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U.S. National Institutes of Health
Last Updated: 01/15/14

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN NICARAGUA

Cancer All cancers
excl. non-melanoma
skin cancer
Gynecological Urological Hematological Malignancies Stomach Breast
New Cancer Cases 5591 1062 813 567 527 468
Rank 1 2 3 4 5
SURGERY % of patients needing surgery 52.68 56.67 73.75 0 33 100.00
Number (#) of patients needing surgery 2946 602 600 0 174 468
Average length of stay (ALOS) for surgery 4.87 6.33 8 0 5 5
# of surgery beds/day 39.25 10.44 13.13 0.00 2.38 6.41
CHEMOTHERAPY % of patients requiring chemo 79.03 66.67 62.5 100 66 100
# of patients requiring chemo 4418.79 708 508 567 348 468
ALOS for chemo 3.80 3 3.5 6.5 3 3
# of chemo beds/day 45.97 5.82 4.87 10.09 2.86 3.84
RADIOTHERAPY % of patients requiring RT 52.75 40 41.25 32.5 50 100
# of patients 2949.25 425 335 184 264 468
# of admitted patients 737.31 106 84 46 66 117
ALOS 5.00 5 5 5 5 5
# of RT beds/day 10.09 1.45 1.15 0.63 0.90 1.60
ONCOLOGY BEDS Maximum # of beds/day 96 18 20 11 7 12
# of 24 bed oncology wards 4 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 2 0 0 2 0 0
Surgical Oncologists 7 2 2 0 1 1
Radiation/Clinical Oncologists 28 6 5 3 3 3
Urologic Oncologists 2 0 2 0 0 0
Gynecologic Oncologist 3 3 0 0 0 0
Pathologists 12 3 2 2 2 1
PHARMACY Onco-Pharmacists 16 4 4 4 4 4
Onco-Pharmacy Technicians 24 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 12 3 2 2 2 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 36 6 5 3 4 6
Medical Physicists 12 2 2 1 2 2
Linac Engineers 3 1 1 1 1 1
Radiation Oncology Nurses 12 2 2 1 2 2
Linacs / Co 60 Megavolt Units 6 1 1 1 1 1
# of Brachytherapy units 3 1 1 1 1 1
# CT simulators 3 1 1 1 1 1
# of treatment planning computers 3 1 1 1 1 1
# of dosimetry/QA package 3 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 60 15 15 15 15 15

CANCER INCIDENCE IN DEPARTMENTS BASED on GLOBOCAN 2008 AND DATA FROM CITYPOPULATION.DE 2012

Managua Matagalpa
Population 1448300 542400
New Cancer Cases 1429 536
SURGERY % of patients needing surgery 52.68 52.68
Number (#) of patients needing surgery 753 282
Average length of stay (ALOS) for surgery 4.87 4.87
# of surgery beds/day 10.03 3.76
CHEMOTHERAPY % of patients requiring chemo 79.03 79.03
# of patients requiring chemo 1129 424
ALOS for chemo 3.80 3.80
# of chemo beds/day 11.75 4.41
RADIOTHERAPY % of patients requiring RT 52.75 52.75
# of patients 754 283
# of admitted patients 188 71
ALOS 5 5
# of RT beds/day 2.58 0.97
ONCOLOGY BEDS Maximum # of beds/day 25 10
# of 24 bed oncology wards 2 1
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 2 1
Radiation/Clinical Oncologists 8 3
Urologic Oncologists 1 1
Gynecologic Oncologist 1 1
Pathologists 3 2
PHARMACY Onco-Pharmacists 8 4
Onco-Pharmacy Technicians 12 6
PALLIATIVE CARE Palliative Care Specialists 3 2
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 10 4
Medical Physicists 4 2
Linac Engineers 1 1
Radiation Oncology Nurses 4 2
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 + 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 5 most frequently occurring cancers