Wednesday, May 30, 2007

Radiotherapy, Radiotherapists, Africa and the NHS

I’m learning a lot.

Percentage rate of various cancer treatments (in the U.K.) goes along the following lines according to therapy:

Surgery: 49%
Radiotherapy: 40%
Chemotherapy: 11%

Hence AfrOx/IAEA emphasising radiotherapy over chemotherapy for developing world treatment. T
here is no mention in the AfrOx or PACT literature on surgical or chemotherapy control and training.

I also note that the IAEA is concentrating on the provision of Cobalt-60 machines. The numbers of the two types of machine in the U.K. are as follows:

Linear Accelarators: 199
Cobalts: 8

The report explicitly states “old cobalt machines”. So I wonder why the IAEA/PACT programme is concentrating on Cobalt-60 machines. Expense of LAs versus C-60s? Expense of maintaining LAs vs C-60s, simplicity of use or maintenance etc etc. I don’t know. But I hope the developing world is not being fobbed off …

So I’ll come on now to the NHS – there is no shortage of radiotherapy machines! Thank your deity etc …

Well, there is …

Radiotherapy capacity seems to be measured in MegaVolts per million population. I love that … visions of Frankenstein movies!

France: 6.12
England: 3.37

And when Italy (4.31 mV) beats England in the league tables, you have to be concerned!

The WHO recommends 5 machines per million. From 1997 to 2002 waiting times have became longer and the number of out-of-date machines has increased.

As in the rest of the NHS, there is a shortage of trained staff:

- a total of 431 of consultant oncologists with a shortage of 14%, and with an additional 262 clinical oncologists needed by 2010 taking into account attrition and increase in cancer occurrence. (Hi MTAS!)

- 17% shortage in therapy radiographers – “many departments are not able to use their full [equipment] capacity because of the lack of therapy radiographers”.

- 6.6% lack of physicists [essential for equipment maintenance] in some areas as high as 25%.

Need I say more …

Reference here.

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