A silent crisis: Cancer treatment in developing countries

A dramatic rise in cancer across the developing world is stretching already limited resources and equipment. Shortages of qualified staff and equipment are growing constraints to treating cancer effectively. Some 5,000 radiotherapy machines are presently needed to help patients fight cancer. But the entire developing world has only about 2,200 such machines. Experts predict a long-term crisis in managing cancer, with an estimated five million new patients requiring radiation therapy every year. Meeting the challenge is not simply a matter of providing appropriate equipment. There must be sufficient trained and knowledgeable staff with clinical and medical physics expertise to deliver a safe and effective radiation dose. Appropriate facilities and radiation protection infrastructure for monitoring and regulatory control are needed. Moreover, cancer treatment must be carried out in a comprehensive context of prevention, early diagnosis, and adequate follow-up care. Providing essential equipment and training of staff to safely treat cancer patients in the developing world is of increasing importance to the IAEA. The Agency has assisted Ethiopia, Ghana, Mongolia, Namibia, and Uganda in establishing their first radiotherapy facilities. The IAEA also provides ongoing support to some 80 developing Member States in upgrading their radiotherapy facilities and providing staff with suitable training. Dosimetry and medical physics are an integral part of any medical treatment that uses ionizing radiation. With computerization, improved techniques are increasingly being used in developing countries to plan and treat patients in a wide range of medical therapies including teletherapy, brachytherapy, and the use of open drinkable or injectable sources. The IAEA works in partnership with the World Health Organisation (WHO) on most of its cancer projects. The WHO works to address the full spectrum of the health-disease continuum from prevention to end-of-life care. The role of the IAEA in cancer control programmes has grown rapidly as radiotherapy and nuclear imaging become increasingly important for the management of cancer. The Agency is actively promoting the international exchange of information on the newest treatment technology and therapies, and has developed standards and codes of practice for safe and effective medical uses of radiation. The IAEA also works with the WHO to support a network of standard dosimetry laboratories that provide calibration services to hospitals throughout the developing world to assist their quality assurance programmes. This publication provides a brief overview of the IAEA's experiences and achievements in the radiotherapy field. In response to growing needs and the demands of Member States, and with the generous support from donor countries and organisations, we anticipate a steady increase in the extension of these services in developing countries in the early 21st century