The National Centre of Radiotherapy and Nuclear Medicine became operational in 1997 through a collaborative effort between the Government of Ghana, acting through the Ministry of Health and the International Atomic Energy Agency (IAEA), and through the Ghana Atomic Energy Commission (GAEC).
What gave rise to the project was the recognition of the fact that over 50% of all cancer patients require Radiotherapy at one stage or the other in the course of the disease. In addition 40% of all the cancer cures result directly from the use of Radiotherapy (WHO REPORT).This is particularly true for Ghana recognising the fact that cancer of cervix is the second most common cancer among women, and that, Radiotherapy plays a major role in its management.
The establishment of the centre was therefore in fulfillment of a cherished dream dated as far back as 1960.During that period a cobalt machine was donated by the Canadian Government to be used for medical purposes.However, because of lack of funds to house it, the machine was donated to the Lagos University Hospital in Nigeria.
Further attempts at establishing the facility began in 1975.This time architectural works on the building were completed by AESL.
To be an ultramodern cancer Centre in West Africa manned by competent Ghanaian specialists, equipped with standard machines, innovative and diagnostic tools, capable of early cancer detection and above all, an effective treatment outcome and palliation of systems arising from the disease.
To provide safe, efficient and holistic treatment facilities which enhance quality of life, prolong survival and above all improve condition of CANCER patients nationwide and the sub-region of Ghana.
The number of patients treated annually increased from 486 in 1998 to 720 last year. This number continues to grow as Medical Practitioners gain knowledge in the application of Radiation in Cancer management and therefore refer appropriately.This is worth noting considering the fact that this modality is only 5 years old in the country.
The hospital is blessed to have such a facility; indeed five per cent of our case load comprises foreigners from other countries in the sub region who do not have this facility.Ghanaians have the luxury of being treated in their own country by fellow Ghanaians.
It is the only operational centre in the country until the recent opening of a second on in Komfo Anokye Teaching Hospital.Cancer of the cervix makes up 25 per cent of our case load topping the list, followed by cancer of the breast, then head and neck malignancy.
It is sad to note that about 65 per cent of patients are managed with palliative intent because they present rather late.In the early stages of cancer of the cervix, Radiotherapy and Surgery yield the same results. Late presentation of cancer problems is a major challenge in the country.This underscores the need for a National Screening Programme in order to allow early case detection.The MOH/John Hopkins Cervical Cancer Screening Project is therefore a step in the right direction and should be extended country wide.
It is also worth noting that the hospital and indeed the country lacks a cancer registry, for that matter the size of the problem cannot be quantified for cancer to be declared a public health problem. With the increase in life expectancy and changes in lifestyles, we need to brace ourselves to handle an increase in cancer incidence that we will be witnessing in the coming years (WHO report).
Our equipment needs cannot be overemphasized.One of the commonest conditions for which patients are sent abroad for management with hard earned foreign currency is cancer and the reason is usually for Radiotherapy. The commonest condition for which this demand is made is prostate cancer which is the second commonest cancer among men after Hepatoma.By improving our capacity to deliver in terms of equipment provision (3D planning system, Simulations with CT linkage and linear accelerator), this service will be made available not only to those who can afford to travel abroad at their own expense and to individuals for whom the country bears the cost but also the ordinary man.
Future Plans For Improvement
- The Centre is in collaboration with MOH/IAEA to improve quality of care.This includes provision of a new facility SPECT, 3D Planning System with CT Linkage, Linear accelerator.Extension work on a new building project is to continue
- The Centre is working towards getting the decayed source of cobalt 60 equipment replaced.
- Partnership with Health Donors for funds to supplement the meagre subvention.This includes formation of Cancer Society, PR programmes on Mass Media, Churches, Mosques and Schools.
-Human Resource Development through training both institutional and in service training of staff. Tied to this is the soliciting of assistance from development partners through structures programmes of research, education and training that would increase understanding of Cancers and to increase survival rates and quality of life in patients with Cancer.
- The Centre will carry out survival analysis on certain Cancers particularly Cancer of the cervix.
The Centre confines itself primarily to the management of Cancer through the use of ionizing radiation and chemotherapy when necessary. The Centres strategic plans call for the creation of a facility that provides a feeling of hope and a sense of inspiration to all cancer patients.
To this end activities are focused on the following priority areas.
- Provision of new facilities, example fluoroscopy unit (C-arm for imaging after brachytherapy for the cancer of the cervix), orthovoltage unit for the treatment of superficial lesions and expansion and rehabilitation of existing facilities as means of providing quality care.
- Human Resource development:(through training both institutional and in-service to improve the technical competence of our staff, and to have enough staff to improve quality care and provide long hours of service for patients)
- Developing curriculum for the training of radiographers in local institutions
- Seeking IAEA assistance in the management of skin cancers and superficial lesion using orthovoltage for radiation oncologists.
- Initiating programmes that will promote greater interaction among cancer surgeons, radiation oncologists, general practitioners and pathologists.
- Seeking assistance through structured programme of research, collaboration, education and training etc to develop an increased understanding of causes and predisposition of cancer and to increase survival rate and quality of life of patients with cancer.
- Establishing multidisciplinary approach to treatment which will improve treatment outcome as tumour control and survival.
- Developing special incentive package to attract and motivate skilled workers and consequently to retain them.
The Administrative Structure
Until the establishment of the Ghana Health Service which placed this centre under Tertiary Health Institutions, the National Centre for Radiotherapy and Nuclear Medicine was a BMC in the scheme of affairs of the Ministry of Health. It has its special building, equipment, staff, budget and administration.
The centre was managed by an eighteen-member board of directors named, the National Radiotherapy Committee which is always headed by the Chairman of the Board of G.A.E.C. Among other things, the Board formulated policies and provided guidance to the internal management committee of the centre. It oversaw development of the centres strategies and approved budget.
The day to day running of the centre was, however, delegated to an Internal Management Committee headed by a Director who is also a Radiation Oncologist, (Specialist).
The Centre has now been placed under Korle Bu Teaching Hospital as a Sub-BMC.
The personnel of the Centre consist of employees on secondment and those employed by the National Radiotherapy Committee.
Those on secondment comprise three Radiation Oncologists (one on study leave), three nurses, three medical officers all from Korle Bu Teaching Hospital, two Medical Physicists from the Ghana Atomic Energy Commission, two accounts personnel from the Accountant General Department.
The other categories of personnel were engaged by the National Radiotherapy Committee. These include two Radiation Therapists, Nurses who have resigned from MOH to join the Centre, Technicians, Administrative staff and other supporting staff. With the absorption of the Centre by the Hospital, the doctors, nurses and therapists will no more be on secondment.
The following are some of the pieces of equipment used in the Centre
- Cobalt 60 Teletherapy unit (f) Gamma camera
- LDR Brachytherapy
- Film Processor
- Othovoltage Unit
- Treatment Planning Unit 2D
- C-arm fluoroscopy machine