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

HUMAN RESOURCES FOR TREATING NEW CANCER CASES IN TUNISIA

Cancer All cancers
excl. non-melanoma
skin cancer
Breast Urological Lung Hematological Colorectal Head and Neck Gynecological Stomach Gallbladder Brain, nervous system
New Cancer Cases 12189 1826 1801 1729 1341 1203 1125 685 470 236 229
Rank 1 2 3 4 5 6 7 8 9 10
SURGERY % of patients needing surgery 53.54 100 73.75 25 0 70 44 56.67 33 33 100
Number (#) of patients needing surgery 6526 1826 1328 432 0 842 495 388 155 78 229
Average length of stay (ALOS) for surgery 6.81 5 8 10 0 9 6.8 6.33 5 9 9
# of surgery beds/day 121.74 25.00 29.09 11.83 0.00 20.75 9.22 6.73 2.12 1.92 5.64
CHEMOTHERAPY % of patients requiring chemo 76.72 100 62.5 50 100 90 66 66.67 66 66 100
# of patients requiring chemo 9351.04 1826 1126 865 1341 1083 743 457 310 156 229
ALOS for chemo 3.44 3 3.5 3 6.5 3 3.4 3 3 3 3
# of chemo beds/day 88.07 15.00 10.79 7.10 23.86 8.89 6.91 3.75 2.55 1.28 1.88
RADIOTHERAPY % of patients requiring RT 59.98 100 41.25 90 32.5 25 71 40 50 50 100
# of patients 7310.35 1826 743 1556 436 301 799 274 235 118 229
# of admitted patients 1827.59 457 186 389 109 75 200 69 59 30 57
ALOS 5.00 5 5 5 5 5 5 5 5 5 5
# of RT beds/day 25.02 6.25 2.54 5.33 1.49 1.03 2.73 0.94 0.80 0.40 0.78
ONCOLOGY BEDS Maximum # of beds/day 235 47 43 25 26 31 19 12 6 4 9
# of 24 bed oncology wards 10 2 2 2 2 2 1 1 1 1 1
ONCOLOGISTS Hematologist Oncologists 3 0 0 0 3 0 0 0 0 0 0
Surgical Oncologists 14 4 3 1 0 2 2 1 1 1 1
Radiation/Clinical Oncologists 61 10 10 9 7 7 6 4 3 2 2
Urologic Oncologists 4 0 4 0 0 0 0 0 0 0 0
Gynecologic Oncologist 2 0 0 0 0 0 0 2 0 0 0
Neuro-Oncologists 1 0 0 0 0 0 0 0 0 0 1
Pathologists 25 4 4 4 3 3 3 2 1 1 1
PHARMACY Onco-Pharmacists 40 8 8 8 8 8 4 4 4 4 4
Onco-Pharmacy Technicians 60 12 12 12 12 12 6 6 6 6 6
PALLIATIVE CARE Palliative Care Specialists 25 4 4 4 3 3 3 2 1 1 1
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 88 22 9 19 6 4 10 4 3 2 3
Medical Physicists 30 8 3 7 2 2 4 2 1 1 1
Linac Engineers 8 2 1 2 1 1 1 1 1 1 1
Radiation Oncology Nurses 30 8 3 7 2 2 4 2 1 1 1
Linacs / Co 60 Megavolt Units 15 4 2 4 1 1 2 1 1 1 1
# of Brachytherapy units 8 2 1 2 1 1 1 1 1 1 1
# CT simulators 8 2 1 2 1 1 1 1 1 1 1
# of treatment planning computers 8 2 1 2 1 1 1 1 1 1 1
# of dosimetry/QA package 8 2 1 2 1 1 1 1 1 1 1
NURSING Oncology Nursing Staff other than Radiation Oncology Nurses 150 30 30 30 30 30 15 15 15 15 15

RESOURCES NEEDED IN CITIES BASED on GLOBOCAN2012 AND DATA FROM CITYPOPULATION.DE2013

Tunis Safaqis (Sfax)
Population 1004500 969800
New Cancer Cases 1144 1105
SURGERY % of patients needing surgery 53.54 53.54
Number (#) of patients needing surgery 613 592
Average length of stay (ALOS) for surgery 6.81 6.81
# of surgery beds/day 11.43 11.04
CHEMOTHERAPY % of patients requiring chemo 76.72 76.72
# of patients requiring chemo 878 848
ALOS for chemo 3.44 3.44
# of chemo beds/day 8.27 7.98
RADIOTHERAPY % of patients requiring RT 59.98 59.98
# of patients 686 663
# of admitted patients 172 166
ALOS 5 5
# of RT beds/day 2.35 2.27
ONCOLOGY BEDS Maximum # of beds/day 23 22
# of 24 bed oncology wards 1 1
ONCOLOGISTS Hematologist Oncologists 1 1
Surgical Oncologists 2 2
Radiation/Clinical Oncologists 6 6
Urologic Oncologists 1 1
Gynecologic Oncologist 1 1
Neuro-Oncologists 1 1
Pathologists 3 3
PHARMACY Onco-Pharmacists 4 4
Onco-Pharmacy Technicians 6 6
PALLIATIVE CARE Palliative Care Specialists 3 3
RADIATION THERAPY STAFF & EQUIPMENT Radiation Therapy Technicians 9 8
Medical Physicists 3 3
Linac Engineers 1 1
Radiation Oncology Nurses 3 3
Linacs / Co 60 Megavolt Units 2 2
# 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, 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