Roughly half of radiotherapy candidates in developing countries lack access: ASTRO

Roughly half of radiotherapy candidates in developing countries lack access: ASTRO

by Lauren Dubinsky, Senior Reporter | September 28, 2016
Rad Oncology Population Health Radiation Therapy
Dr. Elena Fidarova
The old adage "Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime" might have sprung to mind if you were attending a certain news briefing at ASTRO.

The topic was the roadblocks preventing access to radiation therapy treatment in developing countries, and the message was simple: shipping capital equipment to these regions is not enough.

"This is not such an easy problem to solve, because providing all of the radiotherapy machines does not solve all of the associated problems," Dr. Elena Fidarova, radiation oncologist at the IAEA, said at the briefing. "You need human resources and you need to maintain the machines."


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There's an unmet need for radiation therapy among nearly half of eligible cancer patients in nine developing countries, according to an International Atomic Energy Agency (IAEA) study. The nine countries involved in the study were Africa, Asia, Latin America, Europe, Costa Rica, Ghana, Malaysia, Philippines, Romania, Serbia, Slovenia, Indonesia and Uruguay.

Fidarova and her colleagues calculated optimal radiation therapy use for each countries with an epidemiological evidence-based method and then actual radiation therapy use.

They found that the median optimal radiotherapy utilization was about 52 percent. The range was narrow — 47 to 56 percent — with Indonesia having the highest percentage.

The median actual radiotherapy utilization rate was 28 percent, which is nearly half of the optimal rate. That means that about half of the patients that require radiotherapy didn't have access to it.

"When we estimated unmet need for radiotherapy, the highest numbers were found for Ghana and the Philippines," said Fidarova. "Eight in 10 cancer patients that required radiotherapy will not receive it, and therefore might not be receiving the best possible treatment for them."

IAEA does provide new equipment to these countries, but sustainable services need to be in place to support it.

"It's not enough to simply deposit the machinery. It takes a coordinated effort, I think, to go along with that," Dr. Brian Kavanagh, chair of the department of radiation oncology at the University of Colorado and president-elect of ASTRO, said at the briefing.

One such effort is the website,, which allows clinicians in other countries to share cases so experts can interface directly with them. It was launched in Africa about two weeks ago and experts were able to speak with clinicians in Kenya and Zimbabwe about gynecological cases.

"We find that to be a very good outlet for those of us in this country who want to try to help but just don't even know how to help," said Kavanagh. "We can share expertise, which is just as valuable as helping to support the financial costs it takes to supply the machinery."

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