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CURRENT SITUATION ON THE TREATMENT OF CANCER IN GHANA

CURRENT SITUATION ON THE TREATMENT OF CANCER IN GHANA. Dr Hannah N.G.Ayettey Anie. Introduction. The Burden of Cancer amounts daily worldwide. It is alarming! An estimated 12.7 million new cancer cases were diagnosed worldwide in 2008

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CURRENT SITUATION ON THE TREATMENT OF CANCER IN GHANA

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  1. CURRENT SITUATION ON THE TREATMENT OF CANCER IN GHANA Dr Hannah N.G.Ayettey Anie

  2. 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

  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

  4. 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”

  5. 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

  6. Cancer Registries in Africa • The African cancer registry network(AFCRN) was formally inaugurated on 1st 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

  7. 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 • KomfoAnokye hospital registry • National Policy on Cancer- A cancer strategic plan which is yet to be fully established

  8. Korle Bu Teaching Hospital

  9. 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%

  10. 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

  11. National Centre for Radiotherapy and Nuclear Medicine

  12. 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

  13. Engineers - 4 • Secretaries ( Including Bilingual secretaries) -5 • Records/Statisticians – 3 • Orderlies- 3 • Security men – 4 • Driver - 1

  14. 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

  15. Other oncology centres • Public- Oncology Department, KomfoAnokye teaching Hospital • Private- Swedish Ghana Medical Centre

  16. 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, EffiaNkwanta etc

  17. Referrals from Neighbouring countries:- 5% of Patients • Cote D’Ivoire • Togo • Benin • Burkina Faso • Sierra Leone • Liberia • Referrals from Overseas:- UK, USA, South Africa

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. Thank you

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