Forty-nine countries worldwide lack any radiotherapy capacity, one of the most important medical tools to treat cancer, a major killer in the developing world. In developed countries, radiotherapy plays a role in curing about 45 to 50% of cancer survivors and represents, alongside surgery and chemotherapy, a major tool to deal with the disease. Through the IAEA´s Technical Cooperation projects, Member States are receiving technical support from the IAEA´s Human Health experts to address the lack of radiotherapy available in the developing world.
If the disease is diagnosed early enough, radiotherapy is potentially curative for many patients. When the cancer cannot be cured, radiotherapy offers the means to alleviate suffering and improve the patient´s quality of life. Tragically, in low to middle income countries, the majority of cancer patients are diagnosed when cancer has already reached an advanced stage. Radiotherapy thus provides the needed pain control.
In the developing world, cancer incidence has grown to become a chronic epidemic, while treatment capacity in many countries is far too limited to address the need. Eduardo Rosenblatt, Head of the IAEA´s Applied Radiobiology and Radiotherapy Section, explains that "many countries - mainly high- to middle-income - have good facilities and can cope with the cancer burden. However, many countries, mainly among the low-middle income and low-income countries, are currently unable to cope with the current situation, let alone the increased incidence that is projected for the future. These countries face a serious crisis in radiotherapy services provision."
Battling Cancer in Pakistan
Cancer care specialists in Pakistan, for instance, are working with Rosenblatt´s team to strengthen the nation´s care capacity. With a population of 184 million, its 23 operational radiotherapy centres are simply too few to meet the growing demand for cancer treatment.
"The Pakistani Government and professionals are making great efforts to upgrade and modernize their radiotherapy infrastructure, improve conditions, upgrade knowledge through education and participate in clinical research," Rosenblatt said.
In response to Pakistan´s request for support, the IAEA worked with the national medical educators to establish the country´s first radiation therapists training programme, which uses the syllabus developed and tested by the IAEA.
Closing the Expertise Gap
At present, Rosenblatt sees that the lack of trained medical staff presents "a serious obstacle to the development of adequate radiotherapy services in various regions of the world mainly in Africa, Latin America and Asia."
In the IAEA´s Human Health Division, radiation medicine experts develop and publish a series of syllabi to educate all the disciplines involved in the process of radiotherapy: radiation oncologists, medical radiation physicists, technologists, nurses and radiation biologists. These publications have been adopted by national medical training programs around the world, for instance in India, Jamaica, Kenya, Pakistan and Tanzania.
Practical expertise in radiation medicine in cancer diagnosis and treatment is provided through the national workshops, regional training courses, scientific visits and fellowships that are designed and conducted by the IAEA´s radiation medicine experts in Applied Radiation Biology and Radiotherapy, Dosimetry and Medical Radiation Physics and Nuclear Medicine.
To reach the widest possible audience of practitioners, the Human Health Division launched a new website, the Human Health Campus, serving radiation medicine professionals with information and training materials on demand.
A radiation technologist must gain a proficient understanding of both radiotherapy physics, as well as modern oncological medical practice. In a programme combining academic training and practical experience in a hospital environment, the graduate professionals are able to deliver radiotherapy treatment to patients as prescribed by a radiation oncologist. In addition, a skilled radiation technologist will be able to simulate treatment, obtain images, position patients, calculate doses, position and immobilize patients, operate the radiotherapy machines, care for the patient during treatment and in some instances also generate computerised radiotherapy treatment plans.