Ketahui Beberapa Faktor Risiko Terjadinya Kanker Saluran Cerna
Gerbang Banten – Salah satu penyakit yang sering diderita masyarakat yaitu saluran cerna, mulai dari penyakit maag, batu empedu, pankreas dan saluran empedu, penyakit saluran cerna baik atas maupun bawah, usus halus, dan masih banyak lagi.
Setiap tahunnya kasus-kasus penyakit ini terus meningkat. Hal ini dikarenakan pola makan yang tidak sehat serta kebiasaan buruk merokok. Jika sudah terserang penyakit saluran cerna, biasanya pasien akan berkonsultasi dengan dokter, lalu melakukan pemeriksaan darah. Biasanya, dokter juga akan dibantu dengan peralatan endoskopi.
Deteksi Kanker Saluran Cerna Lewat Endoskopi
Endoskopi sendiri adalah salah satu peralatan kedokteran yang berfungsi memindai atau meneropong kelainan atau penyakit pada organ-organ pencernaan. Peralatan ini dilengkapi dengan kamera mikro yang dihubungkan dengan komputer.
Sayangnya, jumlah tenaga dokter yang dapat mengerjakan endoskopi relatif masih terbatas. Di Indonesia, diperkirakan sekitar 600 dokter saja. Namun dari jumlah tersebut, kurang dari 50 dokter spesialis penyakit dalam yang memiliki kemampuan menggunakan peralatan modern tersebut. Sebagian besar dokter yang bisa menggunakan peralatan tersebut hanya terdapat di beberapa kota besar, seperti Jakarta, Bandung, Semarang, Medan, Makasar, Manado, dan Surabaya.
Sebenarnya, kemampuan dokter endoskopi di Indonesia sudah cukup mahir dan mampu bersaing dengan dokter-dokter dari negara-negara lain. Sebab, mereka telah menempuh pendidikan di sejumlah perguruan tinggi di luar negeri. Namun, dengan kemajuan peralatan endoskopi belakangan ini, para dokter endoskopi Indonesia perlu terus mengasah pengetahuannya, sehingga menjadi lebih mahir.
Workshop Endoskopi Dilakukan Dokter di Indonesia
Atas dasar itulah Perhimpunan Endoskopi Gastrointestinal Indonesia (PEGI) akan menggelar workshop endoskopi. Workshop atau course ini merupakan bagian dari kalender acara outreach the Asia Pacific Society for Digestive Endoscopy (APSDE) tahunan yang kali ini diadakan di Jakarta, Indonesia. Sebanyak 40 dokter endoskopi diundang untuk memperdalam ilmunya.
Menurut Dr dr Ari Fahrial Syam SpPD KGEH, Ketua Umum PEGI, acara yang berlangsung selama 5 hari (11-15 September 2017), juga akan menghadirkan beberapa ahli endoskopi dari luar negeri, antara lain Prof Seigo Kitano, MD, President APSDE, dan Prof Hisao Tajiri, MD, President Japanese Gastroenterological Endoscopy Society, kedua dokter tersebut langsung datang dari Jepang.
Selain itu juga ada dua ahli endoskopi dari Jepang yang memberikan kuliah tamu, yaitu Prof. Kazuhisa Okamoto, MD, Prof Mitsuhiro Kidadari dari Fakultas Kedokteran Universitas Kitasato, dan Prof. Eiji Umegaki, MD, dari Departemen Gastroenterologi, Kobe University School of Medicine. Di situ, Okamoto dan Umegaki akan tampil dalam sesi hands-on di hari pertama.
Tim ahli dari Jepang itu akan mengajari para dokter spesialis penyakit dalam dalam sesi hands on dengan cara yang benar. Diharapkan dengan pelatihan selama 5 hari (11-15 September 2017) para dokter spesialis penyakit dalam yang terlibat dalam sesi pelatihan ini mampu melakukan tindakan endoskopi tingkat lanjut (advanced endoscopy).
Pelatihan Mengenai Endoskopi Diberikan Oleh Dokter Dari Jepang
Dokter Ari mengatakan untuk kawasan Asia, Vietnam dan Indonesia mendapatkan kesempatan pelatihan langsung (hands on) dari para ahli endoskopi saluran cerna dari Jepang. “Untuk pelatihan di Jakarta dipimpin oleh tim dari Kobe University School of Medicine. Acara ini bertujuan para dokter Indonesia mampu meningkatkan kemampuan dalam menggunakan endoskopi, sehingga dapat mendiagnosa secara lebih akurat,” ujarnya saat ditemui di Jakarta.
Sebenarnya, menurut dr. Ari peralatan teknologi endoskopi yang terdapat di Indonesia sudah maju. Beberapa rumah sakit sudah memiliki ERCP (endoscopic retrograde cholangiopancreatography), endoskopi ultrasound, endoskopi untuk melihat usus halus, dan intra ductal ultrasound untuk memindai batu empedu. Ada juga manometri untuk meneropong tekanan dalam lambung dan kerongkongan yang biasa terjadi pada penderita penyakit maag dan GERD (Gastroesophageal Reflux Disease).
Tetapi tidak semua rumah sakit yang memiliki fasilitas tersebut. Ambil contoh peralatan untuk ERCP dimiliki Rumah Sakit (RS) Umum Pusat Cipto Mangunkusumo (Jakarta) dan RS Kariadi (Semarang), dan rumah sakit swasta di Bandung dan Surabaya.
Di Jepang sendiri jumlah dokter ahli endoskopi memadai jika dibandingkan dengan jumlah penduduk di sana. Menurut Tajiri, di negeri Sakura itu terdapat sekitar 30.000 ahli endoskopi. Adapun jumlah penduduk Jepang sekitar 127 juta jiwa (data tahun 2016). Bandingkan dengan Indonesia yang berpenduduk 280 juta tapi hanya memiliki 600 dokter endoskopi.
Pembicara lain dalam temu media itu adalah Prof Seigo Kitano (President Asia Pacific Society of Digestive Endoscopy/APSDE). Ia mengatakan bahwa pada saat ini terdapat 20 negara yang menjadi anggota APSDE. “Indonesia merupakan salah satu negara yang penting dan menjadi prioritas pelatihan endoskopi saluran cerna tingkat lanjut karena jumlah populasi yang besar namun dokter yang menguasai advanced endoscopy masih terbilang sedikit,” katanya.
Penyebab Kanker di Saluran Pencernaan
Selain membahas soal pelatihan, para pembicara juga berbicara soal kejadian kanker. Dokter Ari menyinggung, di Indonesia angka kejadian kanker saluran cerna (misal kanker pankreas dan kanker kolorektal) terus meningkat jumlahnya. Peningkatan kasus kejadian kanker itu antara lain disebabkan oleh gaya hidup masyarakat, misalnya suka mengonsumsi makanan berlemak, kurang makan sayur/serat, kurang gerak, juga obesitas.
Kasus lain yang juga banyak terdapat di masyarakat adalah meningkatnya kejadian batu di saluran empedu. “Nah, dengan pelatihan endoskopi saluran cerna tingkat lanjut, maka dokter di Indonesia memiliki kemampuan untuk mengeluarkan batu dari saluran empedu atau mengambil sampel jaringan di pankreas,” katanya.
Di Indonesia, angka kejadian kanker kolorektal terbilang tinggi. Ini berbeda dengan kasus kanker di Jepang. Di Jepang, kata Prof Hisao Tajiri, MD, President Japanese Gastroenterological Endoscopy Society, kasus yang paling banyak adalah kanker lambung. Selain karena pola makan yang salah, juga disebabkan oleh bakteri Helicobacter pylori (H. Pylori).
Hal yang perlu mendapat sorotan adalah, kuman Helicobacter pylori di Jepang banyak diidap oleh orang Jepang. “Kuman ini dapat menyebabkan kanker saluran cerna (gastric cancer) jika tak diobati dengan tuntas,” katanya. Tajiri menekankan kuman H pylori merupakan faktor risiko kanker saluran cerna di Jepang. Kanker usus besar di Jepang termasuk tinggi, antara lain karena adanya perubahan pola makan.
H. Pylori kini juga menjadi perhatian peneliti Indonesia. Dokter Ari yang memimpin studi tersebut juga menemukan ada beberapa faktor yang menyebabkan kuman ini bisa tumbuh di daerah lain, tapi tidak di tempat lain. Selama 3 tahun, Perhimpunan Gastroenterologi Indonesia, khususnya kelompok studi H. Pylori Indonesia, melakukan studi di 20 RS di Indonesia.
Dari hasil penelitian terhadap 1.100 pasien, Dokter Ari bersama Prof Yoshio Yamaoka dari Universitas Iota, Jepang. Menemukan prevalensi H pylori di Indonesia sebesar 22,1%. Satu dari 5 pasien dispepsia (sakit maag) berpotensi mengalami infeksi bakteri tadi. “Suku bangsa dan sumber air menjadi salah satu faktor risiko infeksi kuman itu,” ujarfnya.(irna)
Sumber : KapanLagi.com
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