Sunday, August 18

Cancer Case in Tanzania: Room for Development


  Today Tanzania is facing a cancer crisis with as many as 35,000 new cases expected to be diagnosed a year. 
  In spite of the emergence of cancer as a serious national problem, there are only two cancer hospitals in the country. 
  The largest cancer disease hospital is the Ocean Road Cancer Institute (ORCI), located in Dar-es-salam. The Institute handles nearly 3,000 new cancer patients and up to 10,000 follow-up cases annually. Up to 20% of ORCI’s patients are children, who are usually treated with both chemotherapy and radiotherapy. The ORCI is equipped with diagnostic imaging services and cancer screening. 
  However, regular screening and early diagnosis is not a common event in Tanzania. Only a small number of patients from all over the country can afford to travel to Dar-es-salaam for cancer check-up. 

The United Republic of Tanzania National Health Policy advocates the right for cancer patients to be treated free of charge. Prior to diagnosis, patients are required to cover for themselves the expenses related to screening of cancer and any other necessary medications which are not covered by the government.
  In general, this challenging situation with cancer patients can be alleviated by opening of new screening centers and nuclear medicine facilities which are indispensable for cancer diagnostics and treatment.  

  With advanced nuclear technologies, Tanzanian doctors will be able to deliver more precise diagnosis, treatment and be able to evaluate treatment given to cancer patients. Specialists at ORCI are now able to employ more innovative 3D scanning of tumors, that detects the abnormal cells at early stages with more accuracy than the scanners of previous generation.  
  Once the tumor is identified, medical specialists are able to use modern technology such as contouring computer software to define and separate the healthy tissue from affected one in order to apply radiation and medical isotopes in a more accurate way to minimize exposure to healthy tissues and organs. .

  Tanzanian government is exerting considerable efforts to tackle health issues with new strategies and programs at all levels, starting from preparation of specialists capable to deliver professional service. Compared to other East African countries, Tanzania is the only country with the highest number of nuclear medicine specialists even though their number is still very low.
  Nuclear medicine specialty involves the use of facilities such as PET/CT (Positron Emission Tomography/Computer Tomography) and currently PET/MRI(Positron Emission Tomography/Magnetic Resonance Imaging), Hybrid SPECT/CT (Single Photon  Emission Computed Tomography),Thyroid Uptake System and so on.

  PET/CT, PET/MRI and SPECT/CT require radiopharmaceuticals and radioisotopes in diagnosis of patient’s disease or in evaluation of treatment given to cancer patients.
  Commonly used radiopharmaceuticals in nuclear medicine department include flourine-18 flouorodeoxyglucose (18F-FDG), Technetium-99m (99mTC), Molybdenium-99, Iodine-123 and Iodine-131 (123I and 131I), Thalium-201 (201TI) and so on.
  Development of nuclear medicine can be boosted by creating of nuclear research center, equipped with nuclear research reactor. 

  For instance, production of medical isotopes to treat cancer and other diseases could not be possible without research reactors development. The case of South Africa shows that research reactors have potential to adjust nuclear technologies for social development. Thus, South Africa’s SAFARI-1 research reactor is among the leading producers of medical isotopes in Africa. It is also one of the four largest producers of key isotope Molybdenum-99 which is used in over 70% of nuclear medicine procedures globally. 

  As one of the nuclear medicine specialist in the country, i urge the government to consider setting up a nuclear medicine center which will greatly improve the quality of services provided in the health sector. The center will serve all individuals regardless whether they are suffering from cancer or not. The applications of  nuclear medicine department includes diagnosis of benign and malignant tumor in the body, detection of cancer metastases, evaluation of  bone trauma and  cancer metastases, evaluation of kidney, heart, lung, brain, thyroid diseases and so on. I am aware that the government intends to set-up a nuclear medicine department at Benjamin Mkapa Hospital, Dodoma, Tanzania, since i was actively involved in its planning.

  As the current phase government focuses on industrialization drive, this is an opportunity for her to invest heavily in nuclear medicine department and research centers so as to attract patients from other countries, earning country the much needed foreign currency. The government will save a lot of money which otherwise would have been used to send patients abroad due to lack of nuclear medicine facilities in the country. 

  Other area where the country will also save money is by production of its own radio pharmaceuticals and radioisotopes locally instead of importing them from other countries. Exporting of radio pharmaceuticals and radioisotopes to our neighboring countries will also earn our country foreign currency. The countries with nuclear medicine and research centers in Africa include Egypt and South Africa. This will make Tanzania the leading hub of nuclear medicine technology and researches in the entire east African region. God bless Africa, God bless Tanzania.

  The author is a nuclear medicine physician and lecturer at The University of Dodoma, currently undertaking PhD studies at Tongji Medical College of Huazhong University of Science and Technology, P.R. China.

Dr.Khamis H.Bakari,

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