- Manfaat nuklir sebagai energi terbarukan tidak hanya sebagai alternatif energi saja, tetapi juga dalam kesehatan.
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Pernahkah Sobat EBT Heroes berpikir bahwa nuklir dapat bermanfaat bagi kesehatan sebagai obat penyakit tertentu? Stigma negatif nuklir sebagai materi berbahaya menutup mata masyarakat terhadap manfaat yang berlimpah jika dikelola dengan baik dan benar. Bahkan, untuk meneliti manfaatnya secara medis terciptalah cabang ilmu kedokteran nuklir untuk mendiagnosis organ dan penyakit yang diderita pasien secara akurat.
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- Turkey Nuclear Plant is Threatened by Russia’s War Sanctions
- The Advantages and Disadvantages of Nuclear Energy
Eksistensi Kedokteran Nuklir di Indonesia, Amankah?
Saat ini mayoritas masyarakat, pasien, bahkan beberapa dokter masih awam dan menutup mata terhadap manfaat metode pengobatan kedokteran nuklir di bidang kesehatan. Tidak dapat dipungkiri bahwa asumsi dan ketakutan masyarakat terhadap nuklir sebagai material berbahaya berpotensi menimbulkan kecacatan atau kemandulan akibat efek radiasi. Stigma tersebut tentunya dapat menghambat perkembangan terapi dan metode pengobatan di Indonesia.
Hal ini sangat disayangkan karena metode penyembuhan ini sudah lama dikembangkan sejak tahun 1940-an di Amerika Serikat. Terlebih lagi, produksi radioisotop yang dihasilkan oleh Reaktor Triga 2000 di Bandung sebagai reaktor nuklir pertama di Indonesia saat ini belum dimanfaatkan dengan maksimal. Oleh karena itu, diperlukan inovasi baru didunia medis berupa kedokteran nuklir yang memanfaatkan material tersebut untuk mengobati pasien kanker.
Keberadaan kedokteran nuklir kurang berkembang pesat di Indonesia, jumlah dokter spesialis dan total rumah sakit dengan fasilitas penunjang kedokteran nuklir tidak sebanding dengan tersebarnya rumah sakit konvensional lainnya. Minimnya sosialisasi kepada masyarakat serta keterbatasan SDM dan fasilitas kedokteran membuat Rumah Sakit Hasan Sadikin, Bandung ditetapkan sebagai pusat rujukan nasional spesialis kedokteran nuklir sejak 1998. Semua elemen meliputi dokter, perawat, radiografer, radiofarmasis, dan apoteker memiliki karakteristik dalam pelayanannya.
Terdapat beberapa rumah sakit di Indonesia yang telah memiliki fasilitas kedokteran nuklir seperti RSUP H. Adam Malik (Medan), RSPAD Gatot Subroto (Jakarta), RSUPN Dr. Cipto Mangunkusumo (Jakarta), Rumah Sakit Kanker Dharmais (Jakarta), Rumah Sakit Pusat Pertamina (Jakarta), Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (Jakarta), Rumah Sakit Siloam (Jakarta), Rumah Sakit Gading Pluit (Jakarta), Rumah Sakit Abdi Waluyo (Jakarta), RS Hasan Sadikin (Bandung), RS Santoso Kopo (Bandung), RSUP Dr. Sardjito (Yogyakarta), RSUP Dr. Kariadi (Semarang), dan RSUD Abdul Wahab Sjahranie (Samarinda).
Inovasi Radioterapi dari Nuklir
Ekspansi pemanfaatan nuklir di Indonesia saat ini sudah merambah ke dunia medis. Berbagai inovasi telah dilakukan untuk mengembangkan material tersebut menjadi sumber daya yang mampu bermanfaat bagi kehidupan manusia saat ini. Peran pemerintah dalam menanggulangi masalah kanker melalui Kementerian Kesehatan (Kemenkes) RI ditunjukkan oleh rencana perluasan fasilitas radiodiagnostik, radioterapi, dan kedokteran nuklir di Indonesia.
Rancangan tersebut merupakan kolaborasi antara Kemenkes dengan International Atomic Energy Agency (IAEA) sebagai Dirjen Badan Tenaga Atom Internasional. Kemenkes berperan sebagai lembaga penjaminan mutu setiap tahap perluasan fasilitas, pengembangan kapasitas, sumber daya, dan teknis penyediaan peralatan. Sedangkan IAEA akan membantu Indonesia dalam area penilaian kelayakan perluasan fasilitas tersebut di 34 provinsi dan mendesain pola jaringan untuk instalasi siklotron.
Pelaksanaan agenda technical visit pada 5 Rumah Sakit di Indonesia telah dilakukan pada 13-24 Maret 2023 sebagai expert mission tim IAEA. Kunjungan tersebut bertujuan untuk memperkuat layanan kesehatan nasional khususnya pada radioterapi dan kedokteran nuklir. Fasilitas radioterapi yang baru tersebar di 17 provinsi dan layanan kedokteran nuklir di 10 provinsi Indonesia saat ini diharapkan mampu membantu penderita kanker untuk sembuh dari penyakitnya.
Terlebih dari seluruh populasi warga Indonesia terdapat 396.914 kasus kanker pada tahun 2020 dengan jumlah kematian sebanyak 234.511 jiwa. Persentase kanker terbesar diduduki oleh kanker payudara (16.6%), kanker rahim (9.2%) dan kanker paru-paru (8.8%). Data tersebut bersumber dari Globocan (Global Burden of Cancer Study) 2020 yang membuktikan bahwa kanker merupakan penyakit mematikan kedua setelah penyakit jantung.
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Samarium-153 EDTMP, Terapi Pereda Nyeri dari Nuklir
Samarium-153 EDTMP (Ethylene Diamine Tetra Methylene Phosphonate) merupakan suatu produk radiofarmaka yang berfungsi sebagai terapi paliatif pereda nyeri pasien kanker di RSUP Dr. Sardjito, Yogyakarta. Inovasi ini tidak terlepas dari keberhasilan sinergitas antara rumah sakit (mitra), PT Kimia Farma, BPOM, Bapetan, dan Perhimpunan Kedokteran Nuklir Indonesia (PKNI). Proses yang berlangsung pada pembuatan produk ini terdiri atas 4 tahap sebelum dilakukan pengemasan dan pengiriman meliputi persiapan bahan target iradiasi, proses iradiasi, penanganan pascairadiasi, penandaan, dan pengujian kualitas.
Samarium diproduksi oleh Badan Riset dan Inovasi Nasional (BRIN) melalui Organisasi Riset Tenaga Nuklir (ORTN) yang merupakan inovasi di bidang kedokteran nuklir. EDTMP sendiri merupakan bahan aktif yang dapat berikatan dengan lokasi spesifik pada jaringan tulang dan mampu berikatan dengan radioisotop Samarium-153 sebagai radioisotop terapi. Akibatnya, jaringan tulang tertentu yang harus dilumpuhkan dapat dilokalisir oleh zat radioaktif dalam kombinasi EDTMP dan Sm-153.
Produk Samarium-153 EDTMP dijual dan didistribusikan oleh PT Kimia Farma dengan merk TBONE KaeF. Sm153 EDTMP bekerja dengan cara mereduksi nyeri pada pasien kanker yang sudah menyebar ke tulang. Efek radiasi yang ditimbulkan tergolong ringan sehingga aman untuk digunakan. Melalui penggunaan produk ini, diharapkan pasien tidak merasakan nyeri dan dapat meningkatkan kualitas hidupnya. Terjadi peningkatan permintaan produk Sm153 EDTMP sebesar 43,82% dengan jumlah pengiriman yang dilakukan sebesar 14.250 mCi pada tahun 2020.
Penggunaan Sm153 EDTMP tidak menimbulkan efek kecanduan seperti saat menggunakan obat-obatan analgesik atau penghilang rasa sakit seperti morfin. Daya tahan pereda nyeri dari produk tersebut berkisar antara 1-2 bulan, sehingga kualitas hidup penyintas kanker dapat meningkat dan mereka dapat beraktivitas dengan normal. Selain itu, biaya yang dikeluarkan pasien untuk melakukan terapi dengan Samarium-153 EDTMP lebih murah dibandingkan dengan terapi morfin.
#zonaebt #sebarterbarukan #ebtheroes
Editor: Annisa Nur Fissilmi Kaffah
Referensi:
[1] Indonesia-Global Cancer Observatory
[2] BRIN Aplikasikan Samarium-153 EDTMP untuk Terapi Pasien Kanker di RSUP dr. Sardjito Yogyakarta
[3] Kemenkes Perluas Fasilitas Radioterapi hingga Kedokteran Nuklir
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