Developing the treatment plans for cancer patients requiring radiotherapy is a challenging task: radiation needs to be well targeted to destroy the cancer cells without harming healthy tissue and vital organs. The right dose needs to be administered in order to maximize effectiveness but minimize damage. This is the job of qualified medical physicists.
Indonesia, population 255 million, however, only has 319 medical physicists and 96 radiation oncologists, so telemedicine is crucial to improve and harmonise the quality of care, Gondhowiardjo said. Experience and skills will be in particularly short supply when the country reaches the WHO’s target of a radiotherapy machine per million people – or, in the case of Indonesia, 255 in total.
For now, as part of a pilot project, Gondhowiardjo and her team sometimes send recommendations via email to another hospital in Jakarta with which Cipto Mangunkusumo General Hospital cooperates. “But this is slow, cumbersome and does not scale,” she said. “What we need is a single system to which all hospitals have access.”
Until such a system is available, the teleconferences among the eight radiotherapy departments provide a stopgap measure.
“Discussions like this accelerate our learning,” said Marhendra Satria Utama, a radiation oncologist from the Hasan Sadikin Hospital in Bandung, Indonesia’s third largest city, and a regular at the tele-meetings. “We get to share cases we would not otherwise come across.”
At the meeting last week, participants from hospitals in Banjarmasin and Semarang proposed the organization of similar sessions for medical physicists, and Gondhowiardjo promised to facilitate the development of such a network.
While radiologists, as well as medical physicists, are going to continue to cooperate on a national scale, the expertise and international network of the IAEA will remain crucial in helping Indonesian practitioners keep up-to-date with new technologies and global trends, Gondhowiardjo said.
As for the case presented at the recent meeting, it had a happy ending. “It was a very uncommon case,” Gondhowiardjo said. “Much could have gone wrong but nothing has. It was worth sharing.”
