Present and future of radiotherapy in Pakistan

ABSTRACT

Incidence of cancer is rising worldwide with highest burden in the developing countries including Pakistan. Ensuring that these patients receive standard radiotherapy is a major challenge. To see existing radiotherapy services in Pakistan and suggest future strategies for radiotherapy services. Various technical personnel from 22 radiotherapy centers were contacted through phone calls and emails and asked about the number of therapy machines, simulators, number of technical staff and radiotherapy technologists that they had in their centre in the year 2009. Inconsistencies in the data collection were resolved through frequent phone calls. Main outcome measure was the current radiotherapy services per million populations. Each radiotherapy center covers a mean population of 1.96 million [3.54-19.63] with more access of cancer patients to the public sector due to low costs of radiotherapy treatment. At present, there are only 56 radiation oncologists, 55 medical physicists and 145 radiotherapy technologists. Further only 20 Cobalt-60, 17 linear accelerators, 12 fluoroscopic simulators and 4 CT simulators are present. Majority of modern equipment and treatment delivery is available in private sector. It was estimated that 55-60% of all new cases of cancer are currently being referred for radiotherapy each year and existing services are inadequate. The increase need of radiotherapy services demands unified, better and effective measures to deliver state of art radiotherapy to each patient to improve the outcomes of treatment. More radiotherapy services should be provided to public to reduce accessibility issues