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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN MADAGASCAR

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Breast Urological Hematological Malignancies Head & Neck Colorectal Lung Esophagus Stomach Kaposi sarcoma
New Cancer Cases 14487 1970 1736 1518 1474 1366 1203 848 839 669 599
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 42.24 56.67 100.00 73.75 0 44 70 25 20 33 0
Number (#) of patients needing surgery 6120 1117 1736 1120 0 602 843 212 168 221 0
Average length of stay (ALOS) for surgery 5.91 6.33 5 8 0 6.8 9 10 9 5 0
# of surgery beds/day 100 20 24 25 0 12 21 6 5 4 0
CHEMOTHERAPY % of patients requiring chemo 76.12 66.67 100 62.5 100 66 90 50 90 66 70
# of patients requiring chemo 11028 1314 1736 949 1474 902 1083 424 756 442 420
ALOS for chemo 3.44 3 3 3.5 6.5 3.4 3 3 3 3 3
# of chemo beds/day 104 11 15 10 27 9 9 4 7 4 4
RADIOTHERAPY % of patients requiring RT 58.98 40 100 41.25 32.5 71 25 90 90 50 50
# of patients 8544 788 1736 627 480 970 301 764 756 335 300
# of admitted patients 2136 197 434 157 120 243 76 191 189 84 75
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 30 3 6 3 2 4 2 3 3 2 2
ONCOLOGY BEDS Maximum # of beds/day 234 34 45 38 29 25 32 13 15 10 6
# of 24 bed oncology wards 10 2 2 2 2 2 2 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 3 0 0 0 3 0 0 0 0 0 0
Surgical Oncologists 13 3 4 3 0 2 2 1 1 1 0
Radiation/Clinical Oncologists 73 10 9 8 8 7 7 5 5 4 3
Urologic Oncologists 4 0 0 4 0 0 0 0 0 0 0
Gynecologic Oncologist 4 4 0 0 0 0 0 0 0 0 0
Pathologists 29 4 4 4 3 3 3 2 2 2 2
PHARMACY Onco-Pharmacists 40 8 8 8 8 8 8 4 4 4 4
Onco-Pharmacy Technicians 60 12 12 12 12 12 12 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 29 4 4 4 3 3 3 2 2 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 103 10 21 8 6 12 4 10 10 5 4
Medical Physicists 35 4 7 3 2 4 2 4 4 2 2
Linac Engineers 9 1 2 1 1 1 1 1 1 1 1
Radiation Oncology Nurses 35 4 7 3 2 4 2 4 4 2 2
Linacs / Co 60 Megavolt Units 18 2 4 2 1 2 1 2 2 1 1
# of Brachytherapy units 9 1 2 1 1 1 1 1 1 1 1
# CT simulators 9 1 2 1 1 1 1 1 1 1 1
# of treatment planning computers 9 1 2 1 1 1 1 1 1 1 1
# of dosimetry/QA package 9 1 2 1 1 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 150 30 30 30 30 30 30 15 15 15 15

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

Antananarivo
Population 2128900
New Cancer Cases 1614
SURGERY % of patients needing surgery 42.24
# of patients needing surgery 682
ALOS for surgery 5.91
# of surgery beds/day 12
CHEMOTHERAPY % of patients requiring chemo 76.12
# of patients requiring chemo 1229
ALOS for chemo 3.44
# of chemo beds/day 12
RADIOTHERAPY % of patients requiring RT 58.98
# of patients 952
# of admitted patients 238
ALOS 5
# of RT beds/day 4
ONCOLOGY BEDS Maximum # of beds/day 28
# of 24 bed oncology wards 2
ONCOLOGISTS Hematologist Oncologists 1
Surgical Oncologists 2
Radiation/Clinical Oncologists 9
Urologic Oncologists 1
Gynecologic Oncologist 1
Pathologists 4
PHARMACY Onco-Pharmacists 8
Onco-Pharmacy Technicians 12
PALLIATIVE CARE Palliative Care Specialists 4
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 12
Medical Physicists 4
Linac Engineers 1
Radiation Oncology Nurses 4
Linacs / Co 60 Megavolt Units 2
# of Brachytherapy units 1
# CT simulators 1
# of treatment planning computers 1
# of dosimetry/QA package 1
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