Awareness and Training in Medical Physics: An Avenue to Enhance Cancer Care Delivery in a Low-Resource Setting.

PURPOSE: Awareness and training in medical physics (MP) is crucial to enhance productivity and safety in cancer management. We evaluated the impact of the pioneer teaching hospital in Nigeria on awareness and training in MP in an attempt to appraise and enhance cancer care delivery. METHODS: We reviewed physics students' training records in the MP unit of University College Hospital (UCH), Ibadan, Nigeria, from June 2009 to June 2019. These included demographic data, institutions, levels of study, time and training duration, and contact details. Trainees were contacted for updated information on their professional status. Awareness of the profession had been created at UCH and institutions within and outside Ibadan. Data were analyzed using Microsoft Excel 2016. RESULTS: One hundred thirteen trainees (mean age, 24.1 ± 2.3 years) composed of 65.5% male and 34.5% female students attended UCH within the 10-year period. They were categorized as undergraduates, (n = 83; 73.5%), Master's students (n = 25; 22.1%), Doctoral students (n = 2; 1.8%), and workers within nuclear field (n = 3; 2.7%). Of the 83 undergraduates, 5 (6.0%) were on training as of mid-September 2019, 25 (30.1%) were still in universities or serving in the mandatory national youth service, 11 (13.3%) were in the MP profession, and 42 (50.6%) were in other career pathways. Candidates' institutions spread across 5 of the 6 geopolitical zones in the country. Furthermore, 207 physics students took part in awareness seminars at 2 universities in commemoration of International Day of Medical Physics. CONCLUSION: Candidates from almost all parts of Nigeria benefitted from workplace experience at UCH, which continues to promote the profession. A greater feat will be attained when the University of Ibadan commences MP postgraduate programs.

Effect of Sociodemographic Variables on Patient and Diagnostic Delay of Breast Cancer at the Foremost Health Care Institution in Nigeria.

PURPOSE: Breast cancer (BC) has the highest mortality rate among women with any form of cancer in developing countries. Unfortunately, patients with BC in Nigeria commonly present with late-stage disease. The current study examined the types and magnitude of delay in BC diagnosis at the foremost hospital in Nigeria and also identified the influencing factors. MATERIALS AND METHODS: This cross-sectional study involved questionnaires given to 275 patients with BC at University College Hospital, Ibadan, Nigeria, from August to October 2018. Sociodemographic characteristics and information relevant to management of their health problem were obtained after ethical committee approval. Data collected were analyzed by SPSS (version 23; SPSS, Chicago, IL) to assess the types and magnitude of delay experienced by patients, as well as identify related determinants using the appropriate statistical test with P = .05. RESULTS: The mean age of respondents was 49 (± 11.9) years with the majority being Yoruba (n = 154; 56%), Christians (n = 211; 76.7%), married (n = 193; 70.2%), employed (n = 151; 54.9%), having tertiary education (n = 142; 51.6%) and an average income of more than 18,000 naira (n = 176; 64%). Patient delay and diagnostic delay were observed among 97 respondents (35.3%) and 84 respondents (30.5%), respectively. Although patient delay was significantly associated with age, ethnicity, and marital status, the only variable significantly associated with diagnostic delay was marital status (P < .05). Level of income, education, employment status, and religion did not significantly (P > .05) contribute to either of these delays. CONCLUSION: BC management at the pioneer Nigerian teaching hospital is challenged by both delays in patient presentation at clinics and delays in the process of being diagnosed. Such delays need to be addressed to achieve favorable outcome of patients with BC in Nigeria.

Study of the relationships between brachytherapy plan parameters in an attempt to verify total dwell time in vaginal cylinder applications.

PURPOSE: Source strength (Sk ), sizes of vaginal cylinder applicators (VCA), number of dwell positions (DPs), and the prescribed dose (D) are basic parameters in brachytherapy (BT) treatment planning contributing to total dwell time (TDT). This study was aimed at assessing the relationships between the specified variables in an attempt to verify the TDT in high-dose-rate (HDR) vaginal cylinder applications. METHODS: One hundred and twenty-one patients treated with Gynesource-Co60 (Bebig, Germany) using VCAs of diameters 20, 25, and 30 mm at University College Hospital, Nigeria, were enrolled in this study. Brachytherapy doses ranging from 3 to 7 Gy were always prescribed to points 5 mm away from the cylinder's surface. Treatment planning was undertaken on HDR-Basic treatment planning system (TPS) which utilizes source step size of 5 mm. Data on the stated parameters related to the first BT fractions of the patients were acquired. With the aid of EViews statistical software, two forms of mathematical models were thereafter developed. The resulting TDTs from the models were compared with the TPS values using Minitab statistical software. RESULTS: The relationships obtained for the increasing sizes of the VCA were TDT1(min)=2.22+3.17DSk;TDT1(min)=3.52+3.74DSk;TDT1(min)=-1.96+6.91DSkandTDT2(min)=0.50-0.03Sk+0.02D+0.55DPs;TDT2(min)=7.08-0.06Sk+0.02D+0.67DPs;TDT2(min)=7.02-0.11Sk+0.03D+1.25DPs The model-based TDTs correlate with the TPS-calculated values with r1 = 0.80 (P = 0.412) and r2 = 0.97 (P = 0.468). CONCLUSIONS: The findings of this study could suggest likely variations in the treatment time when certain changes occur in the related parameters. The increasing size of the vaginal cylinder has a positive influence on the brachytherapy treatment time. The latter model has been a useful tool in the verification of the dose delivery time at the first HDR brachytherapy center in Nigeria and West Africa.