'I can walk again': radiotherapy transforms a cancer patient's life.

• Author: Samiei, Massoud
• Position: SystemWatch

THE PAIN IN HIS BACK was so sharp that Wisdom Nutakor, a 48-year-old agribusiness expert from Accra, Ghana, swung his car to the side of the road. He was not going to work today. He phoned his wife, a registered nurse, and quickly agreed it was time to get help. Once in the hospital's emergency room, however, this tall and proud African succumbed to partial paralysis-no feeling below his waist and unable to walk.

Dr. Joel Yarney, a newly-trained oncologist, sized up the CT-scan. "You have a lung tumour that's protruding into your spine and causing pain and paralysis", he explained. "The best we can do is to relieve the pain." A one-month course of cobalt-beam radiotherapy began. "Dr. Yarney saw little hope for my recovery", explained Mr. Nutakor. "I thought I'd be bed-ridden for life." But miracles do happen. The daily dose of radiation was eating away the tumour, and by the end of the treatment Mr. Nutakor was recovering and had feeling again in his legs. With a follow-on course of chemotherapy, he would be walking in less than six months, and with further physical rehabilitation, he would be able to return to work and live a normal life with his wife and young daughter within a year. "My doctors and family were afraid to tell me that cancer was causing my problems", he said. "But my case proves that even in Africa cancer is no longer a death sentence."

With increases in life expectancy, developing countries are experiencing sharp increases in the incidence of cancer. "The most common forms of cancer in Ghanaian men are of the lungs and oesophagus, while in women are breast and cervical cancers", said Dr. K. Frimbong-Boateng, Executive Director of the Korle Bu Teaching Hospital, Ghana's biggest and most effective treatment centre, offering radiotherapy, surgery and chemotherapy services. As more cancer cases are being diagnosed, an increasing number of Africans are seeking modern treatment. However, the statistics for Ghana reveal a service shortage of crisis proportion; with a population of 20 million, it can expect up to 20,000 new cases of cancer each year.

Korle Bu Hospital, which was built with the help of the Technical Cooperation Programme of the International Atomic Energy Agency (IAEA), began treating patients in 1997, although its capacity hardly exceeds 1,000 patients per year, while a second IAEA-assisted facility at Komfo Anokye Hospital in Kumasi started in early 2004. However, even with the expansion of these two facilities and the completion in five years of a third treatment centre in the northern province, Ghana will have a capacity to treat about 6,000 cancer patients a year. This scarcity of facilities and trained personnel can likewise happen in other low- and middle-income countries. As IAEA Director General Mohamed ElBaradei described it, "given the current lack of access to radiotherapy, as well as to nuclear medicine for diagnosis and treatment, we have no time to lose ... only the lives that will be lost, if we fail to act".

Cancer is a global problem and its prevalence will increase dramatically over the next decade, especially in the developing world. Each year over 10 million...