Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology & Global Health...
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Transcript of Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology & Global Health...
Shilpen Patel MD, FACROAssociate Professor Departments of Radiation Oncology & Global Health University of Washington
Founding Board MemberRadiating Hope
Director of Radiation Oncology RAD-AID International
CANCER IN DEVELOPING COUNTRIES:
Quick facts:7 out of 10 cancer deaths globally occur in
developing countriesCancer kills more people than HIV/AIDS,
Malaria, and Tuberculosis combinedDeveloping countries make up roughly 85%
of the world’s population, and possess only one third of the world’s radiation equipment.
Developing countries lack availability to radiation equipment and the equipment they do have is usually outdated and insufficient
1. Salminen E, Anacak Y, Laskar S, et al: Twinning partnerships through International Atomic Energy Agency (IAEA) to improve radiotherapy in common paediatric cancers in low- and mid-income countries. Radiother Oncol 93:368–371, 2009.2. International Atomic Energy Agency: Design and implementation of a radiotherapy programme: Clinical, medical physics, radiation protection and safety aspects. [IAEA-TECDOC-1040.] Vienna, Austria, International Atomic Energy Agency,1998.
INCIDENCE
The number of new cancer cases per year is estimated to be 15 million in 2015, of which two-thirds occurs in developing countries.
•“It is not an exaggeration to say that cancer represents an imminent crisis for developing countries.”
• IAEA Director General Yukiya Amano
3. Ferlay J, Shin HR, Bray F, et al: Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893-2917, 2010. 4. Farmer P, Frenk J, Knaul F, et al: Expansion of cancer care and control in countries of low and middle income: a call to action. Lancet 376:1186-1193, 2010.
Tanzania Africa, 2010
BY THE NUMBERS:
• US: Approximately 1 machine
for 105,000 people2% of machines are cobalt
Africa: 1 machine for 4.8 million
people48% of machines are cobalt
South America: 1 machine for 640,000
people39% of machines are cobalt
Nepal: 1 machine for 6 million
people40% of machines are cobalt
Figure from IAEA (www.IAEA.org)- DIRAC
AFRICA:
Rwanda: No machines
Uganda: 1 machine per 33,000,000
Tanzania: 1 machine per 14,000,000
Sudan: 1 machine per 7,000,000
Mali: No machines Senegal:
1 machine per 13,000,000 Ghana:
1 machine per 1,000,000 Ethiopia:
1 machine per 70,000,000 South Africa:
1 machine per 1,000,000
International Atomic Energy Agency: DIRAC (Directory of Radiotherapy Centres). Updated February 2011. Available at: http://www-naweb.iaea.org/nahu/dirac/informationupdate.asp. Accessed July 21, 2011.
Mission: to provide and update radiation equipment in developing countries and advance cancer care in those countries.
PROJECTS:
Radiation Therapy Project Saves cancer patients in developing
countries Thousand upon thousands of lives
are saved with one machine
Prayer Flag Project Involves people locally giving hope
and strength to them Allows survivors to ‘Pass Along a
Cure’
Mountaineering Project Allows people to climb for cancer Allows cancer survivors to become
‘super-advocates’
RADIATION THERAPY PROJECT
We accept used machines and donated radiation therapy equipmentWe provide a tax deduction for these
machinesMost machines are valued at 200,000 up
to 1 million dolalrs
We then refurbish and ship the machines
Partnering with: Physicians Clinics and Hospital Radiation equipment
manufacturers Non-profit organizations
We then train the physicians and provide ongoing support and partnerships
Panama City, Panama
RADIATION THERAPY PROJECT
Partnering countries: Panama-
Brachytherapy equipmentValue $150,000, RadHope 0
Chile- Children’s Cancer Hospital- Toys
Value $500, RadHope 0 Honduras-
Two radiation therapy machinesValue $400,000, RadHope 0
Peru- One radiation Megavoltage machine
Value $1 Million, RadHope 0 Ethiopia-
Hospital equipment and hygiene kits Senegal-
Radiation Machine and suppliesValue$ 750,000, RadHope $80,000
Madagascar- Radiation Machine
Value $1 mil, RadHope 0 Tanzania-
Radiation centerValue$2 million, RadHope 0
Ukraine- Radiation Machine
Value $1.5 million, RadHope 0
SENEGAL PROJECT:
Currently there is one Radiation Oncology Center in Senegal Africa
The Institut Curie de L’Hopital Aristide Le Dantec, located in the city of Dakar.
Senegal is a country of over 13 million people which currently has only one radiation machine
Radiation Clinic, Senegal Africa
SENEGAL PROJECT:
The Institut Curie: -Cobalt -No HDR -Simulator
Facutly: -2 Rad Oncs -3 physicists -3 therapist -no nurse
Goal: implement HDR brachytherapy
Radiation Clinic, Senegal Africa
SENEGAL PROJECT:
Most common cancer: -40% cervical
Tx for cervical cancer: -External beam, 45 Gy -Boost with external
beam -surgery
Outcomes: mostly palliative
SENEGAL PROJECT: ARRIVAL OF THE HDR MACHINE
SENEGAL PROJECT: OUTREACH
CONCLUSIONS
• Much work needs to be done• Both equipment and training is needed• We need to do more with less money• Critical need is for a true collaboration of:
• The Ministry of Health and the Government• The donor community• The local medical providers• The people themselves• Non government organizations/Non profits