DR SYED MANSOOR HASNAIN - burden of cancer in the gulf region

DR SYED MANSOOR HASNAIN - burden of cancer in the gulf region

DR SYED MANSOOR HASNAIN
MBBS, FRCS(Glasg),FFRRCSI, CCST
CONSULTANT RADIATION ONCOLOGIST
DEPARTMENT OF RADIATION ONCOLOGY
TAWAM HOSPITAL, ALAIN, UAE
INCIDENCE OF CANCER IN UAE - LOW
CANCER 3RD BIGGEST KILLER IN UAE
Age-Adjusted Incidence Rates in Arab World, Females
UAE
77,700 square kilometers
Demographics of the United Arab Emirates
POPULATION
POPULATION
UAE - ETHINICITY
16.6% Emirati
23% other Arabs
42.3% South Asian
12.1% other Asian
6.0% other expatriates
LIFE EXPECTANCY AT BIRTH IN
UAE IN 2012
 MALE : 76
 FEMALE : 78
YOUNG POPULATION IN UAE
MEDIAN AGE OF POPULATION 30 YRS
CHEMOTHERAPY DEPARTMENTS IN
UAE
UAE
ABUDHABI
TAWAM
HOSPITAL
SKMC
MAFRAQ
HOSPITAL
GICC
DUBAI
DUBAI
HOSPITAL
SHARJAH
AMERICAN
HOSPITAL
AJMAN
RAS UL
KHIMA
UMMUL
QUWAIN
FUJAIRAH
RADIOTHERAPY
DEPARTMENTS IN
UAE
UAE
ABUDHABI
FUJAIRAHI
TAWAM HOSPITAL
VARIAN
Varian
RapidArc
RapidArc
TomoTherapy
BRACHYTHERAPY
SHARJAH
RAS UL KHIMA
UMMUL QUWAIN
AMERICAN
HOSPITAL
GICC
VARIAN LA
AJMAN
VARIAN LA
VARIAN LA
DUBAI
Radiation Therapy Centers in Arab countries, compared
to USA
(Equivalent in population numbers)
Countries
Population
RT centers
Radiation
Oncologists
Radiation
technologists
Arab
301,227,000
85
325
490
USA
298,213,000
1875
3068
5155
(Source: International Atomic Energy Agency IAEA 2007 (www.iaea.org)
Updated from El Saghir et al, Int J Surg. 2007 Aug;5(4):225-33
TAWAM HOSPITAL
NATIONAL CANCER
REFERRAL CENTRE IN UAE
Tawam Hospital
Tawam History
 Opened 1979
 MOH Control, 1988
 HAAD Control, 2002
 Polyclinic, 2000
 New ER Department, 2003
 Eastern Medical Region, 2005
 JCIA Accreditation, 2006
 Johns Hopkins Affiliation, 2006
 Satellite Clinics May, 2007
 Regional Blood Center, August 07
TAWAM HOSPITAL




TERTIARY CARE CENTRE
461 BEDS
Affiliated with JOHN HOPKINS MEDICINE
Tawam Hospital received program accreditation in
2012 from the American College of Graduate Medical
Education – International,
 Tawam hospital is a recognized intern, resident, and
fellowship training site for the Arab Medical Board
 Tawam Hospital is accredited by the Joint Commission
International Accreditation,
PATIENTS FROM
OTHER COUNTRIES
LATE DIAGNOSIS – STAGE IV
New ICU
VIP
REFERRAL
1.
INTERNAL :TAWAM HOSPITAL
SURGERY
MEDICAL ONCOLOGY
HAEMATOLOGY
PAEDS ONCOLOGY
2.
EXTERNAL
HOSPITALS IN ALL 7 EMIRATES
NEIGHBOURING COUNTRIES
PROBLEMS WHICH WE FACE
 PATIENT NOT PROPERLY WORKED UP
 STAGING NOT COMPLETE
 TREATMENT ALREADY DONE OR STARTED
AGAINST EVIDENCE BASED MEDICINE.
 SURGERY DONE IN SMALL PERIPHERAL
HOSPITAL BY A NON ONCOLOGIST SURGEON.
 DELAY IN REFERRAL OF PATIENT TO US
TREATMENT COST
 LOCAL EMIRATI PATIENTS
 ‘THIQA CARDS’
 FREE TREATMENT
 EXPATRIATE PATIENTS
 HEALTH INSURANCE
 SELF PAY
 RADIOTHERAPY FREE FOR NEEDY PATIENTS WITH OUT
INSURANCE

Those patients who are resident in country and do not have health
insurance and do not afford to pay are treated free of cost after
approval by social work department. They compromise 50 % of our
work load.
PATIENT LIMITATION
 NOT HEALTH CONCIOUS
 SEEK MEDICAL ADVISE LATE
 NO COORDINATED PATIENT SPECIFIC ,GP




HEALTH SYSTEM
ADOPT NON EVIDENCE BASED TREATMENT
NO EXTENDED FAMILY SUPPORT FOR
EXPETRIATES
LOSS OF JOB DURING LENGTHY TREATMENT
LACK OF NURSING HOME CARE AFTER
DISCHARGE FROM HOSPITAL
NCCN GUIDELINES
100% CASES IN
MDT
TAWAM HOSPITAL
NO WAITING LIST
FOR
RADIOTHERAPY
PREVENTION
 HPV IMMUNISATION
 BREAST SCREENING
 CANCER AWARENESS PROGAMMES
 SMOKING CESATION COMPAIGNS
ONCOLOGY AWARENESS WEEK
TAWAM
RADIOTHERAPY
DEPARTMENT
Tawam Hospital
Cobalt – 60
Hospital Basement
1980 - 1995
1995-2011
2100C (6 and 18 MV) - Varian 600C (6MV)
Varian Linear Accelerators
Two Clinac iX (6 and 15MV) - RAPID ARC
GE 4 Slice CT/Simulator
Planning Section
 Aria data management system
 Treatment planning using Eclipse
Brachytherapy Suite
MOBILE TOMO ON A TRUCK
TomoMobile
TomoTherapy HD
IGRT
IMRT
RapidArc in LYMPHOMA
RapidArc in PROSTATE CANCER
RapidArc in RECTAL CANCER
TOMOTHERAPY IN NASOPHARYNX
PROSTATE WITH POSITIVE LYMPH NODES
CONCLUSION
 EXPERIENCE OF MANAGING CANCER IN UAE IS
CHALLENGING AND REWARDING
 BY GOVERNMENT SUPPORT WE HAVE UPTODATE
MODERN FACILITIES , RESOURCES & STAFFING
FOR CANCER TREATMENT
 NEED TO WORK MORE FOR PREVENTION &
EARLY DIAGNOSIS OF CANCER AT A CURABLE
STAGE
Thank you