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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN BULGARIA

Cancer All cancers
excl. non-melanoma
skin cancer
Colorectal Urological Lung Breast Gynecological Head and Neck Stomach Hematological Pancreas Brain, nervous system
New Cancer Cases 32053 4925 4581 3936 3928 3433 1796 1664 1550 1236 827
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 51.24 70 73.75 25 100 56.67 44 33 0 10 100
Number (#) of patients needing surgery 16424 3448 3378 984 3928 1945 790 549 0 124 827
Average length of stay (ALOS) for surgery 6.91 9 8 10 5 6.33 6.8 5 0 10 9
# of surgery beds/day 310.88 84.95 74.00 26.94 53.77 33.73 14.71 7.52 0.00 3.38 20.38
CHEMOTHERAPY % of patients requiring chemo 75.12 90 62.5 50 100 66.67 66 66 100 50 100
# of patients requiring chemo 24077.25 4433 2863 1968 3928 2289 1185 1098 1550 618 827
ALOS for chemo 3.64 3 3.5 3 3 3 3.4 3 6.5 5 3
# of chemo beds/day 239.95 36.41 27.44 16.16 32.26 18.80 11.03 9.02 27.58 8.46 6.79
RADIOTHERAPY % of patients requiring RT 59.98 25 41.25 90 100 40 71 50 32.5 50 100
# of patients 19223.79 1231 1890 3542 3928 1373 1275 832 504 618 827
# of admitted patients 4805.95 308 472 886 982 343 319 208 126 155 207
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 65.79 4.21 6.47 12.12 13.44 4.70 4.36 2.85 1.72 2.11 2.83
ONCOLOGY BEDS Maximum # of beds/day 617 126 108 56 100 58 31 20 30 14 31
# of 24 bed oncology wards 26 6 5 3 5 3 2 1 2 1 2
ONCOLOGISTS Hematologist Oncologists 4 0 0 0 0 0 0 0 4 0 0
Surgical Oncologists 35 8 8 3 9 5 2 2 0 1 2
Radiation/Clinical Oncologists 161 25 23 20 20 18 9 9 8 7 5
Urologic Oncologists 10 0 10 0 0 0 0 0 0 0 0
Gynecologic Oncologist 7 0 0 0 0 7 0 0 0 0 0
Neuro-Oncologists 2 0 0 0 0 0 0 0 0 0 2
Pathologists 65 10 10 8 8 7 4 4 4 3 2
PHARMACY Onco-Pharmacists 104 24 20 12 20 12 8 4 8 4 8
Onco-Pharmacy Technicians 156 36 30 18 30 18 12 6 12 6 12
PALLIATIVE CARE Palliative Care Specialists 65 10 10 8 8 7 4 4 4 3 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 231 15 23 43 48 17 16 10 7 8 10
Medical Physicists 77 5 8 15 16 6 6 4 3 3 4
Linac Engineers 20 2 2 4 4 2 2 1 1 1 1
Radiation Oncology Nurses 77 5 8 15 16 6 6 4 3 3 4
Linacs / Co 60 Megavolt Units 39 3 4 8 8 3 3 2 2 2 2
# of Brachytherapy units 20 2 2 4 4 2 2 1 1 1 1
# CT simulators 20 2 2 4 4 2 2 1 1 1 1
# of treatment planning computers 20 2 2 4 4 2 2 1 1 1 1
# of dosimetry/QA package 20 2 2 4 4 2 2 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 390 90 75 45 75 45 30 15 30 15 30

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

Sofia Plovdiv
Population 1212935 339077
New Cancer Cases 5256 1470
SURGERY % of patients needing surgery 51.24 51.24
Number (#) of patients needing surgery 2693 753
Average length of stay (ALOS) for surgery 6.91 6.91
# of surgery beds/day 50.98 14.26
CHEMOTHERAPY % of patients requiring chemo 75.12 75.12
# of patients requiring chemo 3948 1104
ALOS for chemo 3.64 3.64
# of chemo beds/day 39.35 11.00
RADIOTHERAPY % of patients requiring RT 59.98 59.98
# of patients 3152 882
# of admitted patients 788 220
ALOS 5 5
# of RT beds/day 10.79 3.02
ONCOLOGY BEDS Maximum # of beds/day 102 29
# of 24 bed oncology wards 5 2
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 6 2
Radiation/Clinical Oncologists 27 8
Urologic Oncologists 2 1
Gynecologic Oncologist 2 1
Neuro-Oncologists 1 1
Pathologists 11 3
PHARMACY Onco-Pharmacists 20 8
Onco-Pharmacy Technicians 30 12
PALLIATIVE CARE Palliative Care Specialists 11 3
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 38 11
Medical Physicists 13 4
Linac Engineers 4 1
Radiation Oncology Nurses 13 4
Linacs / Co 60 Megavolt Units 7 2
# of Brachytherapy units 4 1
# CT simulators 4 1
# of treatment planning computers 4 1
# of dosimetry/QA package 4 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 75 30

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