focus on conducting research on childhood cancers, while others specialize in certain types of cancer.
• Gynecologic oncologists treat cancers that affect women, such as cancer of the ovary, cervix, uterus, vagina, and vulva. Additionally, they also treat complicated gynecological conditions that are not cancerous, such as fibroid tumors and endometriosis.
• Hematologist-oncologists diagnoses and treats blood cancers, such as lymphoma, leukemia, and myeloma. They may also specialize in the management of solid tumors.

Oncologists usually work with a variety of other medical professionals, including pathologists, diagnostic radiologists, oncology nurses, and oncology social workers. They may also work with doctors from other areas of medicine, such as neurologists, dermatologists, or urologists.

What does Oncology Involve?

There are many types of procedures to treat cancer. The types of procedures that you receive will depend on the type of cancer you have and how advanced it is. Some people who have cancer will only have one treatment. However, most people have a combination of treatments, such as surgery with radiation therapy and/or chemotherapy. Below are the types of procedures to treat cancer:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to kill cancer cells in the body and prevent them from growing. The drugs can prevent cell division, target the food source of the cancer cells’ (the hormones and enzymes the cells need to grow), and trigger apoptosis (a process in which cancer cells kill themselves).

• Chemotherapy drugs can be given in several different ways, including.
• Oral – taken in a pill or capsule form.
• Intravenously – through an infusion into a vein.
• Shots – injected with a needle.
• Topical – applying creams or gels into the skin. This type is used to treat certain types of skin cancer.

Chemotherapy drugs can also be given directly to cancer or directly to an area of the body, such as the abdomen or central nervous system.

Immunotherapy

Immunotherapy, or biologic therapy, boosts your body’s natural defenses to fight cancer. It uses substances made by your own body, or in a laboratory, to improve or restore your immune system function. It can stop cancer from spreading to other parts of the body, stop or slow the growth of cancer cells, and help your immune system work better at destroying cancer cells.

There are several types of immunotherapy to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators. Different types of immunotherapy may be given in different ways, such as intravenous (IV), oral, intravesical (directly into the bladder), or topical.

Targeted therapy

Targeted therapy uses drugs that are designed to specifically “target” cancer cells without affecting normal cells. It targets the cancer’s specific proteins, genes, or other tissue environment contributing to cancer survival and growth. These proteins and genes are found in cancer cells or in cells related to cancer growth.

The targeted drugs can block or turn off chemical signals that tell cancer cells when to divide and grow, stop making new blood vessels that feed cancer cells, change proteins within the cancer cells so the cells die, trigger the immune system to kill cancer cells, and carry toxins in the cancer cells to kill them.

• There are two types of targeted therapy:
• Small-molecule drugs, which is given through pills or capsules that you swallow
• Monoclonal antibodies, which are given through a needle in a blood vein.

Radiation Therapy

Radiation therapy uses intense energy beams to kill cancer cells and shrink tumors. It most often uses X-rays, but other types of energy, such as protons may also be used.

Radiation therapy can be done in two ways:

• External-beam radiation therapy – this type of radiation therapy delivers radiation from a machine outside the body. You will lie on a table, and the machine (called a linear accelerator) moves around you to deliver radiation from several different angles. It is a quick and painless procedure.
• Internal radiation therapy – also called brachytherapy, involves both temporary and permanent placement of radioactive sources in the body. During the placement of the radioactive sources, you will be given anesthesia.

Hormone therapy

Hormone therapy stops or slows the growth of cancer that uses hormones to grow. It works by blocking your body’s ability to produce hormones or interfere with how hormones behave in your body. It can reduce the chance that cancer will return by stopping or slowing its growth, as well as preventing or reducing symptoms in men with prostate cancer.

Hormone therapy is usually used to treat breast and prostate cancer. It can be taken in many ways, including orally, through an injection, and surgery.

Stem Cell Transplant

People whose blood-forming stem cells are damaged by the very high doses of radiation therapy or chemotherapy can undergo stem cell transplant to restore the cells. Blood-forming stem cells are vital since they grow into different types of blood cells that you need to be healthy. The stem cells will be given to you through an IV catheter. The process is very much like receiving a blood transfusion.

Surgical treatment

Surgical treatment for cancer is a procedure to remove cancer from your body. There are many types of surgeries to treat cancer, which differ based on the part of the body that requires surgery, the purpose of the surgery, the amount of tissue to be removed, and your preference. In general, the surgery can be open or minimally invasive.

• During open surgery, one large incision is made to remove the tumor, some healthy tissue, and some nearby lymph nodes.
• During minimally invasive surgery, a few tiny incisions are made instead of a large one. These incisions are made to insert a laparoscope (a long, thin tube with a camera on its end) and special surgical tools. The laparoscope allows your surgeon to see the inside of the body, and the surgical tools are used to remove the tumor and some healthy tissue.

How Long Should I Stay in Indonesia?

For chemotherapy, radiation therapy, immunotherapy, hormone therapy, and targeted therapy, the treatment schedule may vary. You may have treatment every day, week, or month. It may also be given in a cycle, which is a period of treatment followed by a period of rest to give your body a chance to recover. For surgical treatment, you may need to stay in the hospital for a few days, and you need to stay in Indonesia for at least 10 to 14 days. Your oncologist and/or medical tourism team will advise you on the length of stay in Indonesia.

What's the Recovery Time?

The type of procedure you undergo determines the recovery period. While you may be able to get back to your normal routine within 10 days after laparoscopic surgery, you may need to wait around 6 weeks to fully recover from open surgery. Your oncologist will give you a detailed recovery timeline.

What About Aftercare?

You will be given instructions on how to take care of yourself. Your surgeon or nurse will explain how to control your pain, how to take care of your wound, activities you can and cannot do, and how to spot signs of infections. You may also need to talk to a dietitian to help with eating problems caused by the treatment. You will need to attend follow-up checkups to monitor your condition.

What's the Success Rate?

Cancer survival has improved significantly due to constant advancement and improvements in the field of oncology, including improvement in treatments and screening (allowing for earlier diagnosis). Still, you need to be aware of the risks, such as infection, bleeding, nerve damage, fatigue, nausea, vomiting, and hair loss.

Are there Alternatives to Oncology?

There is no other alternative than to see an oncologist when it comes to cancer treatments. Some people may choose to undergo meditation, hypnosis, and acupuncture as well, usually to relieve the stress, anxiety, and pain that cancer can bring.

Oncology in and around Indonesia

About Indonesia

Indonesia is a country in Southeast Asia, located between the Indian and Pacific oceans. It is the 4th most populous country in the world with over 260 million inhabitants. The country consists of more than 17,000 islands, which makes it the largest island country in the world. It is packed with beaches, volcanoes, tropical jungles, exotic animals, and culture. This wonderful country invites any adventurous traveler to explore its dramatic landscape. Today, Indonesia is also a potential medical tourism destination. Although it is not as popular as its neighboring countries such as Malaysia, Singapore, and Thailand in terms of medical tourism, the country actually houses numerous excellent medical centers. Many of the medical practitioners are well-trained and can communicate in English. The medical centers are equipped with cutting-edge technology and offer a wide range of affordable treatments. Some of the most sought-after treatments are blepharoplasty, liposuction, and breast augmentation.

Popular Parts of Indonesia

From busy metropolises, and sparkling beaches, to tropical rainforests, tourists will be able to find anything they want here.

• Jakarta is the capital of Indonesia. It is the melting pot of Indonesia's many cultures because thousands of people from all over the country live and work here. The city is home to numerous museums, some of which are the biggest in the country, such as the National Museum of Indonesia and the Museum of Modern and Contemporary Art in Nusantara (MACAN). The most famous landmark in the city is the National Monument or Monas which commemorates the Indonesian struggle for independence. The city also has a unique old city known as Kota Tua, where tourists can find many interesting colonial buildings.  
• Bali is Indonesia’s main tourist destination which attracts more than 15 million tourists every year. The island is packed with striking beaches, diverse marine life, jungle-covered mountains, lively nightlife, opulent culture, and spiritual energy. Almost every beach on the island is worth visiting, particularly Seminyak, Nusa Dua, Sanur, and Padang Padang Beaches. You can visit the Pura Tanah Lot and witness its scenic beauty or go to Ubud Monkey Forest to watch the monkeys and explore the sacred temples.
• The Special Region of Yogyakarta is the center of Java’s traditions and it is the only region in Indonesia that officially recognizes the monarchy. The region is home to numerous ancient buildings and temples. Visit Borobudur temple in the early morning to watch the sunrise, and watch the sunset from Prambanan or Ratu Boko temples. Tourists who are eager to learn about the region’s past can wander around Taman Sari, a park of palaces, pools, and waterways belonging to the sultan.
• Medan is the largest city on the island of Sumatra and it is a gateway to the western part of Indonesia as well as a busy trading city. The most important attraction in Medan is Lake Toba which is one of the natural wonders of the world. It is a massive crater lake with an island in its center. The island, named Samosir, is almost as big as Singapore. This enormous lake has a depth of 450 meters, making it more like an ocean rather than a lake. The clear lake with picturesque mountains in the background gives an incredible view that will leave anyone in awe.
• Bandung is widely known as Parijs van Java or the Paris of Java because of its resemblance to Paris and European cities. Located on a river basin surrounded by volcanic mountains, it has a significantly cooler temperature than any other part of Indonesia. The city is a weekend gateway for people from the surrounding cities and it is popular for its delightful food, fashionable boutiques, creative arts, and lush green spaces. The city is filled with Art Deco, Neoclassical, and Gothic buildings such as the Savoy Homann Hotel and De Vries Building.

Weather and Climate in Indonesia

Indonesia experiences an entirely tropical climate. The average temperatures can vary based on the area. Coastal areas have an average temperature of 28 °C, the inland and mountain areas have an average of 26 °C, and the higher mountain areas have an average of 23 °C. There are two seasons in the country, but the seasons can start differently in each region. Generally, June to October is the dry season and November to March is the rainy season. The dry season is influenced by the Australian continental air masses and has a slightly cooler temperature than the rainy season. Tourists can expect mostly sunny days, but there will be some short rain showers. The rainy season can be very humid, and wet, and has a significant amount of rain.

Getting Around in Indonesia

Indonesia is well-connected by airports in almost every region. However, the largest airports are Soekarno-Hatta International Airport in Jakarta and Ngurah Rai International Airport in Bali. Both airports serve domestic and international flights to major cities around the globe. There are budget airlines in almost every airport, including Air Asia, Citilink, and Wings Air. Domestic flights can be rather expensive but will make traveling around the cities a lot easier. 

Getting around the islands of Java and Sumatra can easily be done by trains operated by PT. KAI. There are 5 classes of trains: economy, business, executive, priority, and sleeper. The economy class can be a little uncomfortable and crowded, but tourists can get around several cities for as low as $4. Since the country is an archipelago, tourists can also travel from one island to another by ferry boats (long-distance) and speed boats (short distances such as Bali to Lombok).

Most of the cities will have their own mode of transport. The most common mode of transport is taxis and buses. Taxis are normally metered, but some drivers refuse to use the meter and force tourists to pay a fixed fare. Tourists should avoid riding these kinds of taxis and always insist on using the meter. The most reliable taxi companies are Blue Bird and Express. Bigger cities like Jakarta have MRT, LRT, and KRL (local trains).

Tourist Visas in Indonesia

Citizens of 170 jurisdictions can visit and stay in Indonesia for up to 30 days. Visa on arrival is available for 68 countries including Japan, the United Kingdom, and the United States. Nationals not listed in the visa exception agreement and visa on arrival need to obtain a visa before entering the country. It is advisable to check at your nearest Indonesia Embassy or Consulate for the visa policy. All visitors will need to have a passport valid for at least 6 months and a valid return ticket.

Additional Information

1. Local Currency: The local currency is Indonesian Rupiah (Rp) and $1 will get you approximately Rp14.000.
2. Money & Payments: ATMs that accept international cards are widely available in many cities. Credit cards are accepted in most established restaurants and hotels. If you are planning to visit small towns, it is advisable to carry some cash. Tipping is not essential but will be highly appreciated.
3. Local Language: The official language is Bahasa Indonesia and people in major cities and tourist areas will speak and understand English.
4. Local Culture and Religion: Most of the population follows Islam, but there are small groups of Hindus, Christians, Buddhists, and Confucianism. It is important to know that Indonesian people are friendly and conservative. Avoid wearing revealing clothes except on the beach.
5. Public Holidays: Indonesia celebrates numerous national and religious holidays such as Independence Day, Eid Mubarak, Christmas, Vesak, and Nyepi.