Cancer Treatment in Africa

Cancer is widely overlooked in Africa due to other diseases such as HIV/AIDS. Researches have shown that there is a huge shortage of equipment aimed towards treating cancer in Africa. The cobalt-60 radiotherapy unit is both cheap and effective, therefore making it an ideal solution to this problem.

Introduction
Cancer is an often overlooked health problem in Africa due to the focus on HIV/AIDS. While many efforts have been made to treat other diseases, but studies have shown (Levin et al, 1999) that there is not nearly enough medical equipment in Africa aimed towards treating cancer. Many researchers believe that radiation therapy is an ideal solution to this problem; however research still needs to be done on the implementation of the equipment and staff, and better access to information and education about cancer. The point of my research is to show that there is not enough cancer treatment in Africa (Levin et al., 1999), to explain how radiation therapy is the most ideal type of treatment that could be used in Africa (Barton et al., 2006), and to briefly examine a way to implement the technology.

Lack of Cancer Treatment in Africa

As mentioned before, when people think of health related problems in some of the poor countries in Africa, HIV/AIDS, infectious diseases, rapid population growth, infant mortality rate, and malnutrition come to mind. However, according to Levin, all these problems contribute to the misconception of a low cancer rate. Although the number documented incidences of cancer in Africa are not necessarily higher than the rest of the world, the actual numbers of cancer cases are lower than the reported number due to difficulties in obtaining accurate statistics. Both Levin and Barton agree that radiation therapy is an effective and low-cost method of treating cancer. In short, radiation therapy works by shooting particles or waves into a cancer cell, damaging its DNA chain. All around Africa, there is a huge shortage in radiation machines, and Barton points out that Africa is in fact the least developed continent in terms of radiation therapy. In Levin et al.'s study conducted in 1998, there were a total of 155 radiation machines in Africa, while the estimated need was 860. That equates to merely 18% of the needed supply. Of the 155 radiation machines in Africa, 53 of them were located in Egypt, one of the more developed countries in the continent. Even then, Egypt still does not have enough radiation machines to meet demand. Because of this lack of treatment, services must be implemented in Africa to bring this technology to those who would otherwise have no solution to cancer.

Radiotherapy Technology

Radiotherapy has the ability to improve a cancer patient's outcome by a great deal. Often, it is the only type of treatment required to cure cancer. Even if a patient's case of cancer is in it's late stages and is too serious to be successfully treated, radiotherapy can still help reduce the symptoms, such as pain and difficulties breathing of swallowing. It is an ideal solution for cancer treatment since it offers the best chance of cure, best improvement in local cancer control, best palliation, fewest side effects, and most importantly for our purposes, it is relatively low cost (Delany et al. (2005), cited in Barton). Barton argues that although the cost may seem high initially, it does not cost much to maintain. With other technologies, the underinvestment in maintenance often results in the underuse of the equipment. There are many different machines that can provide radiotherapy. One option that is popular in Africa is the cobalt-60 unit. It works by shooting gamma rays that are created from the beta decaying of cobalt-60, which is an isotope of cobalt-59. Currently, 80% of cobalt-60 is produced in Canada, and it is one of the cheapest and most effective radiation machines available. Because it is low cost and highly effective, I believe that the cobalt-60 radiotherapy unit is the ideal piece of equipment for cancer treatment in Africa.

Implementation of Radiotherapy

Since each radiation machine can generally treat up to 1 million people, most medical clinics and hospitals in Africa should only need 1-3 radiation machines (depending on location and size of clinic or hospital). The cobalt-60 radiotherapy unit costs up to $480,000 US dollars (Van Der Glessen et al., cited in Barton). In addition to the machine, hospitals and clinics need a radiotherapy treatment room in which to put it. That costs an additional $40,000 US dollars. The initial cost of this setup may seem high, especially for the poor countries in Africa, but the maintenance cost over time is low. In addition, cobalt-60 is produced in Canada at a relatively low price, which also aids in reducing the cost. However, even though radiation therapy is effective, it also has its risks. Radiation, if applied incorrectly, can actually cause cancer and other side effects such as nausea, vomiting, fatigue, and skin irritation. Therefore, it must be applied in an efficient and safe manner. Doctors that use these machines must be certified to ensure that the correct doses are delivered. Barton indicates that radiation is even more effective when used alongside surgery. If a patient requires surgery or would benefit from surgery, doctors must also capable of providing it, although it is more ideal to stick to radiotherapy since it is more cost effective. Radiation therapy, if widely implemented in Africa, could greatly enhance the state of cancer in Africa.

Conclusion

Through several studies, Levin and Barton have both indicated that cancer is a huge health issue in Africa, just as it is anywhere else in the world. However, Africa has a huge shortage of medical equipment aimed towards treating cancer. Although my research has proved that radiotherapy is the technology most suitable for the situation, it does not indicate a way to effectively bring this technology to all parts of Africa. I believe that this shortage in equipment results from a lack of awareness of cancer in Africa due to it being overshadowed by other diseases. Therefore, if I were to continue my research, I would examine ways to promote cancer awareness and plan a way to bring radiotherapy to all who need it. In the end, this technology must be brought into the African mainstream if we are to solve the problem that I have highlighted. Levin notes that in order for this to happen, there must be external assistance due to economic constraints. People in rich countries like ours should raise money and help bring cancer treatment technology to Africa. The problem of cancer in Africa cannot be solved by any one party and must be done together.

References:

Barton, MB. (2006). Role of radiotherapy in cancer control in low-income and middle-income countries. The Lancet Oncology, 7(7)

Levin, VC. (1999). Radiation therapy in Africa: distribution and equipment. Radiotherapy and Oncology, 52(1)