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U.S. National Institutes of Health
Last Updated: 01/08/14

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN AFGHANISTAN

Cancer All cancers
excl. non-melanoma
skin cancer
Hematological Malignancies Stomach Breast Esophagus Urological Head & Neck Colorectal Gynecological Lung Brain, nervous system
New Cancer Cases 14355 2491 1716 1509 1002 983 968 894 865 792 645
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 52.24 0 33 100.00 20 73.75 44 70 56.67 25 100
Number (#) of patients needing surgery 7499 0 566 1509 200 725 426 626 490 198 645
Average length of stay (ALOS) for surgery 6.81 0 5 5 9 8 6.8 9 6.33 10 9
# of surgery beds/day 139.89 0.00 7.75 20.66 4.94 15.88 7.93 15.42 8.50 5.42 15.89
CHEMOTHERAPY % of patients requiring chemo 79.12 100 66 100 90 62.5 66 90 66.67 50 100
# of patients requiring chemo 11357.25 2491 1133 1509 902 614 639 805 577 396 645
ALOS for chemo 3.44 6.5 3 3 3 3.5 3.4 3 3 3 3
# of chemo beds/day 106.96 44.33 9.30 12.39 7.41 5.89 5.95 6.61 4.74 3.25 5.30
RADIOTHERAPY % of patients requiring RT 63.98 32.5 50 100 90 41.25 71 25 40 90 100
# of patients 9183.61 810 858 1509 902 405 687 224 346 713 645
# of admitted patients 2295.90 202 215 377 225 101 172 56 87 178 161
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 31.43 2.77 2.94 5.16 3.09 1.39 2.35 0.76 1.18 2.44 2.21
ONCOLOGY BEDS Maximum # of beds/day 279 48 20 39 16 24 17 23 15 12 24
# of 24 bed oncology wards 12 2 1 2 1 1 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 5 5 0 0 0 0 0 0 0 0 0
Surgical Oncologists 16 0 2 4 1 2 1 2 2 1 2
Radiation/Clinical Oncologists 72 13 9 8 6 5 5 5 5 4 4
Urologic Oncologists 2 0 0 0 0 2 0 0 0 0 0
Gynecologic Oncologist 2 0 0 0 0 0 0 0 2 0 0
Neuro-Oncologists 2 0 0 0 0 0 0 0 0 0 2
Pathologists 29 5 4 4 3 2 2 2 2 2 2
PHARMACY Onco-Pharmacists 48 8 4 8 4 4 4 4 4 4 4
Onco-Pharmacy Technicians 72 12 6 12 6 6 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 29 5 4 4 3 2 2 2 2 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 111 10 11 19 11 5 9 3 5 9 8
Medical Physicists 37 4 4 7 4 2 3 1 2 3 3
Linac Engineers 10 1 1 2 1 1 1 1 1 1 1
Radiation Oncology Nurses 37 4 4 7 4 2 3 1 2 3 3
Linacs / Co 60 Megavolt Units 19 2 2 4 2 1 2 1 1 2 2
# of Brachytherapy units 10 1 1 2 1 1 1 1 1 1 1
# CT simulators 10 1 1 2 1 1 1 1 1 1 1
# of treatment planning computers 10 1 1 2 1 1 1 1 1 1 1
# of dosimetry/QA package 10 1 1 2 1 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 180 30 15 30 15 15 15 15 15 15 15

CANCER INCIDENCE IN MOST POPULOUS CITY BASED on GLOBOCAN 2008 AND DATA FROM CITYPOPULATION.DE 2012

Kabul
Population 3289000
New Cancer Cases 1736
SURGERY % of patients needing surgery 52.24
Number (#) of patients needing surgery 907
Average length of stay (ALOS) for surgery 6.81
# of surgery beds/day 16.92
CHEMOTHERAPY % of patients requiring chemo 79.12
# of patients requiring chemo 1373
ALOS for chemo 3.44
# of chemo beds/day 12.94
RADIOTHERAPY % of patients requiring RT 63.98
# of patients 1111
# of admitted patients 278
ALOS 5
# of RT beds/day 3.80
ONCOLOGY BEDS Maximum # of beds/day 34
# of 24 bed oncology wards 2
ONCOLOGISTS Hematologist Oncologists 1
Surgical Oncologists 2
Radiation/Clinical Oncologists 9
Urologic Oncologists 1
Gynecologic Oncologist 1
Neuro-Oncologists 1
Pathologists 4
PHARMACY Onco-Pharmacists 8
Onco-Pharmacy Technicians 12
PALLIATIVE CARE Palliative Care Specialists 4
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 14
Medical Physicists 5
Linac Engineers 2
Radiation Oncology Nurses 5
Linacs / Co 60 Megavolt Units 3
# of Brachytherapy units 2
# CT simulators 2
# of treatment planning computers 2
# of dosimetry/QA package 2
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 30

Key to Calculations

  1. Number of beds/day = number who require surgery*ALOS/365.25
  2. Oncology beds per day = beds for surgery + beds for chemotherapy + beds for radiation therapy
  3. Number of 24 bed oncology wards = (Oncology beds per day)/24
  4. Number of Hematologist oncologists = (2/1000)*hematologic malignancy cases
  5. Number of Radiation Oncologists = (5/1000)*total number of cancer cases
  6. Number of Surgical oncologists = (number of surgeries)/480. This is based on 2 surgeries per day, 5 days a week for 48 weeks)
  7. Number of GYN-oncologists = (2/1000)*GYN cancer cases
  8. Number of Urologic Oncologists = (2/1000)* urological cancer cases
  9. Number of Neuro-Oncologists = (2/1000)* brain, nervous system cancer cases
  10. Number of pathologist = (2/1000)*total number of cancer cases
  11. Number of Pharmacists = 4* number of 24 bed oncology wards
  12. Number of Pharmacy Technicians = 6 * number of 24 bed oncology wards
  13. Number of Palliative Care Specialists = (2/1000)*total number of cancer cases
  14. Number of Medical Physicists = (4/1000) * number of patients requiring radiation therapy
  15. Number of Radiation Technicians = (12/1000) * number of patients requiring radiation therapy
  16. Number of Linac Engineers = (1/1000) * number of patients requiring radiation therapy
  17. Number of Radiation Therapy nurses = (4/1000) * number of patients requiring radiation therapy
  18. Number of Linacs = (2/1000) * number of patients requiring radiation therapy
  19. Number of Brachy therapy units/CT simulators/treatment planning computers/ dosimetry/QA package = (1/1000) * number of patients requiring radiation therapy
  20. Number of nurses = 15*number of 24 bed oncology wards (1 head nurse + 1 nurse specialist + 13 nurses for each 24 bed oncology ward).
  21. The table below lists the estimated percentage of patients requiring surgery, chemotherapy and radiation therapy for the different types of cancers as well as the average length of stay (ALOS) in hospital (in days) for each of these treatments.
Type of cancer % of patients requiring Surgery ALOS % of patients requiring Chemotherapy ALOS % of patients requiring Radiation therapy ALOS
Cervix uteri Gynecological 20 5 80 3 80 5
Corpus uteri Gynecological 80 5 20 3 20 5
Ovary Gynecological 70 9 100 3 20 5
Gynecological cancers 56.67 6.33 66.67 3 40 5
Larynx Head & Neck 50 9 50 3 75 5
Lip, oral cavity Head & Neck 40 9 80 3 80 5
Nasopharynx Head & Neck 0 0 100 3 100 5
Other pharynx Head & Neck 40 9 80 3 80 5
Thyroid Head & Neck 90 7 20 5 20 5
Head and Neck cancers 44 6.8 66 3.4 71 5
Hodgkin lymphoma Hematological Malignancy 0 0 100 5 40 5
Leukaemia Hematological Malignancy 0 0 100 7 20 5
Multiple myeloma Hematological Malignancy 0 0 100 7 20 5
Non-Hodgkin lymphoma Hematological Malignancy 0 0 100 7 50 5
Hematological Malignancies 0 0 100 6.5 32.5 5
Bladder Urological 100 9 50 3 50 5
Kidney Urological 75 9 50 3 20 5
Prostate Urological 20 9 50 3 65 5
Testis Urological 100 5 100 5 30 5
Urologica cancers 73.75 8 62.5 3.5 41.25 5
Brain, nervous system 100 9 100 3 100 5
Breast 100 5 100 3 100 5
Colorectal 70 9 90 3 25 5
Gallbladder 33 9 66 3 50 5
Kaposi sarcoma 0 0 70 3 50 5
Liver 5 10 20 3 20 5
Lung 25 10 50 3 90 5
Melanoma of skin 100 3 50 3 50 5
Esophagus 20 9 90 3 90 5
Pancreas 10 10 50 5 50 5
Stomach 33 5 66 3 50 5
All cancers excl. non-melanoma skin cancer average of top 10 cancers