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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN  MALAWI

Cancer All cancers
excl. non-melanoma
skin cancer
Kaposi sarcoma Gynecological Esophagus Urological Hematological Malignancies Breast Liver Brain, nervous system Head & Neck Colorectal
New Cancer Cases 14487 4741 2532 1318 1090 994 528 362 312 294 222
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 46.94 0 56.67 20 73.75 0 100 5 100 44 70
Number (#) of patients needing surgery 6800 0 1435 264 804 0 528 18 312 129 155
Average length of stay (ALOS) for surgery 6.31 0 6.33 9 8 0 5 10 9 6.8 9
# of surgery beds/day 117.55 0.00 24.88 6.50 17.61 0.00 7.23 0.50 7.69 2.41 3.83
CHEMOTHERAPY % of patients requiring chemo 76.52 70 66.67 90 62.5 100 100 20 100 66 90
# of patients requiring chemo 11085.02 3319 1688 1186 681 994 528 72 312 194 200
ALOS for chemo 3.44 3 3 3 3.5 6.5 3 3 3 3.4 3
# of chemo beds/day 104.40 27.26 13.87 9.74 6.53 17.69 4.34 0.59 2.56 1.81 1.64
RADIOTHERAPY % of patients requiring RT 56.98 50 40 90 41.25 32.5 100 20 100 71 25
# of patients 8253.97 2371 1013 1186 450 323 528 72 312 209 56
# of admitted patients 2063.49 593 253 297 112 81 132 18 78 52 14
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 28.25 8.11 3.47 4.06 1.54 1.11 1.81 0.25 1.07 0.71 0.19
ONCOLOGY BEDS Maximum # of beds/day 251 36 43 21 26 19 14 2 12 5 6
# of 24 bed oncology wards 11 2 2 1 2 1 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 2 0 0 0 0 2 0 0 0 0 0
Surgical Oncologists 15 0 3 1 2 0 2 1 1 1 1
Radiation/Clinical Oncologists 73 24 13 7 6 5 3 2 2 2 2
Urologic Oncologists 3 0 0 0 3 0 0 0 0 0 0
Gynecologic Oncologist 6 0 6 0 0 0 0 0 0 0 0
Neuro-Oncologists 1 0 0 0 0 0 0 0 1 0 0
Pathologists 29 10 6 3 3 2 2 1 1 1 1
PHARMACY Onco-Pharmacists 44 8 8 4 8 4 4 4 4 4 4
Onco-Pharmacy Technicians 66 12 12 6 12 6 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 29 10 6 3 3 2 2 1 1 1 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 100 29 13 15 6 4 7 1 4 3 1
Medical Physicists 34 10 5 5 2 2 3 1 2 1 1
Linac Engineers 9 3 2 2 1 1 1 1 1 1 1
Radiation Oncology Nurses 34 10 5 5 2 2 3 1 2 1 1
Linacs / Co 60 Megavolt Units 17 5 3 3 1 1 2 1 1 1 1
# of Brachytherapy units 9 3 2 2 1 1 1 1 1 1 1
# CT simulators 9 3 2 2 1 1 1 1 1 1 1
# of treatment planning computers 9 3 2 2 1 1 1 1 1 1 1
# of dosimetry/QA package 9 3 2 2 1 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 165 30 30 15 30 15 15 15 15 15 15

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

Lilongwe Blantyre
Population 817300 751600
New Cancer Cases 798 734
SURGERY % of patients needing surgery 46.94 46.94
Number (#) of patients needing surgery 375 345
Average length of stay (ALOS) for surgery 6.31 6.31
# of surgery beds/day 6.47 5.96
CHEMOTHERAPY % of patients requiring chemo 76.52 76.52
# of patients requiring chemo 611 562
ALOS for chemo 3.44 3.44
# of chemo beds/day 5.75 5.29
RADIOTHERAPY % of patients requiring RT 56.98 56.98
# of patients 455 418
# of admitted patients 114 105
ALOS 5 5
# of RT beds/day 1.56 1.43
ONCOLOGY BEDS Maximum # of beds/day 14 13
# of 24 bed oncology wards 1 1
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 1 1
Radiation/Clinical Oncologists 4 4
Urologic Oncologists 1 1
Gynecologic Oncologist 1 1
Neuro-Oncologists 1 1
Pathologists 2 2
PHARMACY Onco-Pharmacists 4 4
Onco-Pharmacy Technicians 6 6
PALLIATIVE CARE Palliative Care Specialists 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 6 6
Medical Physicists 2 2
Linac Engineers 1 1
Radiation Oncology Nurses 2 2
Linacs / Co 60 Megavolt Units 1 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 15 15

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