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chemotherapy and radiotherapy

chemotherapy and radiotherapy . Dr C Nyongesa-Watta , MMED (Wits), FC Rad Onc (SA). Modes of treating cancer. Surgery Radiotherapy Chemotherapy Hormonal therapy Others. Radiotherapy 1895-1898.

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chemotherapy and radiotherapy

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  1. chemotherapy and radiotherapy Dr C Nyongesa-Watta , MMED (Wits), FC Rad Onc(SA)

  2. Modes of treating cancer • Surgery • Radiotherapy • Chemotherapy • Hormonal therapy • Others

  3. Radiotherapy 1895-1898 • The use of ionizing radiation for the treatment of cancer datesback to the late 19th century, remarkably soon after Roentgendescribed X-rays in 1895 • Brachytherapy came to use afterMarie and Pierre Curie discovered radium in 1898

  4. Radiotherapy at the End of the Nineteenth Century • On the evening of November 8, 1895, Wilhelm Conrad Roentgenwas working alone in his laboratory in Germany • Whilestudying cathode rays that emanated from evacuated glass tubes,he observed a new kind of ray that could penetrate through blackcardboard but not through lead or platinum

  5. Roentgen • He secretly laboredover his experiments for the next 7 weeks, even requiring thathis bed be moved into the lab • One night, he used these raysto record the shadow of his wife's hand and rings on a photographicplate, creating the now famous Roentgen photograph

  6. The first X-ray of Mrs. Roentgen's hand

  7. Introduction • Considering the established Ministry of Health referral system, Cancer patients have to travel from all corners of the country, some from as far as 600 kilometres away, to access treatment at treatment centre in Kenyatta National Hospital.

  8. Cancer Burden in Kenya • Using estimates of cancer incidence of 0.25% per annum as suggested by International Agency for Research on Cancer (IARC), a specialised Agency of the World Heath Organisation (WHO), the country can expect 82,500 new cancer patients per annum. According to the IARC, 62,000 of these patients would benefit from radiotherapy

  9. Cancer Burden in Kenya • The incidence of cancer in Kenya has been rising steadily over the last decade • The HIV/AIDS pandemic, population growth, change in lifestyle and environment, are some of the factors contributing to the rise in cancer cases • Most of the patients present in late stage disease and end up getting palliative rather than curative treatment

  10. Cancer Burden in Kenya • Provision of healthcare in Kenya is the responsibility of the Government under the Ministry of Health with token cost sharing contribution by the patients • Funding for health services has been greatly overstretched by the HIV/AIDS pandemic resulting in inadequate budgetary allocations for development of specialized services like cancer treatment.

  11. Cancer Burden in Kenya • Kenya has only one public Cancer Treatment Centre based at the Kenyatta National Hospital in Nairobi, equipped with two (2) Cobalt-60 units, brachytherapy unit • The centre was established in 1968 when the country's population was 12 million as a research unit project by the Karolinska Institute of Stockholm Sweden

  12. Cancer Burden in Kenya • Because of lack of facilities some patients opt to have cancer treatment abroad. • There are no clear records on patients referral for cancer treatment outside the country but it is estimated that about 300 patients do so annually • The estimated cost of seeking treatment abroad is Kshs.300 -600 million • Considering the amount transferred for the treatment this is drain to the limited resources of this country

  13. Cancer Treatment Centre-KNH • It was officially handed over on 11th December 1968 to the government of Kenya. • The cancer treatment equipment and auxiliary facilities were upgraded in 1994 by the government of Japan under the Japan International Cooperation (JICA) programme.

  14. KENYATTA NATIONAL HOSPITAL

  15. Most common cancers treated at this facility • Cancer of the cervix • Cancer of the breast • Head and Neck( Nasopharynx,Larynx, Tongue) • Ca Esophagus • Stomach and colorectal • Kaposi sarcoma • Ca prostate

  16. KNH-1983 Cobalt 60

  17. 2011 KNH CTC • NEW COBALT 60

  18. KNH-1993 Cobalt 60

  19. KNH- SIMULATOR 2009

  20. Chemotherapy KNH

  21. Patients for day care chemotherapy

  22. LIP CANCER BEFORE DXT

  23. LIP CANCER AFTER DXT

  24. KS BEFORE DXT

  25. KS AFTER DXT

  26. SINONASAL ANAPLASTIC CA B4 DXT

  27. SINONASAL ANAPLASTIC CA AFTER DXT

  28. 17 yr old patient with HN ca-B4

  29. Young patient with HN ca- B4

  30. AFTER CHEMO RT

  31. 3 MONTHS LATER CHEMORT

  32. HIV RELATED H/N CA 2008

  33. AFTER DXT 2008

  34. CHILD BEFORE CHEMO RT 2009

  35. CHILD AFTER CHEMORT

  36. BRACHYTHERAPY • Currently three brachtherapy machines are domant in KNH and Kisumu • HDR and LDR

  37. Challenges • Influx of chemotherapy drugs in the country from India mostly brought by patients because they are “cheaper” • Cold chain not maintained in some cases • Misconception by members of the public that only place for cancer treatment is overseas

  38. THANK YOU !!!

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