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U.S. National Institutes of Health
Last Updated: 06/29/15

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN AFGHANISTAN

Cancer All cancers
excl. non-melanoma
skin cancer
Breast Hematological Gynecological Head and Neck Stomach Esophagus Urological Lung Colorectal Brain, nervous system
New Cancer Cases 19978 3108 2092 1935 1885 1781 1326 1064 989 906 851
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 52.24 100 0 56.67 44 33 20 73.75 25 70 100
Number (#) of patients needing surgery 10437 3108 0 1097 829 588 265 785 247 634 851
Average length of stay (ALOS) for surgery 6.81 5 0 6.33 6.8 5 9 8 10 9 9
# of surgery beds/day 194.69 42.55 0.00 19.01 15.44 8.05 6.53 17.19 6.77 15.63 20.97
CHEMOTHERAPY % of patients requiring chemo 79.12 100 100 66.67 66 66 90 62.5 50 90 100
# of patients requiring chemo 15805.99 3108 2092 1290 1244 1175 1193 665 495 815 851
ALOS for chemo 3.44 3 6.5 3 3.4 3 3 3.5 3 3 3
# of chemo beds/day 148.86 25.53 37.23 10.60 11.58 9.65 9.80 6.37 4.06 6.70 6.99
RADIOTHERAPY % of patients requiring RT 63.98 100 32.5 40 71 50 90 41.25 90 25 100
# of patients 12780.93 3108 680 774 1338 891 1193 439 890 227 851
# of admitted patients 3195.23 777 170 194 335 223 298 110 223 57 213
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 43.74 10.64 2.33 2.65 4.58 3.05 4.08 1.50 3.05 0.78 2.91
ONCOLOGY BEDS Maximum # of beds/day 388 79 40 33 32 21 21 26 14 24 31
# of 24 bed oncology wards 17 4 2 2 2 1 1 2 1 1 2
ONCOLOGISTS Hematologist Oncologists 5 0 5 0 0 0 0 0 0 0 0
Surgical Oncologists 22 7 0 3 2 2 1 2 1 2 2
Radiation/Clinical Oncologists 100 16 11 10 10 9 7 6 5 5 5
Urologic Oncologists 3 0 0 0 0 0 0 3 0 0 0
Gynecologic Oncologist 4 0 0 4 0 0 0 0 0 0 0
Neuro-Oncologists 2 0 0 0 0 0 0 0 0 0 2
Pathologists 40 7 5 4 4 4 3 3 2 2 2
PHARMACY Onco-Pharmacists 68 16 8 8 8 4 4 8 4 4 8
Onco-Pharmacy Technicians 102 24 12 12 12 6 6 12 6 6 12
PALLIATIVE CARE Palliative Care Specialists 40 7 5 4 4 4 3 3 2 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 154 38 9 10 17 11 15 6 11 3 11
Medical Physicists 52 13 3 4 6 4 5 2 4 1 4
Linac Engineers 13 4 1 1 2 1 2 1 1 1 1
Radiation Oncology Nurses 52 13 3 4 6 4 5 2 4 1 4
Linacs / Co 60 Megavolt Units 26 7 2 2 3 2 3 1 2 1 2
# of Brachytherapy units 13 4 1 1 2 1 2 1 1 1 1
# CT simulators 13 4 1 1 2 1 2 1 1 1 1
# of treatment planning computers 13 4 1 1 2 1 2 1 1 1 1
# of dosimetry/QA package 13 4 1 1 2 1 2 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 255 60 30 30 30 15 15 30 15 15 30

RESOURCES NEEDED IN CITIES BASED ON GLOBOCAN2012 AND DATA FROM CITYPOPULATION.DE2012

Kabol Herat
Population 3289000 436300
New Cancer Cases 1968 261
SURGERY % of patients needing surgery 52.24 52.24
Number (#) of patients needing surgery 1028 136
Average length of stay (ALOS) for surgery 6.81 6.81
# of surgery beds/day 19.18 2.54
CHEMOTHERAPY % of patients requiring chemo 79.12 79.12
# of patients requiring chemo 1557 206
ALOS for chemo 3.44 3.44
# of chemo beds/day 14.66 1.94
RADIOTHERAPY % of patients requiring RT 63.98 63.98
# of patients 1259 167
# of admitted patients 315 42
ALOS 5 5
# of RT beds/day 4.31 0.57
ONCOLOGY BEDS Maximum # of beds/day 39 6
# of 24 bed oncology wards 2 1
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 3 1
Radiation/Clinical Oncologists 10 2
Urologic Oncologists 1 1
Gynecologic Oncologist 1 1
Neuro-Oncologists 1 1
Pathologists 4 1
PHARMACY Onco-Pharmacists 8 4
Onco-Pharmacy Technicians 12 6
PALLIATIVE CARE Palliative Care Specialists 4 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 16 3
Medical Physicists 6 1
Linac Engineers 2 1
Radiation Oncology Nurses 6 1
Linacs / Co 60 Megavolt Units 3 1
# of Brachytherapy units 2 1
# CT simulators 2 1
# of treatment planning computers 2 1
# of dosimetry/QA package 2 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 30 15

KEY TO CALCULATIONS

  1. Number of beds/day = number who require surgery*ALOS/365.25
  2. Oncology beds per day = beds for surgery, chemotherapy or radiation therapy
  3. Number of 24 bed oncology wards = (Oncology beds per day)/24
  4. Number of Hematologist Oncologists = (2/1000)*hematology 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 Gynecologic Oncologists = (2/1000)*GYN cancer cases
  8. Number of Urologic Oncologists = (2/1000)* urological cancer cases
  9. Number of Neurologic Oncologists = (2/1000)* brain cancer cases
  10. Number of Pathologists = (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 = 1 head nurse + 1 nurse specialist + 13 nurses for each 24 bed oncology ward.
  21. The table below lists the estimated number 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 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 GYN cancer 20 5 80 3 80 5
Corpus uteri GYN cancer 80 5 20 3 20 5
Ovary GYN cancer 70 9 100 3 20 5
Gynecological cancers 56.67 6.33 66.67 3 40 5
Larynx Head and neck 50 9 50 3 75 5
Lip, oral cavity Head and neck 40 9 80 3 80 5
Nasopharynx Head and neck 0 0 100 3 100 5
Other pharynx Head and neck 40 9 80 3 80 5
Thyroid Head and 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
Urological 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