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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN MALAWI

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Kaposi sarcoma Esophagus Hematological Urological Breast Head and Neck Colorectal Liver Stomach
New Cancer Cases 15349 3918 2807 1969 1334 1100 762 372 281 206 203
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 40.24 56.67 0 20 0 73.75 100 44 70 5 33
Number (#) of patients needing surgery 6177 2220 0 394 0 811 762 164 197 10 67
Average length of stay (ALOS) for surgery 5.91 6.33 0 9 0 8 5 6.8 9 10 5
# of surgery beds/day 100.00 38.50 0.00 9.70 0.00 17.77 10.43 3.05 4.85 0.28 0.92
CHEMOTHERAPY % of patients requiring chemo 73.12 66.67 70 90 100 62.5 100 66 90 20 66
# of patients requiring chemo 11222.73 2612 1965 1772 1334 688 762 246 253 41 134
ALOS for chemo 3.44 3 3 3 6.5 3.5 3 3.4 3 3 3
# of chemo beds/day 105.70 21.45 16.14 14.56 23.74 6.59 6.26 2.29 2.08 0.34 1.10
RADIOTHERAPY % of patients requiring RT 51.98 40 50 90 32.5 41.25 100 71 25 20 50
# of patients 7977.64 1567 1404 1772 434 454 762 264 70 41 102
# of admitted patients 1994.41 392 351 443 108 113 191 66 18 10 25
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 27.30 5.36 4.80 6.06 1.48 1.55 2.61 0.90 0.24 0.14 0.35
ONCOLOGY BEDS Maximum # of beds/day 233 66 21 31 26 26 20 7 8 1 3
# of 24 bed oncology wards 10 3 1 2 2 2 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 3 0 0 0 3 0 0 0 0 0 0
Surgical Oncologists 13 5 0 1 0 2 2 1 1 1 1
Radiation/Clinical Oncologists 77 20 15 10 7 6 4 2 2 2 2
Urologic Oncologists 3 0 0 0 0 3 0 0 0 0 0
Gynecologic Oncologist 8 8 0 0 0 0 0 0 0 0 0
Pathologists 31 8 6 4 3 3 2 1 1 1 1
PHARMACY Onco-Pharmacists 40 12 4 8 8 8 4 4 4 4 4
Onco-Pharmacy Technicians 60 18 6 12 12 12 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 31 8 6 4 3 3 2 1 1 1 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 96 19 17 22 6 6 10 4 1 1 2
Medical Physicists 32 7 6 8 2 2 4 2 1 1 1
Linac Engineers 8 2 2 2 1 1 1 1 1 1 1
Radiation Oncology Nurses 32 7 6 8 2 2 4 2 1 1 1
Linacs / Co 60 Megavolt Units 16 4 3 4 1 1 2 1 1 1 1
# of Brachytherapy units 8 2 2 2 1 1 1 1 1 1 1
# CT simulators 8 2 2 2 1 1 1 1 1 1 1
# of treatment planning computers 8 2 2 2 1 1 1 1 1 1 1
# of dosimetry/QA package 8 2 2 2 1 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 150 45 15 30 30 30 15 15 15 15 15

RESOURCES NEEDED IN REGIONS BASED on GLOBOCAN2012 AND DATA FROM CITYPOPULATION.DE2014

Southern Central
Population 6890400 6824200
New Cancer Cases 6660 6596
SURGERY % of patients needing surgery 40.24 40.24
Number (#) of patients needing surgery 2680 2654
Average length of stay (ALOS) for surgery 5.91 5.91
# of surgery beds/day 43.39 42.97
CHEMOTHERAPY % of patients requiring chemo 73.12 73.12
# of patients requiring chemo 4870 4823
ALOS for chemo 3.44 3.44
# of chemo beds/day 45.86 45.42
RADIOTHERAPY % of patients requiring RT 51.98 51.98
# of patients 3462 3428
# of admitted patients 865 857
ALOS 5 5
# of RT beds/day 11.85 11.73
ONCOLOGY BEDS Maximum # of beds/day 102 101
# of 24 bed oncology wards 5 5
ONCOLOGISTS Hematologist Oncologists 2 2
Surgical Oncologists 6 6
Radiation/Clinical Oncologists 34 33
Urologic Oncologists 2 2
Gynecologic Oncologist 4 4
Pathologists 14 14
PHARMACY Onco-Pharmacists 20 20
Onco-Pharmacy Technicians 30 30
PALLIATIVE CARE Palliative Care Specialists 14 14
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 42 42
Medical Physicists 14 14
Linac Engineers 4 4
Radiation Oncology Nurses 14 14
Linacs / Co 60 Megavolt Units 7 7
# of Brachytherapy units 4 4
# CT simulators 4 4
# of treatment planning computers 4 4
# of dosimetry/QA package 4 4
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 75 75

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