A syllabus for the education and training of radiation oncology nurses

A dramatic rise in cancer incidence across the developing world is stretching already limited resources and equipment. Shortages of qualified staff and equipment are growing constraints to treating cancer efficiently. More than 5000 radiotherapy machines are presently needed to help patients fight cancer, yet the entire developing world has only about 2200 such machines. Experts predict a long term crisis in managing cancer, with an estimated five million new patients requiring radiotherapy 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. Cancer treatment must be carried out in a comprehensive context of prevention, early diagnosis and palliative care. In the early stages of development of a radiotherapy department or unit, the staffing needs of radiotherapy services should also be specifically and carefully addressed. To make radiotherapy available to all patients who need it, human resources should be urgently expanded globally, along with the rational acquisition of additional equipment. The recommended staffing - for a basic radiotherapy facility with 1 teletherapy machine, simulator and high dose rate brachytherapy (HDR) - should be: 5 radiation oncologists, 4 medical physicists, 7-8 radiotherapy technologists (RTTs), 3 oncology nurses and 1 maintenance engineer. Where possible, training should be undertaken in centres with patient populations, equipment and training programmes relevant to the needs of the country. Radiotherapy staff should also be required to obtain a qualification adequate for registration in their own country. The human resources listed above could treat on average about 1000 patients per year by extending operations to a minimum of 12 hours per day. The equipment and staffing indicated would be sufficient to start operations, but certainly would not be sustainable without adding a training component. Hence, to qualify as a centre of 'competence' a clinic should provide training to replace its own radiotherapy technologists and radiation oncology nurses. In addition, it should be able to provide financial resources to enable academic training for replacement of radiation oncologists and medical physicists as well as on-site clinical training for these professionals. This IAEA syllabus provides the basic contents of an education course for radiation oncology nurses. It is a minimally essential syllabus which can and should be adapted to the particular needs and characteristics of the centre and country. It should be translated and used in a local language version for the training of nurses who plan to join a radiotherapy team