Introduction The Burden of Cancer amounts daily worldwide. It
is alarming! An estimated 12.7 million new cancer cases were
diagnosed worldwide in 2008 Lung, female Breast, Colorectal and
Stomach cancers were most commonly diagnosed. 40% of all cases
Worldwide, an estimated 7.6 million deaths from cancer occurred in
2008 Cancer is now the third leading cause of death worldwide In
Africa, cancer is emerging as a major public health threat
Slide 3
With improvement in our lifestyle and environmental changes,
cancer has become an increasing problem in Africa The problem is
compounded by limited assess to Screening, Treatment and Palliative
care in some regions Africa lacks the infrastructure, expertise and
technology to halt cancer in its track This problem is also
compounded by lack of cancer awareness In a few years and decades,
if appropriate measures are not put in place to contain this
burden, there will be a big problem
Slide 4
Slide 5
Africa The cancer incidence in Africa has been increasing
dramatically Especially after the onset of AIDS epidemic Most of
the efforts and helps provided by the Western countries to Africa
are spent to prevent and cure Infectious diseases and Malnutrition
This leaves the patients with Cancer to their poor destiny! Comment
from ESMO Annals of Oncology :- Infact, Oncology in Africa seems to
be a branch of medicine that is practised by the Local Traditional
Healers
Slide 6
The lowest cancer incidence rates are in middle and western
Africa for men Middle and northern Africa for women Most cancer
epidemiology studies involve people living in North America and
Europe, which represent only a fraction of the global
population
Slide 7
Cancer Registries in Africa The African cancer registry
network(AFCRN) was formally inaugurated on 1 st March 2012
Succeeded and expanded the East African Cancer Registry(Jan 2011)
To improve the effectiveness of Cancer surveillance in Sub Saharan
Africa This is the basis for any Rational programme for Cancer
control Population-based cancer registration is developing fairly
rapidly in some areas of Africa There are now at least 30
registries in the continent Algeria, Zimbabwe, Guinea, Uganda,
Rwanda, Gabon, Malawi, South Africa, Ivory Coast, Niger, Nigeria,
Tanzania, Ethiopia, Burkina Faso, Botswana and Kenya
Slide 8
Ghana No Cancer Registry as yet Hospital based Registry Korle
Bu Registry Any case of cancer that comes to the hospital. Whether
through the clinics or the pathology department Komfo Anokye
hospital registry National Policy on Cancer- A cancer strategic
plan which is yet to be fully established
Slide 9
Korle Bu Teaching Hospital
Slide 10
Korle Bu Registry As at 2012 Report of 830 out of 1136 patients
Breast- 28% Cervix-17.8% Prostate- 7.7% Colorectal-5.1% Uterus-3.1%
Bone 3.1% Ovary 2.9% Skin 2.8% Stomach- 2.5% Thyroid 2.3%
Slide 11
National Centre for Radiotherapy and Nuclear Medicine The
National centre for Radiotherapy and Nuclear Medicine was
established in 1997 By Flight Lieutenant Jerry John Rawlings It is
located in the Korle Bu teaching Hospital on Guggisberg Avenue A
semi- Autonomous Centre A tertiary referral centre
Slide 12
National Centre for Radiotherapy and Nuclear Medicine
Slide 13
Slide 14
Slide 15
Slide 16
Staffing at Radiotherapy Department Doctors - 2 Consultants, 3
Specialists, 4 Residents in training Nurses 13 trained Nurses and 6
Health Care Assistants Pharmacists- 2 Radiotherapists - 14
Physicists- 6 Radiation Protection Officer 1
Slide 17
Engineers - 4 Secretaries ( Including Bilingual secretaries) -5
Records/Statisticians 3 Orderlies- 3 Security men 4 Driver - 1
Slide 18
Equipment A Cobalt Teletherapy machine (Uses gamma rays) Two
Low Dose Brachytherapy machines (Cesium 137) A Conventional
Simulator 3 Consulting Rooms A Waiting Area for patients A Nurses
room 1 Chemotherapy Suite for patients
Slide 19
Slide 20
Slide 21
Slide 22
Slide 23
Slide 24
Slide 25
Other oncology centres Public- Oncology Department, Komfo
Anokye teaching Hospital Private- Swedish Ghana Medical Centre
Slide 26
Referrals Referrals from within the country Korle Bu teaching
hospital 37 Military hospital Police Hospital Ridge Hospital SSNIT
Trust hospital Other private hospitals Regional hospitals
including- Koforidua, Central, Volta, Tamale, Effia Nkwanta
etc
Slide 27
Referrals from Neighbouring countries:- 5% of Patients Cote
DIvoire Togo Benin Burkina Faso Sierra Leone Liberia Referrals from
Overseas:- UK, USA, South Africa
Slide 28
Common Cancers Breast Cancer(Monday) 26% Cervical
Cancer(Tuesday) 18% Ovarian Cancer 2% Endometrial cancer Prostate
Cancer(Thursday) 9% Colorectal Cancer 4% Head and Neck cancers-
Nasopharyngeal cancer, Laryngeal cancer(Wednesday) 13% Stomach
cancer Lung cancer Hepatocellular Cancer
Patients commonly present with advanced stage disease across
board(60-80%) However some people present early Investigations-
Blood tests, Chest Xray, Xrays of vertebrae, Abdominal ultrasound,
CT Scan, MRI, Bone Scan Treatment- Surgery, Chemotherapy,
Radiotherapy, Hormonal therapy Prognosis- This depends on the Type
of tumor, Grade and Stage at presentation
Slide 32
Awareness of Cancer is gradually increasing Over the years
patient numbers have been increasing Many more doctors are
referring patients Patients are turning up for screening Cancer
screening for some diseases like breast cancer and Cervical cancer
is gradually improving Talk shows with topics on Cancer
Slide 33
Necessary Interventions.Improvement on Public awareness
(Advantages of early presentation, Curative and Palliative
treatment) Support from Physicians, Media, NGOs, Patient
interviews, Support groups Training of health personnel Improvement
of Palliative care in Ghana Hospices to assist in management of
terminally ill patients
Slide 34
Patient Challenges Cost of Treatment Very few drugs on NHIS,
hence a lot of financial burden on patients who are already
battling with the disease Need to establish more Support groups to
encourage patients Elimination of Societal Stigma of cancer
(Demystification) Establishment of a Cancer Foundation
Slide 35
Departmental needs/ Requirements to improve patient care Wheel
Chairs Patient Trolleys/ Stretchers View Boxes for Xrays Linen
Water dispensers Soap and Tissue dispensers Hand sanitizer
dispensers Refurbishing of patient toilet facilities Hematology and
Chemistry analyzer machines Breast Prosthesis for mastectomy
patients
Slide 36
Conclusion The Global Cancer epidemic is Huge and set to Rise!
Globally every month, 600,000 people die from Cancer! Many of these
deaths can be avoided with increased Government support and Funding
for Prevention, detection and treatment strategies