Transcript EARLY DETECTION, DIAGNOSIS & TREATMENT in LRS

CERVICAL CANCER: EARLY DETECTION,
DIAGNOSIS & TREATMENT in LRS
By
Dr D. A. Kombe, MD, Mmed (Rad/onc)
2nd East Africa WE CAN Breast & Cacx Advocacy, Education and Outreach
Summit
September 11-13 ,2014
NEW ORCI
OLD ORCI
INTRODUCTION
• ANNUAL CANCER INCIDENCE IN TZ (Glob can
2012):
– 40,000 new cancer cases
• In Tz there is a well-established patient referral
system from health centers to referral hospitals;
however no proper guideline for cancer patients’
referral.
• It is the policy of our government to treat cancer
patients for free (once diagnosed).
TANZANIAN HEALTH SYSTEM …
• Health promotion & education, cancer advocacy,
prevention and early detection/screening are not
yet a priority for funding in our health system!!!
Reasons:The Government is overwhelmed with a
burden of both communicable and noncommunicable diseases; therefore, a bigger
portion is allocated mainly to treatments!
EARLY DETECTION
• For reasons mentioned above, prevention and
early detection/screening are still an up-hill
battle. This is done in few places mainly by ORCI
and international NGOs – eg: ICAP, JHIPIEGO, IMA
world, PSI, MST UMATI and probably a few
national NGOs such as MEWATA.
However, currently there has been recognition and
therefore efforts are now being directed towards
this goal.
PRECISE DIAGNOSIS OF CANCER
• Oncologists (medical & radiation) are aware of
the crucial need and closer collaboration with
surgeons and pathologists for precise diagnosis
and staging of cancer patients when planning
subsequent management... THIS IS
PARAMOUNT!!!
• Lack of such collaboration leads to poor decisions
of treatment planning on the side of the
oncologist! And, this further compromises the
ability to offer optimal treatment to the patient.
• We have a good team –tumour board for this
DIAGNOSIS: CURRENT STATUS
• Few/non pathologists in some referral centers.
• Pathology services available are slow & often
lack proper reporting.
• It has been observed in general, that prompt
referral is a major problem for most of cases.
TREATMENT OF CANCER IN TZ: CURRENT STATUS
• Like most countries in Africa, Tz is among the low
resource countries.
• Even with this fact, the policy of our government
policy is to treat cancer patients for free.
CURRENT STATUS...
• So far ONLY ONE Treatment center for ˃
45million population .
- Two cobalt-60 machines (one is down) working
round the clock including w/ends…
- Two HDR machines which are currently not
operating (mechanical problem which need to
fix).
- Never enough chemotherapy drugs. Demand &
supply always is out of proportion!
CHALLENGES
• Serious lack of financial and material/equipment
resources.
• Rapidly increasing cancer burden: Number of
new cases doubling every 3 years (With no
resource to accommodate them)!
• Late Presentation: Approx. 75% of cases present
with FIGO III- IV stage.
• Serious lack of awareness of cancer symptoms
and signs in majority of these women!
Recommendation
• Whilst efforts of addressing cancer awareness
advocacy & screening are taking toll, more
and more patients are coming requiring
treatment. Currently bookings at ORCI are
approaching January 2015!!!
• Therefore then, parallel with the above, there
is a great need to advocate for and improve
tertiary care as well. The latter can not be
over- emphasized.
Indeed, WE CAN