By; MATTHEW UKACHUNWA, Lagos
Worried by inadequate access to radiotherapy equipment to more than half of cancer patients, World Health Organization (WHO) and International Atomic Energy Agency (IAEA have launched a new publication on the procurement of the equipment.
The authors believe the new guidance on the procurement of radiotherapy equipment could improve access to this life-saving cancer treatment option that is still lacking in many parts of the world.
“More than 50% of cancer patients require radiotherapy as part of cancer care and it is frequently used to treat the most common types, such as breast, cervical, colorecial, and long cancer. Yet access to radiotherapy is inadequate, particularly in low- and middle-income countries,” WHO explained in a statement dated 5th March 2021.
The new technical guidance aims to ensure that the selection of radiotherapy equipment is appropriate to country and health facility contexts, that treatment is delivered safely, that quality is maintained, and that services are sustainable, the publishers elaborated.
They said the publication is intended for medical physicists, biomedical and clinical engineers, radiation oncologists, oncologists and anyone else with responsibility for manufacturing, planning, selecting, procuring, regulating, installing or using radiotherapy equipment.
They clarified that the publication was developed as part of the ongoing collaboration between WHO and the IAEA to foster safety and quality in the medical use of radiation technology.
“IAEA data shows that around one-third of countries still do not have radiotherapy available, out of which 28 are in Africa,” May Abdel-Wahab, Director of the IAEA’s Division of Human Health, said. “Many of them would benefit from increased access to radiotherapy services. The key is tailoring radiation oncology solutions to the situation on the ground, underpinned by appropriate safety infrastructure.”
Types of radiotherapy equipment covered by the guide include external beam radiotherapy machines (both Cobalt-60 and linear accelerators), brachytherapy devices that apply radiation sources directly to tumours.
Others are complementary imaging devices such as conventional or computed tomography (CT) simulators, as well as other tools essential for safe operation and quality control.
“Depending on the type of radiotherapy machine, the need for specialized professionals and infrastructure, as well as quality assurance and maintenance, may vary,” WHO/IAEA declared.
They stressed that safety is also covered extensively, with information provided on planning for bunkers to house radiotherapy equipment, shielding for walls, floor and ceilings and emergency buttons for treatment and control rooms.
In addition, clear guidance is provided on what is required to ensure functionality of equipment for an optimal equipment lifespan, usually a period of 10-15 years, they narrated.
They pointed out that selecting radiotherapy systems appropriate for given settings and matched to the existing workforce help ensure the delivery of safe radiotherapy.
They added that it contributes to the improvement of access to life-saving treatment by minimizing service interruptions because of machine downtime and builds a solid foundation for further expansion of services when the health-care system is ready for adoption of more complex radiotherapy systems.
“While interruptions of radiotherapy equipment predate COVID-19,” Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO, said, “they have been exacerbated during the pandemic because of breakdowns in global supply chains and barriers to the free movement of technical service personnel.
“Any improvement that reduces interruptions can make the difference between life and death for patients whose tumours continue growing while they await treatment.”
Radiotherapy equipment is, however, just one element of cancer management services, WHO/IAEA stated.
According to them, others that need to be in place relate to early detection, diagnostic imaging, laboratory testing, pathology, surgery, systemic treatment and palliative care.
The technologies associated with all of these services are listed in the WHO List of Priority Medical Devices for Cancer Management, they illustrated.