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CERVICAL CANCER: EARLY DETECTION, DIAGNOSIS & TREATMENT in LRS

CERVICAL CANCER: EARLY DETECTION, DIAGNOSIS & TREATMENT in LRS. By Dr D. A. Kombe, MD, Mmed (Rad/onc) 2 nd East Africa WE CAN Breast & Cacx Advocacy, Education and Outreach Summit September 11-13 ,2014. NEW ORCI. OLD ORCI. INTRODUCTION.

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CERVICAL CANCER: EARLY DETECTION, DIAGNOSIS & TREATMENT in LRS

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  1. CERVICAL CANCER: EARLY DETECTION, DIAGNOSIS & TREATMENT in LRS By Dr D. A. Kombe, MD, Mmed (Rad/onc) 2nd East Africa WE CAN Breast & Cacx Advocacy, Education and Outreach Summit September 11-13 ,2014

  2. NEW ORCI

  3. OLD ORCI

  4. INTRODUCTION • ANNUAL CANCER INCIDENCE IN TZ (Glob can 2012): • 40,000 new cancer cases  • In Tz there is a well-established patient referral system from health centers to referral hospitals; however no proper guideline for cancer patients’ referral. • It is the policy of our government to treat cancer patients for free (once diagnosed).

  5. TANZANIAN HEALTH SYSTEM … • Health promotion & education, cancer advocacy, prevention and early detection/screening are not yet a priority for funding in our health system!!! Reasons:The Government is overwhelmed with a burden of both communicable and non- communicable diseases; therefore, a bigger portion is allocated mainly to treatments!

  6. EARLY DETECTION • For reasons mentioned above, prevention and early detection/screening are still an up-hill battle. This is done in few places mainly by ORCI and international NGOs – eg: ICAP, JHIPIEGO, IMA world, PSI, MST UMATI and probably a few national NGOs such as MEWATA. However, currently there has been recognition and therefore efforts are now being directed towards this goal.

  7. PRECISE DIAGNOSIS OF CANCER • Oncologists (medical & radiation) are aware of the crucial need and closer collaboration with surgeons and pathologists for precise diagnosis and staging of cancer patients when planning subsequent management... THIS IS PARAMOUNT!!! • Lack of such collaboration leads to poor decisions of treatment planning on the side of the oncologist! And, this further compromises the ability to offer optimal treatment to the patient. • We have a good team –tumour board for this

  8. DIAGNOSIS: CURRENT STATUS • Few/non pathologists in some referral centers. • Pathology services available are slow & often lack proper reporting. • It has been observed in general, that prompt referral is a major problem for most of cases.

  9. TREATMENT OF CANCER IN TZ: CURRENT STATUS • Like most countries in Africa, Tz is among the low resource countries. • Even with this fact, the policy of our government policy is to treat cancer patients for free.

  10. CURRENT STATUS... • So far ONLY ONE Treatment center for ˃ 45million population . - Two cobalt-60 machines (one is down) working round the clock including w/ends… - Two HDR machines which are currently not operating (mechanical problem which need to fix). - Never enough chemotherapy drugs. Demand & supply always is out of proportion!

  11. CHALLENGES • Serious lack of financial and material/equipment resources. • Rapidly increasing cancer burden: Number of new cases doubling every 3 years (With no resource to accommodate them)! • Late Presentation: Approx. 75% of cases present with FIGO III- IV stage. • Serious lack of awareness of cancer symptoms and signs in majority of these women!

  12. Recommendation • Whilst efforts of addressing cancer awareness advocacy & screening are taking toll, more and more patients are coming requiring treatment. Currently bookings at ORCI are approaching January 2015!!! • Therefore then, parallel with the above, there is a great need to advocate for and improve tertiary care as well. The latter can not be over- emphasized.

  13. Indeed, WE CAN Together we can beat cancer

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