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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN NEPAL COUNTRY

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Lung Head and Neck Hematological Breast Stomach Gallbladder Urological Colorectal Esophagus
New Cancer Cases 18802 3132 2499 2423 1843 1716 1126 904 806 698 504
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 45.54 56.67 25 44 0 100 33 33 73.75 70 20
Number (#) of patients needing surgery 8563 1775 625 1066 0 1716 372 298 594 489 101
Average length of stay (ALOS) for surgery 6.81 6.33 10 6.8 0 5 5 9 8 9 9
# of surgery beds/day 159.73 30.77 17.10 19.85 0.00 23.49 5.09 7.35 13.02 12.04 2.48
CHEMOTHERAPY % of patients requiring chemo 75.72 66.67 50 66 100 100 66 66 62.5 90 90
# of patients requiring chemo 14236.31 2088 1250 1599 1843 1716 743 597 504 628 454
ALOS for chemo 3.44 3 3 3.4 6.5 3 3 3 3.5 3 3
# of chemo beds/day 134.08 17.15 10.26 14.89 32.80 14.09 6.10 4.90 4.83 5.16 3.73
RADIOTHERAPY % of patients requiring RT 58.98 40 90 71 32.5 100 50 50 41.25 25 90
# of patients 11088.48 1253 2249 1720 599 1716 563 452 332 175 454
# of admitted patients 2772.12 313 562 430 150 429 141 113 83 44 113
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 37.95 4.29 7.70 5.89 2.05 5.87 1.93 1.55 1.14 0.60 1.55
ONCOLOGY BEDS Maximum # of beds/day 332 53 36 41 35 44 14 14 19 18 8
# of 24 bed oncology wards 14 3 2 2 2 2 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 4 0 0 0 4 0 0 0 0 0 0
Surgical Oncologists 18 4 2 3 0 4 1 1 2 2 1
Radiation/Clinical Oncologists 95 16 13 13 10 9 6 5 5 4 3
Urologic Oncologists 2 0 0 0 0 0 0 0 2 0 0
Gynecologic Oncologist 7 7 0 0 0 0 0 0 0 0 0
Pathologists 38 7 5 5 4 4 3 2 2 2 2
PHARMACY Onco-Pharmacists 56 12 8 8 8 8 4 4 4 4 4
Onco-Pharmacy Technicians 84 18 12 12 12 12 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 38 7 5 5 4 4 3 2 2 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 134 16 27 21 8 21 7 6 4 3 6
Medical Physicists 45 6 9 7 3 7 3 2 2 1 2
Linac Engineers 12 2 3 2 1 2 1 1 1 1 1
Radiation Oncology Nurses 45 6 9 7 3 7 3 2 2 1 2
Linacs / Co 60 Megavolt Units 23 3 5 4 2 4 2 1 1 1 1
# of Brachytherapy units 12 2 3 2 1 2 1 1 1 1 1
# CT simulators 12 2 3 2 1 2 1 1 1 1 1
# of treatment planning computers 12 2 3 2 1 2 1 1 1 1 1
# of dosimetry/QA package 12 2 3 2 1 2 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 210 45 30 30 30 30 15 15 15 15 15

RESOURCES NEEDED IN ZONES BASED ON GLOBOCAN2012 AND DATA FROM CITYPOPULATION.DE2011

Bagmati Narayani
Population 3843596 2975908
New Cancer Cases 2331 1805
SURGERY % of patients needing surgery 45.54 45.54
Number (#) of patients needing surgery 1062 822
Average length of stay (ALOS) for surgery 6.81 6.81
# of surgery beds/day 19.80 15.33
CHEMOTHERAPY % of patients requiring chemo 75.72 75.72
# of patients requiring chemo 1765 1367
ALOS for chemo 3.44 3.44
# of chemo beds/day 16.62 12.87
RADIOTHERAPY % of patients requiring RT 58.98 58.98
# of patients 1375 1064
# of admitted patients 344 266
ALOS 5 5
# of RT beds/day 4.70 3.64
ONCOLOGY BEDS Maximum # of beds/day 42 32
# of 24 bed oncology wards 2 2
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 3 2
Radiation/Clinical Oncologists 12 10
Urologic Oncologists 1 1
Gynecologic Oncologist 1 1
Pathologists 5 4
PHARMACY Onco-Pharmacists 8 8
Onco-Pharmacy Technicians 12 12
PALLIATIVE CARE Palliative Care Specialists 5 4
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 17 13
Medical Physicists 6 5
Linac Engineers 2 2
Radiation Oncology Nurses 6 5
Linacs / Co 60 Megavolt Units 3 3
# of Brachytherapy units 2 2
# CT simulators 2 2
# of treatment planning computers 2 2
# of dosimetry/QA package 2 2
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 30 30

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