Cases soar but docs in short supply

  • warding off silent killer
- Manish Gautam, Kathmandu
Cases soar but docs in short supply

Feb 3, 2015-

Every year an estimated 30,000 people are diagnosed with cancer, but there are only about 40 doctors specialised in oncology in Nepal.

Statistics suggest that the number of cancer patients has increased two-fold in the past one decade, and experts project that this rate will increase in the years to come. If that growth continues, the country’s health system will not be able to treat patients to the extent required.

The current patient-oncologist ratio means that there is only one oncologist for 450 patients. And those numbers still do not tell the whole story. According to Nepal Medical Council’s data as of December 2013, there were 15 doctors registered as surgical oncologists—and three of them were radiotherapists.

Doctors say that it was only after the NMC recently began categorising doctor specialties that many oncologists shed their ‘oncologist’ label and have now gone back to referring to themselves as general physicians and general surgeons—which they actually were in the first place.

Apart from doctors calling themselves oncologists on account of the post-graduate courses in oncology they had taken at universities, there are also those who with just six months to one-year courses claim themselves oncologists. And many of them were general physicians with experience of working with cancer patients.

To tackle the doctor-patient ratio disparity, Nepal needs more practising oncologists. The 2014 data from the National Cancer Institute in the US shows that Nepal needs at least 139 radiation/clinical oncologists, 27 surgical oncologists, 10 gynaecologic oncologists and 56 pathologists.

“It has been just over two decades that Nepal saw development in cancer treatment. We are still struggling to be on par with international standard. And we of course had a human resource crunch,” say Dr Bishnu Dutta Poudel, an oncologist at Bir Hospital.

The educational institutions here, as they stand, cannot meet the demand. Dr Poudel, the National Academy of Medical Sciences’ coordinator of the DM programme on cancer, a course that can be taken by doctors after completing a Master’s in Medicine, says the programme takes in two students each year.

Three students are also taken in for the master’s programme in radiation oncology.

That lack of graduates has a direct impact on the cancer-afflicted. “People are in need of cancer care. But there are very few centres for people to go to,” says Dr Poudel. “Hence, we have to seriously think about improving our human resource and establishing new cancer treatment facilities.”

According to Globocan, of the World Health Organisation, which estimates the cancer trends on a global level, there were 27,768 cancer cases in Nepal. Globocan states that the five most common cancers in Nepal are gynaecological, lung, head and neck (lip and oral cavity, nasopharynx, other pharynx, larynx and thyroid) and various haematological malignancies.

There are essentially three kinds of oncologists and Nepal needs all of them: medical oncologists, who specialise in chemotherapies; radiation oncologists, who treat patients through radiation; and surgical oncologists, who perform surgery on cancer patients.

Dr Rajendra Prasad Baral, an oncologist at Bhaktapur Cancer Hospital, says that owing to the lack of proper specialists, many patients are getting treatments that are questionable at best.

“We see many patients who have gone through unwarranted use of cancer medicines and radiation regimens. If we want to improve cancer care in the country, then we need to start producing cancer specialists,” says Dr Baral.

Published: 04-02-2015 09:05

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