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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN MADAGASCAR

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Urological Breast Head and Neck Hematological Colorectal Esophagus Lung Stomach Liver
New Cancer Cases 17960 3527 2172 1799 1524 1489 998 908 792 543 476
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 42.74 56.67 73.75 100 44 0 70 20 25 33 5
Number (#) of patients needing surgery 7676 1999 1602 1799 671 0 699 182 198 179 24
Average length of stay (ALOS) for surgery 6.91 6.33 8 5 6.8 0 9 9 10 5 10
# of surgery beds/day 145.30 34.66 35.09 24.63 12.48 0.00 17.21 4.47 5.42 2.45 0.65
CHEMOTHERAPY % of patients requiring chemo 71.12 66.67 62.5 100 66 100 90 90 50 66 20
# of patients requiring chemo 12772.61 2351 1358 1799 1006 1489 898 817 396 358 95
ALOS for chemo 3.44 3 3.5 3 3.4 6.5 3 3 3 3 3
# of chemo beds/day 120.30 19.31 13.01 14.78 9.36 26.50 7.38 6.71 3.25 2.94 0.78
RADIOTHERAPY % of patients requiring RT 55.98 40 41.25 100 71 32.5 25 90 90 50 20
# of patients 10053.11 1411 896 1799 1082 484 250 817 713 272 95
# of admitted patients 2513.28 353 224 450 271 121 62 204 178 68 24
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 34.40 4.83 3.07 6.16 3.70 1.66 0.85 2.80 2.44 0.93 0.33
ONCOLOGY BEDS Maximum # of beds/day 300 59 52 46 26 29 26 14 12 7 2
# of 24 bed oncology wards 13 3 3 2 2 2 2 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 3 0 0 0 0 3 0 0 0 0 0
Surgical Oncologists 16 5 4 4 2 0 2 1 1 1 1
Radiation/Clinical Oncologists 90 18 11 9 8 8 5 5 4 3 3
Urologic Oncologists 5 0 5 0 0 0 0 0 0 0 0
Gynecologic Oncologist 8 8 0 0 0 0 0 0 0 0 0
Pathologists 36 8 5 4 4 3 2 2 2 2 1
PHARMACY Onco-Pharmacists 52 12 12 8 8 8 8 4 4 4 4
Onco-Pharmacy Technicians 78 18 18 12 12 12 12 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 36 8 5 4 4 3 2 2 2 2 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 121 17 11 22 13 6 3 10 9 4 2
Medical Physicists 41 6 4 8 5 2 1 4 3 2 1
Linac Engineers 11 2 1 2 2 1 1 1 1 1 1
Radiation Oncology Nurses 41 6 4 8 5 2 1 4 3 2 1
Linacs / Co 60 Megavolt Units 21 3 2 4 3 1 1 2 2 1 1
# of Brachytherapy units 11 2 1 2 2 1 1 1 1 1 1
# CT simulators 11 2 1 2 2 1 1 1 1 1 1
# of treatment planning computers 11 2 1 2 2 1 1 1 1 1 1
# of dosimetry/QA package 11 2 1 2 2 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 195 45 45 30 30 30 30 15 15 15 15

RESOURCES NEEDED IN CITIES BASED on GLOBOCAN2012 AND DATA FROM CITYPOPULATION.DE2011

Antananarivo Toamasina
Population 2128900 260300
New Cancer Cases 1744 214
SURGERY % of patients needing surgery 42.74 42.74
Number (#) of patients needing surgery 745 91
Average length of stay (ALOS) for surgery 6.91 6.91
# of surgery beds/day 14.11 1.73
CHEMOTHERAPY % of patients requiring chemo 71.12 71.12
# of patients requiring chemo 1240 152
ALOS for chemo 3.44 3.44
# of chemo beds/day 11.68 1.43
RADIOTHERAPY % of patients requiring RT 55.98 55.98
# of patients 976 120
# of admitted patients 244 30
ALOS 5 5
# of RT beds/day 3.34 0.41
ONCOLOGY BEDS Maximum # of beds/day 30 4
# of 24 bed oncology wards 2 1
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 2 1
Radiation/Clinical Oncologists 9 2
Urologic Oncologists 1 1
Gynecologic Oncologist 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 12 2
Medical Physicists 4 1
Linac Engineers 1 1
Radiation Oncology Nurses 4 1
Linacs / Co 60 Megavolt Units 2 1
# of Brachytherapy units 1 1
# CT simulators 1 1
# of treatment planning computers 1 1
# of dosimetry/QA package 1 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