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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN NEPAL

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Lung Head & Neck Hematological Malignancies Breast Stomach Gallbladder Urological Colorectal Esophagus
New Cancer Cases 27768 4730 3443 3263 2671 2574 1509 1280 1125 948 673
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 45.54 56.67 25 44 0 100.00 33 33 73.75 70 20
Number (#) of patients needing surgery 12646 2680 861 1436 0 2574 498 422 830 664 135
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 235.90 46.48 23.57 26.73 0.00 35.24 6.82 10.41 18.17 16.35 3.32
CHEMOTHERAPY % of patients requiring chemo 75.72 66.67 50 66 100 100 66 66 62.5 90 90
# of patients requiring chemo 21025.10 3153 1722 2154 2671 2574 996 845 703 853 606
ALOS for chemo 3.44 3 3 3.4 6.5 3 3 3 3.5 3 3
# of chemo beds/day 198.02 25.90 14.14 20.05 47.53 21.14 8.18 6.94 6.74 7.01 4.97
RADIOTHERAPY % of patients requiring RT 58.98 40 90 71 32.5 100 50 50 41.25 25 90
# of patients 16376.18 1892 3099 2317 868 2574 755 640 464 237 606
# of admitted patients 4094.04 473 775 579 217 644 189 160 116 59 151
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 56.04 6.48 10.60 7.93 2.97 8.81 2.58 2.19 1.59 0.81 2.07
ONCOLOGY BEDS Maximum # of beds/day 490 79 49 55 51 66 18 20 27 25 11
# of 24 bed oncology wards 21 4 3 3 3 3 1 1 2 2 1
ONCOLOGISTS Hematologist Oncologists 6 0 0 0 6 0 0 0 0 0 0
Surgical Oncologists 27 6 2 3 0 6 2 1 2 2 1
Radiation/Clinical Oncologists 139 24 18 17 14 13 8 7 6 5 4
Urologic Oncologists 3 0 0 0 0 0 0 0 3 0 0
Gynecologic Oncologist 10 10 0 0 0 0 0 0 0 0 0
Pathologists 56 10 7 7 6 6 4 3 3 2 2
PHARMACY Onco-Pharmacists 84 16 12 12 12 12 4 4 8 8 4
Onco-Pharmacy Technicians 126 24 18 18 18 18 6 6 12 12 6
PALLIATIVE CARE Palliative Care Specialists 56 10 7 7 6 6 4 3 3 2 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 197 23 38 28 11 31 10 8 6 3 8
Medical Physicists 66 8 13 10 4 11 4 3 2 1 3
Linac Engineers 17 2 4 3 1 3 1 1 1 1 1
Radiation Oncology Nurses 66 8 13 10 4 11 4 3 2 1 3
Linacs / Co 60 Megavolt Units 33 4 7 5 2 6 2 2 1 1 2
# of Brachytherapy units 17 2 4 3 1 3 1 1 1 1 1
# CT simulators 17 2 4 3 1 3 1 1 1 1 1
# of treatment planning computers 17 2 4 3 1 3 1 1 1 1 1
# of dosimetry/QA package 17 2 4 3 1 3 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 315 60 45 45 45 45 15 15 30 30 15

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

Bagmati Narayani
Population 3849011 2993114
New Cancer Cases 3741 2909
SURGERY % of patients needing surgery 45.54 45.54
Number (#) of patients needing surgery 1704 1325
Average length of stay (ALOS) for surgery 6.81 6.81
# of surgery beds/day 31.78 24.71
CHEMOTHERAPY % of patients requiring chemo 75.72 75.72
# of patients requiring chemo 2833 2203
ALOS for chemo 3.44 3.44
# of chemo beds/day 26.68 20.74
RADIOTHERAPY % of patients requiring RT 58.98 58.98
# of patients 2206 1716
# of admitted patients 552 429
ALOS 5 5
# of RT beds/day 7.55 5.87
ONCOLOGY BEDS Maximum # of beds/day 67 52
# of 24 bed oncology wards 3 3
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 4 3
Radiation/Clinical Oncologists 19 15
Urologic Oncologists 1 1
Gynecologic Oncologist 2 2
Pathologists 8 6
PHARMACY Onco-Pharmacists 12 12
Onco-Pharmacy Technicians 18 18
PALLIATIVE CARE Palliative Care Specialists 8 6
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 27 21
Medical Physicists 9 7
Linac Engineers 3 2
Radiation Oncology Nurses 9 7
Linacs / Co 60 Megavolt Units 5 4
# of Brachytherapy units 3 2
# CT simulators 3 2
# of treatment planning computers 3 2
# of dosimetry/QA package 3 2
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 45 45

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