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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN BULGARIA

Cancer All cancers
excl. non-melanoma
skin cancer
Colorectal Urological Lung Breast Gynecological Head & Neck Stomach Hematological Malignancies Pancreas Brain, nervous system
New Cancer Cases 30701 4625 4149 3996 3729 3223 1846 1785 1563 1167 771
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 51.24 70 73.75 25 100.00 56.67 44 33 0 10 100
Number (#) of patients needing surgery 15732 3238 3060 999 3729 1826 812 589 0 117 771
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 297.76 79.77 67.02 27.35 51.05 31.67 15.12 8.06 0.00 3.20 19.00
CHEMOTHERAPY % of patients requiring chemo 75.12 90 62.5 50 100 66.67 66 66 100 50 100
# of patients requiring chemo 23061.67 4163 2593 1998 3729 2149 1218 1178 1563 584 771
ALOS for chemo 3.64 3 3.5 3 3 3 3.4 3 6.5 5 3
# of chemo beds/day 229.83 34.19 24.85 16.41 30.63 17.65 11.34 9.68 27.82 7.99 6.33
RADIOTHERAPY % of patients requiring RT 59.98 25 41.25 90 100 40 71 50 32.5 50 100
# of patients 18412.92 1156 1711 3596 3729 1289 1311 893 508 584 771
# of admitted patients 4603.23 289 428 899 932 322 328 223 127 146 193
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 63.01 3.96 5.86 12.31 12.76 4.41 4.49 3.05 1.74 2.00 2.64
ONCOLOGY BEDS Maximum # of beds/day 591 118 98 57 95 54 31 21 30 14 28
# of 24 bed oncology wards 25 5 5 3 4 3 2 1 2 1 2
ONCOLOGISTS Hematologist Oncologists 4 0 0 0 0 0 0 0 4 0 0
Surgical Oncologists 33 7 7 3 8 4 2 2 0 1 2
Radiation/Clinical Oncologists 154 24 21 20 19 17 10 9 8 6 4
Urologic Oncologists 9 0 9 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 62 10 9 8 8 7 4 4 4 3 2
PHARMACY Onco-Pharmacists 100 20 20 12 16 12 8 4 8 4 8
Onco-Pharmacy Technicians 150 30 30 18 24 18 12 6 12 6 12
PALLIATIVE CARE Palliative Care Specialists 62 10 9 8 8 7 4 4 4 3 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 221 14 21 44 45 16 16 11 7 8 10
Medical Physicists 74 5 7 15 15 6 6 4 3 3 4
Linac Engineers 19 2 2 4 4 2 2 1 1 1 1
Radiation Oncology Nurses 74 5 7 15 15 6 6 4 3 3 4
Linacs / Co 60 Megavolt Units 37 3 4 8 8 3 3 2 2 2 2
# of Brachytherapy units 19 2 2 4 4 2 2 1 1 1 1
# CT simulators 19 2 2 4 4 2 2 1 1 1 1
# of treatment planning computers 19 2 2 4 4 2 2 1 1 1 1
# of dosimetry/QA package 19 2 2 4 4 2 2 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 375 75 75 45 60 45 30 15 30 15 30

CANCER INCIDENCE IN CITIES BASED on GLOBOCAN 2008 AND DATA FROM CITYPOPULATION.DE 2011

Sofia Plovdiv
Population 1208097 338184
New Cancer Cases 4886 1368
SURGERY % of patients needing surgery 51.24 51.24
Number (#) of patients needing surgery 2504 701
Average length of stay (ALOS) for surgery 6.91 6.91
# of surgery beds/day 47.39 13.27
CHEMOTHERAPY % of patients requiring chemo 75.12 75.12
# of patients requiring chemo 3670 1028
ALOS for chemo 3.64 3.64
# of chemo beds/day 36.58 10.24
RADIOTHERAPY % of patients requiring RT 59.98 59.98
# of patients 2930 820
# of admitted patients 733 205
ALOS 5 5
# of RT beds/day 10.03 2.81
ONCOLOGY BEDS Maximum # of beds/day 94 27
# of 24 bed oncology wards 4 2
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 6 2
Radiation/Clinical Oncologists 25 7
Urologic Oncologists 2 1
Gynecologic Oncologist 2 1
Neuro-Oncologists 1 1
Pathologists 10 3
PHARMACY Onco-Pharmacists 16 8
Onco-Pharmacy Technicians 24 12
PALLIATIVE CARE Palliative Care Specialists 10 3
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 36 10
Medical Physicists 12 4
Linac Engineers 3 1
Radiation Oncology Nurses 12 4
Linacs / Co 60 Megavolt Units 6 2
# of Brachytherapy units 3 1
# CT simulators 3 1
# of treatment planning computers 3 1
# of dosimetry/QA package 3 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 60 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